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Hashemi Eye Care - Neuroscience Institute and Research Center

Anti-VEGF Injections (Intravitreal Injections)

Eye injections that treat wet AMD, diabetic eye disease, and other retinal conditions. Learn what to expect from this highly effective treatment.

4 min read

Anti-VEGF (vascular endothelial growth factor) injections are a revolutionary treatment for various retinal conditions. Delivered directly into the eye, these medications block the signals that cause abnormal blood vessel growth and leakage. They've transformed the treatment of wet AMD, diabetic macular edema, and other sight-threatening conditions.

Key Takeaways

  • Highly effective treatment for wet AMD, diabetic eye disease, and vein occlusions
  • Injected directly into the eye in an office procedure
  • Eye is numbed—most patients report minimal discomfort
  • Ongoing treatment usually needed—frequency varies by condition and response
  • Can preserve and often improve vision
  • Generally very safe with rare serious complications

How Anti-VEGF Works

VEGF is a protein that signals the growth of new blood vessels. In the eye, abnormal VEGF activity causes:

  • Growth of fragile, leaky blood vessels
  • Fluid leakage into the retina (edema)
  • Bleeding in the eye
  • Scarring and vision loss

Anti-VEGF medications block this protein, reducing vessel growth and leakage, allowing fluid to reabsorb and vision to stabilize or improve.

Conditions Treated

  • First-line treatment
  • Often dramatically improves vision
  • Requires ongoing treatment
  • Over 90% of patients stabilize or improve

Diabetic Macular Edema (DME)

  • Reduces retinal swelling
  • Improves vision
  • Often combined with diabetes management

Diabetic Retinopathy

Retinal Vein Occlusions

Other Conditions

  • Myopic choroidal neovascularization
  • Central serous retinopathy complicated by choroidal neovascularization
  • Retinopathy of prematurity
  • Neovascular glaucoma (adjunctive)

Available Medications

Ranibizumab (Lucentis)

  • FDA-approved for multiple conditions
  • Given monthly or less frequently
  • Specifically designed for eye use

Aflibercept (Eylea)

  • Targets VEGF and related proteins
  • Often given every 8 weeks after loading doses
  • Widely used

Bevacizumab (Avastin)

  • Originally a cancer drug
  • Used off-label for eye conditions
  • Significantly less expensive
  • Equally effective in many studies

Brolucizumab (Beovu)

  • Newer agent
  • May allow longer intervals between injections
  • Some concerns about inflammation risk

Faricimab (Vabysmo)

  • Targets both VEGF and Ang-2
  • May allow longer treatment intervals
  • FDA-approved for wet AMD and DME

The Injection Procedure

Anti-VEGF medications are delivered via intravitreal injection — a quick, in-office procedure where medication is injected directly into the eye. See our intravitreal injection guide for full details on what to expect, preparation, aftercare, treatment schedules, and risks.

Systemic Considerations

Anti-VEGF medications are absorbed into bloodstream in small amounts:

  • Theoretical cardiovascular risks
  • Studies show minimal systemic risk
  • Inform your doctor of heart disease or recent stroke

Long-Term Expectations

Duration of Treatment

  • Most patients need ongoing treatment for years
  • Some may eventually stop with careful monitoring
  • Stopping too soon can lead to recurrence

Treatment Outcomes

For Wet AMD:

  • About 90% stabilize or improve
  • About 30-40% gain significant vision
  • Best outcomes with early treatment

For Diabetic Eye Disease:

  • Significant improvement in many patients
  • Also requires blood sugar control
  • May need laser treatment in addition

Frequently Asked Questions

How long do the effects last?

The medication remains active for 4-8 weeks depending on the drug. This is why repeated injections are needed. Some newer medications may last longer.

Will I need injections forever?

Many patients need ongoing treatment, though frequency may decrease over time. Some patients can eventually stop with careful monitoring. Your doctor will guide the treatment plan based on your response.

Does insurance cover these injections?

Generally yes, including Medicare. Some medications are more expensive than others. Your doctor's office can discuss costs and coverage options.

What about the injection procedure itself?

See our intravitreal injection page for detailed information about the procedure, what to expect, pain management, aftercare, and treatment schedules.

References

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