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What
is an intravitreal injection?
What
different types of intravitreal injections are there?
Avastin (Bevacizumab)
Lucentis
(Ranibizumab)
Kenalog (Triamicinolone)
What is an intravitreal injection?
An intravitreal injection is an injection of a compound into
a particular part of the eye called the vitreous cavity, which
lies behind the lens of the eye.
Intravitreal injections are used to treat many different eye
conditions. The most common are diabetic retinopathy, age-related
macular degeneration, vein obstructions, neovascular glaucoma
and macular edema of any cause.
An Intravitreal Injection
What different types of intravitreal injections are
there?
There are three main types of intravitreal injections commonly
used to treat problems within the eye, Avastin, Lucentis and
Kenalog.
Avastin (Bevacizumab)
Avastin is an antibody that binds to all forms of the natural
human protein called Vascular Endothelial Growth Factor (VEGF).
This VEGF stimulates the growth of and promotes leakage from
blood vessels in the eye, like the ones we see in Proliferative
Diabetic Retinopathy, Vascular occlusions,
Age-related macular Degeneration and Neovascular
glaucoma. Avastin is the first commercially
available angiogenesis inhibitor, that prevents the formation
of abnormal blood vessels, therefore helping in the treatment
of these conditions. Although currently not approved by FDA
for use in the eye, numerous studies have demonstrated that
it is a safe and effective treatment for specific eye disorders.
Side effects: minimal side-effects have been reported with the
use of intravitreal Avastin. Complications that relate to all
intravitreal injections include: Endophthalmitis (infection
in the eye), inflammation, retinal detachment, cataract and
glaucoma. However, we do not recommend you have an Avastin injection
if you have had a heart attack or a stroke in the last 12 months.
Lucentis (Ranibizumab)
Lucentis is an antibody derived from Avastin, specifically
designed for use in the eye. It is a smaller molecule than
Avastin and binds to VEGF-A. It is the only currently approved
(by the FDA) angiogenesis inhibitor for the treatment of Wet
Age-Related Macular Degeneration. Results
from large phase III clinical trials ANCHOR and MARINA showed
that 90% of Lucentis-treated patients stabilized vision and
40% improved vision by 3 lines on the chart. Monthly injections
are required for 3 months, and further injections may be needed
depending on response. Like Avastin, and because of the risk
of thrombo-embolic events, we do not recommend a Lucentis
injection if you have had a heart attack or a stroke in the
last 12 months. No systemic side-effects have been reported
with Lucentis.
Kenalog (Triamcinolone)
Kenalog is a long-acting synthetic steroid used in the treatment
of many eye conditions, most commonly macular edema of any
cause. Like Avastin its intravitreal use is Off-Lable. When
injected into the eye, it improves vision by drying the macular
edema. The beneficial effects last approximately 3 months,
and repeated injections are sometimes required.
The most common side-effects are: glaucoma (raised intraocular
pressure), cataracts, inflammation and very rarely endophthtalmitis.
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