There are many eye conditions, especially retinal conditions that may require
treatment with Intravitreal injection of anti-VEGF and/or Steroids. These conditions
commonly are Age Related Macular Degeneration, SRNVM, Diabetic Retinopathy,
Retinal Vascular blocks, Uveitis, etc. Your treating doctor shall be explaining the
disease you have and which Intravitreal Injection shall be best suited for you.
What are various Intravitreal Injections Available?
The commonly used Intravitreal Injections are Anti-VEGF injections like Ranibizumab (Lucentis/Accentrix/Razumab), Aflibercept (Eylea), Brolucizumab (Pagenax) and Off Label Bevacizumab (Avastin and Zybev). The other option is Steroid injections like Sustained Release Dexamethasone Implant (Ozurdex) and Traimcinolone Acetate.
Is Intravitreal anti-VEGF or Steroid treatment right for me?
Your ophthalmologist (Retinal Specialist) would suggest the best-suited injection for you. The treatment modality is decided based on the specific disease, the stage of the disease, the condition of the central retina (macula) and visual acuity. OCT scans and fundus photographs and fundus angiography etc. assist your retina specialist to decide on the treatment. These tests would need to be repeated at regular intervals to monitor the disease and to decide bout further need for injections. Since it is likely that you would require multiple injections, the cost consideration also plays a role to decide the right choice of injection for you.
Would I regain my lost vision with the help of these Intravitreal Injections?
Most of the retinal diseases that require Intravitreal injection treatment are serious diseases and often the vision lost is not regained. The primary aim of the treatment of these conditions is to maintain the vision, which target is achieved in approximately 90% of patients, provided proper follow-ups and timely and regular treatment is carried out.
Moreover, nowadays with better injection options, some degree of improvement in visual acuity and quality of vision may be expected in many of the patients. Proper follow-ups and monitoring with the help of periodic tests like OCT, Fluorescein Angiography etc. is very important and the patient would need to be very regular with his checkups and treatment, as many of these conditions have a tendency to recur and decrease the vision later.
How many injections will be required for me?
Most of the cases would require more than one injections. These injections may need to be repeated at regular intervals (often 4-12 weeks, depending upon the kind of injection) for a very long time. There are various strategies like PRN, Treat and Extend, etc. to minimize the number of injections required, without compromising on the efficacy and safety. Your retina specialist would guide you accordingly.
For Anti-VEGF treatment, most patients require a loading course of three injections at regular intervals of four weeks. As explained earlier, it is of utmost importance that you maintain a very regular follow-up schedule, so as to monitor the disease and intervene with necessary investigations and injections and/or laser/surgery at the right stage to achieve the best results.
The patient and his/her attendants need to be aware about the disease and its treatment and have to be actively involved in decision making and should be regular in their follow-ups and treatment to get the best results of this treatment with Intravitreal injections.