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Anti-VEGF Intravitreal Injection

Office-based intravitreal administration of vascular endothelial growth factor inhibitors (ranibizumab, aflibercept, faricimab, brolucizumab) for treatment of neovascular AMD, diabetic macular edema, retinal vein occlusion, and other VEGF-driven retinal diseases.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Göz Hastalıkları department. Book Appointment →

What is Anti-VEGF Intravitreal Injection?

Anti-VEGF therapy involves intravitreal injection of monoclonal antibodies or fusion proteins that bind and neutralize vascular endothelial growth factor-A (VEGF-A) and other isoforms, reducing pathological angiogenesis, vascular leakage, and macular edema.

Available agents: ranibizumab (Lucentis, antibody fragment), aflibercept (Eylea, fusion protein blocking VEGF-A, VEGF-B, PlGF), faricimab (Vabysmo, bispecific Ang-2/VEGF-A antibody), brolucizumab (Beovu, single-chain antibody), and bevacizumab (Avastin, off-label).

Injection technique uses 30-32 gauge needle inserted 3.5 mm posterior to limbus through pars plana under sterile conditions with topical anesthesia and povidone-iodine prep. Treat-and-extend protocols personalize injection intervals (4-16 weeks) based on disease activity assessed by OCT.

Symptoms

Sudden central vision loss in wet AMD
Distortion of straight lines (metamorphopsia)
Central scotoma or dark spot in vision
Decreased visual acuity in diabetic patient
Vision changes after retinal vein occlusion
Floaters from neovascular vitreous hemorrhage
Fluctuating vision in macular edema

Risk Factors

Wet (neovascular) age-related macular degeneration
Diabetic macular edema (focal or diffuse)
Proliferative diabetic retinopathy
Branch or central retinal vein occlusion with macular edema
Myopic choroidal neovascularization
Polypoidal choroidal vasculopathy
Retinopathy of prematurity (selected cases)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Sudden distortion or central vision loss
  • Wet AMD diagnosed on OCT and fluorescein angiography
  • Diabetic macular edema with vision <20/40
  • Retinal vein occlusion with macular edema
  • Recurrent fluid on OCT during anti-VEGF therapy
  • Failed initial response requiring agent switch
  • Pre-operative neovascularization treatment

Treatment Methods

01
Pre-injection OCT macula and fluorescein angiography for diagnosis and monitoring
02
Sterile preparation: povidone-iodine 5% for periocular skin, 5% for conjunctival sac
03
Topical anesthesia with proparacaine or tetracaine drops
04
Lid speculum placement and exposure of injection site (3.5-4 mm posterior to limbus)
05
30-gauge needle injection of 0.05 mL anti-VEGF agent through pars plana
06
Cotton swab pressure at injection site to prevent reflux
07
Post-injection IOP check and central retinal artery patency assessment
08
Treat-and-extend regimen with monthly loading dose (3 doses), then extending intervals based on OCT activity
09
Patient education on signs of endophthalmitis (pain, vision loss, redness)
10
Long-term monitoring with OCT every visit and fundus photography periodically

Which Department to Visit?

You can visit our Göz Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Göz Hastalıkları Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.