What are Anti-VEGF injections?

VEGF stands for Vascular Endothelial Growth Factor, which is a protein that promotes the growth of new blood vessels needed for healing, after an injury for example. However, in some eye diseases this protein stimulates the abnormal growth of blood vessels at the back of the eye which can interfere with vision.

Anti-VEGF injections are a type of medication used to reduce the rate of abnormal blood vessel growth in the retina when directly injected into the eye, with the goal of preserving vision.

There are now a wide variety of Anti-VEGF drug brands available after being made commercially available in Australia in the mid-2000s.

How do Anti-VEGF injections work?

Anti-VEGF drugs block the action of the VEGF protein which slows the growth of abnormal blood vessels in the eye, therefore slowing down disease progression and the decline in vison.

What is the goal of Anti-VEGF injections?

It is important to note that Anti-VEGF injections are not designed to improve vision or cure the underlying health condition but aim to preserve your remaining vision. It is therefore critical to stick to the schedule your ophthalmologist recommends when it comes to receiving your injections.

What conditions are treated with Anti-VEGF?

Anti-VEGF is used to treat the following eye conditions:

Small, abnormal blood vessels that can grow under the retina and lead to vision loss (called choroidal neovascularisation).
Wet age-related macular degeneration (AMD).
Swelling of the retina, called macular oedema.
Diabetic retinopathy.
Retinal vein occlusion.

How do I prepare for eye injections?

Understand the procedure: Understanding how the procedure will work can reduce anxiety about receiving an injection in the eye. Ask your ophthalmologist any questions you may have about the process, potential side effects and what to expect both before and after the treatment.
Other medications: Let your ophthalmologist know about any other medications you are currently taking, including over-the-counter drugs and supplements. They will advise you on whether any adjustments need to be made to your intake.
Inform about any allergies: Let your ophthalmologist know about any allergies you have, particularly if you have had a reaction to a previous injection, anaesthetic, or any related medications.
Arrange transport: Since your vision may be temporarily affected after the injection, it is recommended that you arrange for someone to drive you home after the procedure.
Bring a loved one: Having a friend or family member accompany you to the appointment can provide emotional support and assistance, especially if you need someone to help you get home.
Relaxation techniques: If you are feeling anxious about the procedure, consider practicing relaxation techniques such as deep breathing or meditation beforehand.
Ask questions: If you have any concerns or questions about the procedure and ensure you feel comfortable with the information you have received.

What happens during Anti-VEGF treatment?

Typically done as an outpatient procedure, your ophthalmologist may:

Administer drops to dilate (widen) your pupils.
Clean your eye with an antiseptic solution (suitable for use around the eye) to prevent infection.
Reduce your discomfort by administering an anaesthetic to numb your eye.
Use a very thin needle to inject the drug through the sclera (white part of your eye) directly into your eye.

You may need to continue having these injections over many months. At times, ophthalmologists will combine Anti-VEGF treatment with other treatments for the best chance of saving your existing vision.

What are the risks of Anti-VEGF treatment?

It is important to understand that any treatment can have some degree of risk. It is important to understand the benefits and risks of any treatment you might have. Ask your eyecare practitioner to talk to you about your recommended treatment, its benefits, risks, and side effects.

Common side effects after an eye injection may include:

Some eye redness.
Feeling like something is in your eye.
Dry or itchy eyes.
Eye discomfort.
Temporarily blurry vision.
Floaters (black spots ‘floating around’ in your vision).

These usually resolve within a week or two after the injection. Eye injections may also be associated with the following RARE side effects:

Eye infection or inflammation.
Detached retina (where the retina lifts up from the back of the eye).
Cataracts (clouding of the eye’s normally clear lens).
Light sensitivity.
Eye pain.
Swelling inside the eye.
Increased eye pressure.
Bleeding.

Call your ophthalmologist immediately if you have any of these symptoms.

What to do after eye injections

Always follow the advice from your Ophthalmologist first and foremost.

Do not drive: Injections can have a transient effect on your vision and therefore it may not be safe to drive after your procedure.
Avoid rubbing the eye: This can increase the risk of infection. Your eye has been numbed for the procedure so you may not feel yourself applying too much pressure or potentially scratching your eye.
Follow your doctor’s post-procedure care instructions: Attend any follow-up appointments.

How long do eye injections take to work?

The time it takes for eye injections to take effect can vary depending on the specific medication being administered and the underlying eye condition being treated. You may not notice any changes to your vision after receiving an eye injection of an Anti-VEGF drug as the primary goal of Anti-VEGF injections is prevention of further blood vessel growth. You may receive monthly injections to quickly address the abnormal blood vessel growth in the macula. The frequency may decrease over time based on how well your eye responds to the treatment.

Common types of Anti-VEGF drugs available in Australia

The brand names for some of the common drugs used for anti- VEGF injections in Australia are Ozurdex, Beovu, Eyelea, Lucentis and Vabysmo. However, this list is ever evolving. Your ophthalmologist will advise you which drug is best for your condition or stage of disease, with each having slightly different advantages and disadvantages. Be sure to ask your ophthalmologist about the drug chosen for you. It is likely you will receive an information sheet with information and instructions specifically for your brand of injection.

Always speak to your GP and eyecare professional about the best treatment options for you.

What are Anti-VEGF injections?