Injection therapy using anti-vascular endothelial growth factor (anti-VEGF) agents is the most common and effective treatment to manage wet macular degeneration. Anti-VEGF represents the first line of treatment for other diseases such as macular edema due to diabetic retinopathy or retinal vein occlusion, and can also decrease abnormal blood vessel growth in diabetic retinopathy.
Several large clinical trials have compared the effectiveness and side effects of each of these medications. There are very rare systemic complications, as the medication is delivered into the eye to minimize the delivery of medication to other parts of your body. Your doctor will speak with you regarding which medication option may be best for you, depending on your condition and response to the medications. The use of these drugs may require frequent re-treatment, but injection schedules are determined on a case-by-case basis.
Intravitreal injections are generally well tolerated and rarely associated with serious adverse events such as infectious endophthalmitis or retinal detachment. The injection is given in the office under local anesthesia to minimize discomfort. After an injection, it is normal to feel eye irritation, itching, burning, and to see redness in the area of the injection. You may also have some floaters or bubbles in your vision due to the medications. Symptoms suggestive of post-injection endophthalmitis or retinal detachment require prompt evaluation.
Retinal laser treatments are used for a variety of conditions and can be performed in our office. Swelling or edema is caused by leaking blood vessels close to the center of your vision, your macula. Your doctor may recommend treatment with a focal laser to specifically target an area of swelling close to the center of your vision due to diabetes, retinal vein blockage, or central serous chorioretinopathy. Typically this type of laser is painless and takes a few minutes. The goal of the laser is to stop the swelling from causing further vision loss and to try to improve your vision.
Retinal tears are also amenable to laser treatments- more on this topic in the retinal tears section.
For severe diabetic retinal disease, your doctor may recommend pan-retinal photocoagulation. This type of laser targets the peripheral retinal tissue to decrease damage caused by abnormal blood vessel growth. The goal is to preserve vision caused by bleeding of damaged blood vessels due to diabetes.