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Intravitreal injections (for age-related macular degeneration and diabetic retinopathy)

Intravitreal injections are performed after a full ophthalmological (visual acuity, intraocular pressure measurement, refraction and fundus examination) and imaging examination consisting of an OCT (Optical Coherence Tomography) and, if necessary, an Angiofluorography (AFG).

What you need to know about intravitreal injections?

Intravitreal administration has been practiced worldwide since 2005. When a medication or a medical device is approved by the competent authorities for a specific indication, the physician may use it off-label, meaning outside the indications listed on the authorized technical sheet, for different purposes, based on clinical evidence derived from published studies in the scientific literature and their own professional experience. Thus, the off-label use of medications is not only authorized by law but is also frequently put into practice.

Examples of off-label use in ophthalmology include the intravitreal use of Avastin, acetonide triamcinolone, and the injection of vancomycin (antibiotic); lidocaine (anesthetic) in the anterior chamber of the eye to enhance topical anesthesia; subconjunctival injection with gentamicin and dexamethasone, etc. The patients will be properly informed and must give their written consent, on a consent form, regarding the condition they suffer from, about alternatives to this therapeutic option, about the progression of the condition with or without treatment, about the adverse reactions and side effects of the medication, and about potential complications.

An intravitreal injection is administered through the white part of the eye into the gel that fills the interior of the eye (known as the vitreous). The special medications injected into the vitreous spread to the retina (the inner layer at the back of the eye) and other structures in the eye.

The most common reason for using intravitreal injections is for the treatment of wet age-related macular degeneration (AMD). This is when the growth of abnormal blood vessels under the macula (the part of the eye responsible for central vision) disrupts the normal functioning of the eye. This will lead to difficulties in reading, colors appearing less vibrant, and challenges in recognizing people’s faces.

Injecting an anti-vascular endothelial growth factor (anti-VEGF) in gel form can help treat the condition by stopping the growth of new blood vessels.

Typically, you will need injections for a year or more for the treatment to be effective.

Intravitreal injections are performed after a full ophthalmological examination (visual acuity, intraocular pressure measurement, refraction, and fundus examination) and imaging, which includes performing an OCT (Optical Coherence Tomography) and, if necessary, an Angiofluorography (AFG).

The actual injection with Avastin or another medication is done in the operating room, with topical anesthesia (drops), following aseptic rules.

What are the alternatives to surgery?

The ophthalmologist will perform an evaluation and will tell you if an intravitreal injection is suitable for you. In some cases, laser treatment may be appropriate, although it is less effective than an intravitreal injection.

What will happen during the procedure?

The injection is usually performed under local anesthesia, which will be administered in the form of eye drops or gel. The injection typically lasts about 30 seconds. The surgeon will insert a fine needle through the white part of the eye (sclera) and will inject the medication into the gel in the central part of the eye. It is normal to feel some discomfort during the injection and for a few hours afterwards.

 

In general, intravitreal injections are recommended in the following situations:

  • Age-related macular degeneration.
  • Diabetic retinopathy;
  • High myopia;
  • Various ocular traumas.

Recovery

What is recommended after injections with Avastin?

After these intravitreal injections, rubbing the eye should be avoided, and 1-2 drops of antibiotic solution should be instilled in the conjunctival sac three times a day for one week. Injections are repeated at intervals of 4-6 weeks according to a protocol established with your doctor.

You will feel discomfort inside the eye, but this usually sets in a few hours after treatment. You should be able to go home (with assistance) after about an hour. Most people will need a few days off. Do not participate in activities such as swimming, which will expose your eye to infection, and avoid lifting heavy objects or bending so that your head is below your waist.

Do not drive until you can read a license plate from 20 meters.

Your doctor will tell you when you can return to normal activities.

MAKE AN APPOINTMENT

You can make an appointment quickly via the form on the right, or directly over the phone. Our colleagues at the reception desk will be happy to provide you with the availability and information you need to make an appointment. Filling in the form does not represent the registration or confirmation of an appointment, but submitting an appointment request. You will be contacted by our team to check the availability of doctors and make an appointment.

SEE PRACTICES AND CLINICS

Important note regarding patient consultations and surgery appointments

A patient who cancels a consultation or surgery appointment once, at least one day prior to the scheduled appointment, has the right to a second appointment under the same conditions.
If the patient cancels the second consultation and/or surgery appointment, a new appointment can be made only if the patient accepts to pay for both the consultation and the surgery in advance. This can be done either by payment order or in cash at the clinic reception.
A patient who does not show up for their consultation or surgery, who does not cancel the appointment in due time, or does not answer the clinic’s calls, may request a second appointment only if they pay for the consultation/surgery in advance. 
Patients requesting an appointment for retinal surgeries or laser Prk/Femtolasik/Smile Pro must pay 30% of the cost of the surgery in advance. The appointment will be scheduled only after receiving the advance payment. If the patient is unable to attend the scheduled consultation or surgery, and cancels the intervention at least 48 hours beforehand, they will be refunded in full. If the patient does not show up and does not cancel or contact the clinic at least 48 hours in advance, the advance paid is considered to be lost as damages and will no longer be refunded.