Intravitreal Injection

Intravitreal Injections in Chattanooga, Knoxville, and the Tri-Cities Region

With intravitreal injections, medications can be administered directly into the eye’s vitreous. Due to their effectiveness, accuracy, safety, and convenience, this delivery method has emerged as the standard of care for many disorders impacting the retina, vitreous, and macula (i.e. the retina’s center). We provide injections at all of our Southeastern Retina Associates (SERA) retinal clinics.

Benefits of Intravitreal Injections

In many cases, if provided at the earliest opportunity upon being diagnosed with a condition, intravitreal injections have a greater likelihood of preventing further progression of retinal diseases. Benefits of intravitreal injections include:

• Delivery of medication to specific parts and areas of the eye, including those that are more difficult to access
• Direct access allows better and faster absorption rates into the retina
• They can be personalized to patients’ individualized specific conditions and responses
• Simplifies frequency and dosage modifications
• Fewer side effects compared to oral medications
• Receiving injections may enable patients to have fewer frequent treatments as compared to other techniques, such as laser or surgery

Common Retinal Conditions Treated With Intravitreal Injections

Intravitreal injections are used to treat and relieve symptoms for a wide array of vitreoretinal diseases, including:

• Wet age-related macular degeneration (AMD)
• Diabetic retinopathy
• Retinal vascular occlusions
• Macular edema
• Geographic atrophy

Many of these conditions are characterized by a process called neovascularization, which refers to the abnormal formation of new blood vessels. These newly formed vessels are fragile and prone to leakage, leading to complications like vision impairment.

Intravitreal Injections at Southeastern Retina Associates

At our multiple SERA retinal clinics, our retinal specialists and their teams provide a variety of intravitreal injections, based on your specific condition and severity. These treatments include:

Anti-VEGF Injections (Avastin, Beovu, Eylea, Lucentis, Vabysmo)

Anti-vascular endothelial growth factor (anti-VEGF) medications are considered the standard of care for multiple retinal and macular conditions. Shown to dramatically improve and stabilize patients’ vision, anti-VEGF medications are administered in situations involving neovascularization. They work by inhibiting new blood vessel growth, delaying or stopping them from leaking, or preventing them from ever forming. Among the most common medications are:

• Avastin® (bevacizumab) injections are often used to treat AMD and diabetic macular edema (DME), inhibiting new and potentially harmful blood vessel growth. First approved by the Food and Drug Administration (FDA) to treat different cancer forms, since 2005, it’s been safely used for eye diseases.
• Beovu® (brolucizumab) injections are typically used to treat wet AMD and DME.
• Byooviz® (ranibizumab-nuna) injections are used to treat wet AMD.
• Cimerli® (ranibizumab-eqrn) injections are used to treat wet AMD, diabetic retinopathy, and DME.
• Eylea® (aflibercept) injections are employed to treat macular degeneration and similar retinal conditions. Unlike other medications, they stop the VEGF molecule’s receptors, instead of blocking the VEGF protein itself.
• Lucentis® (ranibizumab) injections, also FDA-approved for cancer treatment, are used to treat wet AMD, retinal vein occlusions, and various diabetic conditions affecting the retina.
• Vabysmo® (faricimab-svoa) injections are FDA-approved to treat wet AMD and DME.

Geographic Atrophy Injections

Syfovre™ (pegcetacoplan injection) and Izervay™ are the first-ever FDA-approved medications for the treatment of geographic atrophy, an advanced, late-stage form of dry age-related macular degeneration. Both of these medications work by targeting a protein in the complement pathway, a part of the immune system that may play a major role in geographic atrophy progression.

Corticosteroid Intravitreal Injections (Xipere)

Xipere® (SCS triamcinolone acetonide) is a corticosteroid, an anti-inflammatory medicine. It’s FDA-approved for the treatment of macular edema associated with uveitis, a condition involving inflammation of the eye’s uvea, the middle layer between the retina and sclera (i.e., the white part), which contains many blood vessels carrying blood to and from the eye. Aside from uveitis, intravitreal steroids may reduce inflammation associated with such conditions as diabetic retinopathy and retinal vein occlusion.

Injectable Intravitreal Implants

Intravitreal implants, which deliver controlled medications via a microimplant device, have emerged as an effective means to treat various eye conditions. Injectable intravitreal implants may be either non-biodegradable (NBI) or biodegradable (BI). NBI implants last longer, but as they can be large in size, surgical removal or replacement may be required. BIs degrade and disintegrate over time, eliminating all components from the body, so surgical removal or replacement isn’t required. Among these medications are:

• Iluvien (fluocinolone acetonide), the smallest NBI implant, is used to treat DME. It’s also being evaluated to treat dry AMD, retinal vein occlusion, and non-infectious uveitis.
• Ozurdex (dexamethasone intravitreal implant), an FDA-approved BI implant, contains a corticosteroid called Dexamethasone. It’s used to treat retinal vein occlusions associated with macular edema, DME, and non-infectious posterior uveitis.
• Yutiq (fluocinolone acetonide), is a corticosteroid implant used for the treatment of chronic non-infectious uveitis affecting the back of the eye.

Intravitreal Injections: What to Expect

Generally, the administration of intravitreal injections is a simple experience, typically taking about 10-15 minutes to perform. You can expect the following steps:

• Performed within our SERA retinal clinics, you’ll recline in an exam room chair.
• There should be little, if any pain, and only a little pressure, as your eye and eyelids are anesthetized with special drops or gel.
• The eye’s eyelids will be kept open with an eyelid speculum – a wire device with curved ends that are designed to fit into the surgical site.
• The specific eye and eyelids will be cleaned, ensuring a sterile environment.
• When the eye is prepared and ready for injection, you’ll be asked to look in the opposite direction of the injection’s location.
• The medicine is injected with a very small needle into the sclera.
• Following the injection’s completion, the speculum is removed, and your eye is cleaned.

Most often, there won’t be any restrictions following the injection, other than avoiding potential contamination of the afflicted eye on the day of the procedure. You should contact your retina specialist if you experience certain symptoms of complications, including eye pain or discomfort, increased floaters, increased light sensitivity, and decreased vision. You may also feel like you have something in your eye, which may be a reaction to the povidone-iodine. Artificial tears may help to ease these symptoms of dryness and surface irritation.

Intravitreal Injection FAQ

• How long do intravitreal injections last?

  Intravitreal injections typically last for about 4 to 6 weeks. However, the duration can vary based on the specific medication used and the underlying eye condition being treated. Patients may require regular injections as part of their treatment plan, and the frequency is determined by their ophthalmologist.

• Do intravitreal injections have any side effects?

  While a safe procedure, there may be side effects and risk factors associated with intravitreal injections. In most cases, they’re only temporary and can be treated with eye drops. Among the more common ones are pain, scratchy sensations, conjunctival hemorrhage, floaters, increased eye pressure, eye inflammation, and bruising. Rarely, there may be infection, bleeding, redness, retinal tears or detachment, lens damage, and cataract formation.

• How many intravitreal injections are needed?

  Depending on the condition being treated, your retina specialist will schedule a follow-up visit, typically about 4- 6 weeks after the injection. Repeat injections, possibly once a month, may be required, especially for chronic conditions, such as AMD and diabetic retinopathy. Our retina specialists will discuss your long-term treatment options. Depending on the specific condition, you may experience vision improvement.