Anti-VEGF treatment

They are used to treat different eye conditions that cause new abnormal blood vessel growth (neovascularisation) or swelling (oedema) under the macular area of your retina. These eye conditions can cause problems with your central vision, for example with reading, watching television and recognising faces.

Your retina is the light sensitive layer that lines the back of the eye. The macula is a small area of your central retina which is very important for seeing detail, colour and objects in the centre of your vision. Anti-VEGF treatment should usually be started quickly before the new blood vessels or swelling cause too much damage to the macula.

This page contains a summary of our information on anti-VEGF treatment. To read our full information, download our factsheet:

Anti-VEGF treatment is used for different retinal conditions including the following:

• wet age-related macular degeneration (wet AMD)
• diabetic macular oedema (DMO)
• macular oedema caused by retinal vein occlusion
• myopic choroidal neovascularisation (myopic CNV).

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 straightforward, quick and isn’t usually painful.

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.

The risk of complications from anti-VEGF injections is 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 small risk that comes with the injection.

Common complications occurring in about 3 in 10 people who have anti-VEGF injections:

• Slight ache or pain in the eye lasting a day or two
• Temporary floaters - clearing in a week
• Bruising on the white of your eye that appears red or bloodshot, but this should clear in a week or two
• Eye may feel sore and gritty.

Rare complications that may occur from the treatment can include:

• Infection
• Glaucoma
• Retinal detachment
• Inflammation inside the eye
• Bleeding in the eye
• Cataract.

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

Wet AMD

If you are diagnosed with wet AMD, you should receive an initial assessment and your first anti-VEGF injection, if required, within two weeks of referral to the eye clinic. 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 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 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.

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.They may continue to be given monthly or may be given every few months. This 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.

Anti-VEGF treatments are very successful and give a good chance of preventing further sight loss. In most 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 and reduce distortion.

How much your vision will improves will depend on your individual circumstances. It may not help with any other eye conditions that you have. 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. They will be able to consider your individual circumstances and eye condition.

Anti-VEGF treatment can mean a lot of injections and visits to the hospital. However, it has greatly improved visual outcomes for people with these conditions.

It’s completely natural to be concerned if you have an eye condition that requires anti-VEGF treatment. We’re here to support you every step of the way, and to answer any questions you may have – just get in touch with our Sight Loss Advice Service.

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.