Intravitreal injections
PricelistGENERAL INFORMATION
Intravitreal injections are injections that are performed into the vitreous. A non-expert would call it an ‘injection into the eye,’ and indeed it is an injection into a carefully selected spot in the eyeball. The injection is performed under local anesthesia, so it doesn’t hurt at all. Not counting the time it takes to dilate the pupil, the intravitreal injection itself takes literally two minutes.
Indications for intravitreal injections:
- Exudative-hemorrhagic AMD (wet form of age-related macular degeneration),
- Central Retinal Vein Occlusion (CRVO),
- Diabetic Macular Edema (DME),
- Choroidal Neovascularization (CNV) in patients with high myopia
- other diseases with abnormal neovascularization, such as Coats’ disease.
The main goal of intravitreal injection with anti-VEGF preparations is to inhibit or slow down choroidal neovascularization and seal the vascular endothelium.
PRACTICAL INFORMATION
Intravitreal injections are made with a very thin needle, which the doctor inserts into the vitreous body (the jelly-like substance that fills the eyeball). This is where the procedure got its name. During the procedure, the patient does not feel pain, as the eye is locally anesthetized beforehand. Injections are performed in sterile conditions of the operating room.
Treatment regime depends on the disease. It often involves a series of injections, the number of which, as well as the length of intervals and the duration of treatment is determined by the doctor, who also selects and prescribes the appropriate drug.
Recommendations for the patient:
- Although the injection itself takes about 1-2 minutes, an hour or so should be reserved for the appointment. This is because it takes quite a lot of time to examine and prepare the patient before the injection is administered.
- Preparing the patient for the injection involves the administration of antibiotics and medication that disinfects the surface of the eye.
- The patient can leave the Clinic immediately after the injection.
- Driving after the injection is not recommended.
What is wet AMD?
Intravitreal injections with anti-VEGF preparations are currently the most common and effective treatment for exudative-hemorrhagic AMD, which is the wet form of age-related macular degeneration.
AMD is a macular degeneration related to age. It is a chronic and progressive eye disease, leading to damage of central vision. In the case of a large hemorrhage under the retina, it can even lead to total blindness.
AMD is a ‘reading disease’ because the patient retains peripheral vision, but loses central vision, making it impossible to read or recognize faces.
There are two forms of AMD: dry and wet (exudative).
Exudative AMD (wet AMD) is less common – it affects 10-20% of patients with macular degeneration. Exudative AMD can show a rapid and aggressive course, causing sudden and extensive loss of central vision even within weeks. The exudative form of AMD has a much worse prognosis than the dry form, so it requires an immediate implementation of therapy.
Intravitreal injections – what to expect?
Patients with AMD receive a series of three injections at monthly intervals, then the progress of treatment is verified by performing an OCT test (OCT, or Optical Coherence Tomography, is an ultra-modern and non-invasive method of viewing the tissues in the eye) and decision is made on the future treatment.
Very often 3 injections is where the treatment ends. After that, it will be necessary to have a periodical check-up (usually every 3 months) and take booster injections, if necessary. Sometimes, however, patients need to continue regular injections, usually at longer intervals.
Is it true that the Avastin, the drug used for intravitreal injections, is actually a cancer drug
Yes, and it continues to be an effective drug used in oncology. Soon after Avastin was approved for use in cancer therapy in 1997, it was used off-label in AMD patients. When an improvement in vision was noticed after intravenous administration of Avastin, the decision was made to inject it into the vitreous body. Ophthalmologists in many countries note its high efficacy in the treatment of the exudative form of AMD, as well as in diabetic retinopathy, some forms of glaucoma, and diabetic macula edema. Avastin has similar effects to the slightly more expensive drug Lucentis.