Intraocular injections are used to deliver a
high dose of medicine into the eye to treat
retinal diseases. They may be given to dry
up new vessels so that they do not bleed.
They may be given to decrease swelling of
the macula. Hence they are commonly given
for diabetic retinopathy, age related
macular degeneration, retinal vein
occlusions, macular edema, uveitis,
retinitis.
Which injections are given?
The commonly given injections are
Bevacizumab (Avastin), Ranibizumab (Lucentis),
Pegaptanib sodium (Macugen) and
Triamcinolone (Tricort/Kenacort),
Ganciclovir, Cidofovir.
Injections Anti VEGF Agents (Lucentis /
Avastin /Macugen)
There has been a lot of excitement in
management of retinal diseases, ever since
the newer anti-VEGF injections have become
available. These agents are being used for
many eye diseases, especially for wet form
of AMD (Age related Macular Degeneration),
CNVM (Choroidal Neo Vascular Membrane),
Severe Diabetic Retinopathy, Macular Edema
(swelling), Vascular Blocks, Neovascular
Glaucoma (NVG), Vitreous Hemorrhage, etc.
These retinal diseases, which were earlier
considered incurable, or had very poor
results with existing treatments are now
being tackled with good results with these
anti-VEGF agents.
VEGF is a short form for Vascular
Endothelial Growth Factor, which is
responsible for growth of blood vessels.
Besides having a role in normal vascular
growth, VEGF is also responsible for many
retinal diseases by causing new vessels
growth and by increasing leakage and thus
causing retinal swelling.
The anti-VEGF agents block the VEGF
molecules and thus benefit the patients by
decreasing the abnormal and harmful new
blood vessels formation and by decreasing
the leakage and swelling of the retina. This
leads to stabilization of vision and even
improvement in vision in many cases.
What is the procedure? The injections are given in the
operation theatre after preparing the eye
like for other eye surgeries. It is best to
have the blood sugars and blood pressure
well controlled before the injection. Blood
thinning medication does not need to be
stopped. The pupils are dilated and numbing
drops are put. The injection is given using
the operating microscope. A very fine needle
is used and hence there is little
discomfort. The entire procedure takes a few
minutes. The eye is patched for a few hours
and if triamcinolone has been injected it is
advised to remain seated for 4 hours after
the injection and not to lie flat.
Do injections need to be repeated?
The effect of the commonly injected
medications lasts for 1-3 months. If the
disease needs further management then the
medication needs to be injected again. It is
common for these injections to be given
several times.
Steroids Implants
OZURDEX� is an FDA-approved drug treatment
to reduce macular edema following branch or
central retinal vein occlusion.
OZURDEX� (dexamethasone intravitreal
implant) is an implant injected into the eye
(vitreous) and used:
To treat adults with macular edema following
branch retinal vein occlusion (BRVO) or
central retinal vein occlusion (CRVO)
To treat adults with noninfectious uveitis
affecting the posterior segment of the eye
To treat adults with macular edema following
branch retinal vein occlusion (BRVO) or
central retinal vein occlusion (CRVO)
