Anti-VEGF treatment

Anti-VEGF treatments are a group of medicines which reduce new blood vessel growth (neovascularisation) or oedema (swelling). They can be used to treat a number of eye conditions that cause new blood vessel growth or swelling under the macular area of your retina, at the back of the eyes.

The macula is a tiny area of your central retina, which is very important for seeing detail, colour and objects directly in front of you. When there is new, abnormal blood vessel growth or swelling at the macula, it can cause problems with your central detailed vision and with tasks such as reading, watching television or recognising faces. Anti-VEGF treatment usually has to be started quickly before the new blood vessels or swelling does too much damage to the macula.

Our downloadable factsheet has more information about anti-VEGF treatment:

Download our full guide on anti-VEGF treatment in Word

 

What eye conditions is anti-VEGF treatment used for?

Currently anti-VEGF treatment is used for the following conditions:

How is anti-VEGF treatment given?

Anti-VEGF treatment is given as an injection into the white of your eye (the sclera). The drug is injected directly into the vitreous, the jelly that fills your eye. This is called an “intravitreal” injection. The procedure is generally very straightforward and quick and isn’t usually painful. Further detail about how an anti-VEGF injection is given can be found in our full guide to anti-VEGF treatment.

 

Watch our video

For more information on what it is like to have an anti-VEGF injection, watch our video which features Reg talking about having his anti-VEGF injections.

 


What are the complications of anti-VEGF injections?

The risk of complications from anti-VEGF injections is very small. Most of the possible complications come from having an injection into your eye, rather than the anti-VEGF drug itself. For most people, the benefit of having the treatment to protect your sight outweighs the very small risk that comes with the injection.

Complications due to anti-VEGF injections can include: 

  • infection
  • increase in eye pressure
  • retinal detachment
  • blood clots and bleeding in the eye
  • inflammation inside the eye
  • cataract.

Although some of these complications are serious, they can be treated, so permanently losing your sight following an anti-VEGF injection is rare.

How will I be followed up during my treatment?

 

Wet AMD

If you are diagnosed with wet AMD you should receive your first anti-VEGF injection within two weeks. Usually you will start by having a course of three injections, once every four weeks for three months. This is known as a “loading dose”. 

How often you need further injections will depend on the type of anti-VEGF drug you are receiving and how well the treatment is working. It’s very common for people to have more injections after the first three. 

Macular oedema caused by retinal vein occlusion

Usually, you will start with a loading dose of three anti-VEGF injections, once a month for three months. After this, your ophthalmologist will check how well the treatment is working. It’s quite common for people to have more injections after the first three. Your ophthalmologist may want to see you fairly regularly in the eye clinic for the first six months and then perhaps less so for the next 12 months. 

Diabetic macular oedema (DMO)

Anti-VEGF treatment for DMO is given when the amount of fluid or swelling has caused your macula to thicken by a certain amount. Injections are usually given once a month to begin with, and then may continue to be given monthly or may be given every two months. How many injections and how often you might need them will depend on the type of anti-VEGF drug you are receiving and how the DMO responds to treatment. 

Myopic choroidal neovascularisation (myopic CNV)

Treatment for myopic CNV usually starts with one anti-VEGF injection. After this you’ll normally be monitored at the eye clinic every month for the first couple of months. You may be given further injections at these visits if your ophthalmologist thinks they are needed. If your condition becomes stable, you may not need further injections, but you’ll still be monitored closely, normally around once every three months for the first year.

 

How successful is anti-VEGF treatment?

Anti-VEGF treatments are very successful and give a good chance of preventing further sight loss. In the majority of cases, the aim of treatment is to stabilise vision and prevent it from getting worse. In some cases, treatment can also help to improve vision.

  • Wet AMD: Anti-VEGF treatment has a very high success rate and in the majority of people they stop sight from getting worse. Up to 40 per cent may also see an improvement in their vision.  
  • Macular oedema following retinal vein occlusion: Studies have shown that as well as stabilising vision, around 40-60 per cent of people may also get a significant improvement in vision (being able to read an extra three lines on the letter chart).
  • DMO: Studies have shown that around 30-40 per cent of people’s vision can improve by an extra three lines on the letter chart with anti-VEGF treatment.
  • Myopic CNV: Studies have shown that most people can get some improvement in vision, with up to 50 per cent being able to read an extra three lines on the letter chart.

All these outcomes are based on studies, and how much your vision will improve will depend on your individual circumstances. Generally the better your level of vision is before starting treatment, the better the outcome is likely to be. You should ask your ophthalmologist what improvement they would expect, as they will be able to take into account your individual circumstances and eye condition.

Download our factsheet for more information about anti-VEGF treatment.
 

Further help and support

The Macular Society can put you in touch with a ‘treatment buddy’ who can support people who are anxious about their injections and offer information and reassurance.