Anti-VEGF treatment

Anti-VEGF therapy is a medical treatment that involves the injection of medications directly into the eye. These medications block the activity of vascular endothelial growth factor (VEGF) – a protein produced by diseased cells in the retina which causes leakage from damaged blood vessels or the growth of new blood vessels. These abnormal blood vessels may leak and bleed in the eye, and cause vision problems.

Anti-VEGF intravitreal injections are used to treat several retinal conditions characterised by abnormal fluid leakage and blood vessel growth These conditions include:

• Wet age-related macular degeneration (AMD) – the wet form of AMD, which occurs when abnormal blood vessels grow at the macula (the central part of the retina) and leak or bleed, leading to problems with your central vision.
• Diabetic macular oedema – a condition caused when blood vessels damaged by high blood sugar leak and cause swelling in the macula, leading to reduced vision.
• Retinal vein occlusion – the veins to your retina can become blocked, preventing blood from leaving your retina and leading to bleeding, leakage, and swelling (macula oedema).
• Myopic choroidal neovascularisation – a complication of severe myopia (short-sightedness), where the growth of abnormal blood vessels can lead to leakage and bleeding, ultimately resulting in vision loss.
• Proliferative diabetic retinopathy – a complication of diabetes in which high blood sugar causes progressive loss of fine blood vessels (capillaries) in the retina. This can eventually lead to the development of abnormal blood vessels that can bleed or cause scarring, causing severe visual problems which can present acutely.
• Other atypical or idiopathic neovascularisation – neovascularisation refers to new blood vessels developing in your eye where they shouldn’t exist. Many eye conditions can be complicated by neovascularisation, and anti-VEGF treatment may be used to treat this finding.

The diagnostic tests used to confirm a condition that may be treated with anti-VEGF injections will depend on the diagnosis. However, these same tests are likely to be used to monitor the effectiveness of the treatment.

These may include any of the following:

• Optical coherence tomography (OCT) – this non-invasive technology uses a laser to scan the back of your eye, providing high-definition cross-sectional images of your retina to enable accurate diagnosis and management.
• OCT-A (optical coherence tomography angiography) – using the same OCT scanner as above, this supplementary examination can help confirm the diagnosis being investigated.
• Fluorescein angiography (FA) – this imaging technique involves injecting a fluorescent dye into your bloodstream through your arm. Once the dye reaches the blood vessels in your eye, a series of photographs are taken using a special camera to identify areas of retinal damage and patterns of leakage.
• Indocyanine green angiography – similar to FA but using a different dye, this technique is particularly useful for imaging the choroid, a deeper layer of blood vessels located under the retina.
• Fundus photography and wide-field retinal imaging – these approaches take high-resolution photographs of the retina, allowing accurate diagnosis, management, and monitoring of your condition.
• Visual acuity testing – a range of standard eye chart tests designed to measure vision sharpness, helping assess the impact of your condition on your vision and the treatment’s effectiveness.

You can be assured that our consultants at The London Clinic Eye Centre will make the best personalised treatment decision for you, guided by the most sophisticated retinal imaging available.