Intravitreal injection

Intravitreal Injections

Table of Contents

What is an intravitreal injection?

An intravitreal injection is a procedure to place a medication directly into the eye which is filled with a jelly-like fluid called the vitreous humor gel. The procedure is usually performed by a trained retina specialist in the office setting.

What are the indications for intravitreal injections?

Intravitreal injections are used to administer medications to treat a variety of retinal conditions such as diabetic retinopathy (diabetic eye disease), age-related macular degeneration, retinal vein occlusions, eye inflammation and other retinal problems. These drugs are injected into the eye and their main objective is to stop visual loss.

Age-related macular degeneration is the main indication for intraocular medications worldwide Copyright Retina Center

The main group of drugs are anti-VEGF. Anti-VEGF medications block the growth of abnormal veins in the back of the eye. These abnormal veins leak fluid between the layers of the retina causing loss of vision. Age-related macular degeneration and diabetic retinopathy are the main diseases that produce these abnormal veins.

The anti-VEGF that we have in the market are Eyelia, Wetlia (aflibercept), Lucentis (ranibizumab) and Vabysmo (Faricimab) they are FDA approved.

There is a tiny implant that slowly releases corticosteroid medication over time (OZURDEX), without the need for monthly injections. It will dissolve naturally and will not need to be removed. This implant is approved to treat 3 conditions in adults Diabetic macular edema (DME), Swelling of the macula following retinal vein occlusion and noninfectious uveítis (an inflamatory disease of the eye) affecting the back of the eye.

Macular edema due to Central Retinal Vein Occlusion before and after treatment Copyright Retina Center

The intravitreal injection procedure

The application of these medications is an outpatient procedure that can be performed in a specific area of the office.

Before the procedure, anesthetic and antiseptic drops for the eye will be applied, as well as the careful cleaning of the surface of the face to avoid an infection. Afterwards, an eyelid speculum is placed and injected in to the white part of the eye with a very small needle, causing minimal discomfort. Usually, you do not see the needle. Typically, patients feel pressure, with little or no pain during the injection.

After the injection, the speculum is removed and the eye is cleaned. The entire process takes about 5 to 10 minutes. You may need several injections for several months depending on the severity of your problem.

Application of intraocular medication (ozurdex) in aseptic conditions Copyright Retina Center

Possible complications and benefits

All medications can have side effects. It is very important to understand the benefits and risks that you may have with any treatment. The benefits are clear and have been proven scientifically for many years, these are to stop the progression of the disesase and delay the loss of vision. Severe complications are very rare with intravitreal injections. The major risks are:

  • Infection in the eye or endophthalmitis
  • Inflammation in the eye (a non-infectious inflammatory reaction to some medications)
  • Bleeding into the vitreous gel (vitreous hemorrhage)
  • Retinal detachment

The risks inherent in the injection are extremely low, the most worrisome is an infection that if detected early can be controlled by a specialist in the retina.

Retinal detachment after intravitreal injections is uncommon, with a rate of approximately 1 in 7500 injections Copyright Retina Center

What to expect after the injection

There are usually no restrictions following the injection apart from avoiding potential contamination of the eye on the day of the injection. However, you should contact your retina specialist if you experience signs and symptoms of complications, such as:

  • Eye pain or discomfort
  • Increased floaters after the first day
  • Increased sensitivity to light
  • Decreased vision

Sometimes after an intravitreal injection, you may get the feeling that “something is in your eye”—this can be a reaction to povidone-iodine, which is used to clean the eye before the injection. Artificial tears (preferably sterile single use droppers) can be used to help ease symptoms of dryness and surface irritation. Sometimes there may be a small bleed or subconjunctival hemorrhage on the surface of the eye where the needle enters; this usually heals within a week.

Subconjunctival hemorrhage on the surface of the eye this usually heals within a week. Copyright Retina Center

A follow-up visit with your retina specialist will be scheduled depending on the disease being treated, but is usually about 4 to 6 weeks after the injection.

EACH PATIENT IS DIFFERENT AND YOUR RETINA SPECIALIST WILL DECIDE WHAT IS THE MOST SUITABLE MEDICINE FOR YOUR PROBLEM AND HOW MANY INJECTIONS WILL BE NECESSARY.

IF YOU HAVE ANY QUESTIONS ABOUT YOUR EYES OR YOUR VISION, BE SURE TO ASK. YOUR DOCTOR IS COMMITTED TO PROTECTING YOUR SIGHT.  

Wet-AMD Before treatment
Wet-AMD After treatment Copyright Retina Center
Entrevista Televisa Todo acerca de inyecciones intraoculares
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