A treatment in which anti-VEGF or corticosteroid medications are delivered into the eye through a fine needle to slow vision loss in retinal diseases.
Indication
- Wet (neovascular) age-related macular degeneration (AMD)
- Diabetic macular edema (DME)
- Macular edema due to retinal vein occlusion
- Choroidal neovascularization associated with pathologic myopia
- Selected cases of uveitis with macular edema
- Adjunctive therapy in suitable cases of retinopathy of prematurity
Preparation
- Pre-procedure eye examination, OCT and visual field data are updated
- All medications, blood thinners and allergies are reported to the physician
- Contact lenses are removed; the eye is checked to be free of active inflammation or infection
- Antiseptic (povidone-iodine) and topical anesthetic drops are applied before the procedure
- The patient is positioned lying down and prepared with a sterile drape
How it's performed
- The area around the eye is sterilely cleaned and the eyelid is held open with a lid speculum
- After topical anesthesia, a fine needle is inserted at a marked site on the sclera (white of the eye)
- Anti-VEGF medications such as ranibizumab, aflibercept or bevacizumab are injected into the vitreous cavity
- In cases requiring corticosteroids, a suitable steroid implant is preferred
- After the needle is withdrawn, the eye is briefly checked by the physician
- The entire procedure usually takes 5-10 minutes
Post-procedure
- Patients can usually go home the same day; heavy exertion and rubbing the eye should be avoided
- Prescribed antibiotic drops are used for several days
- Urgent medical attention is required if redness, pain, vision loss or discharge occurs
- Treatment may be repeated at 4-8 week intervals depending on the disease
- Response is regularly assessed with OCT and visual acuity testing
Risks
- Endophthalmitis (intraocular infection) — a rare but serious complication
- Transient rise in intraocular pressure
- Limited intravitreal hemorrhage or retinal tear (rare)
- Temporary blurred vision or floaters
- Local allergic reaction to drops or medication
FAQ
Will I see the needle entering my eye during the injection?
No. Your gaze is directed away during the procedure and, because of the topical anesthetic, the needle is not seen clearly and no pain is felt.
How many injections will I need?
It depends on the disease. In wet AMD and DME, three monthly loading doses are usually given initially, followed by extended intervals based on clinical response.
Will the treatment fully restore my vision?
No. The aim is to slow disease progression, reduce vision loss and, when possible, achieve some improvement. Outcomes vary by disease and stage.
Can I drive after the procedure?
Because the eye may be sensitive and blurry for a few hours, driving immediately after the procedure is not recommended.
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