Intravitreal injections

Table of contents

Maculodystrophy

Macular dystrophy is a lesion in the central part of the retina. It most often leads to a decrease or loss of central vision. The affected eye can see the world, but cannot see faces, letters, and objects. A spot covers the objects which the eye is focused on.

The changes develop gradually. At first, brightness and color saturation may decrease. Small fragments in the image may disappear. Over time, the image in the center of the field of vision dims, distortion appears. Gradually, the ability to see in front of oneself is lost. Only peripheral vision remains. Servicing oneself in this situation is extremely problematic.

The main cause of this kind of problem is vascular disease. Vessels are affected all over the body. The strain on them in the eye is very high. The price of their failure or damage can be blindness.

Age-related maculodystrophy (AMD), diabetes, circulatory disorders, damage to the central part of the retina caused by severe myopia, are the most frequent causes of visual impairment and disability. The triggers for these diseases are different, but the outcome may be the same – the death of the central part of the retina which is responsible for visual acuity. The retina may dry out or swell, or be replaced by a scar in the case of hemorrhage.

In any of these cases, the lack of blood flow to the retina leads to ischemia (oxygen deficiency). Vascular endothelial growth factor (VEGF) increases in the tissue. It is this factor that stimulates the increased permeability of normal vessels and the growth of new ones. The more edema, the more waste, toxic products accumulate in the retina. The newly formed vessels are very weak and often burst. In addition, they further deform the fine structure of the macula.

Duration

The time from the beginning of the disease to the terminal stage can vary greatly and can last from a few months (lightning-fast) to many years (sluggish).

Up to some stage, the processes may be reversible. Often the process can be stopped. But when a retinal scar or an extensive ischemic edema has formed, treatment is currently ineffective.

Anti-VEGF therapy

A modern and effective way to treat the aforementioned diseases is anti-VEGF therapy.

In the Republic of Belarus the drugs Eilea and Lucentis are approved for use in ophthalmology. The drug is injected directly into the eye under operating room conditions (intravitreal injection).

Contraindications:

– Hypersensitivity to the drug or any other component of the drug;

– active or suspected intra- or periocular infection;

– active severe intraocular inflammation;

– Pregnancy and breast-feeding;

– under 18 years of age.

The course of treatment always begins with three injections at an interval of one month (five injections for DME). Subsequently, for complete stabilization of the process, treatment is continued at longer intervals.

The main diagnostic criterion for prescribing anti-VEGF therapy is the presence of retinal edema according to OCT (optical coherence tomography). Our center uses spectral OCT. Angio-OCT is performed when needed.

Treatment of common diseases (arterial hypertension, diabetes mellitus, etc.) should not be interrupted! Check your blood pressure the evening before and the morning of the procedure. There is no need to change your diet.

Prevention

Prophylaxis of age-related maculodystrophy is control of blood pressure, weight, giving up smoking. It is essential to follow the recommendations of your general practitioner. It is useful to protect your eyes from bright sun with protective sunglasses with a UV filter. The risk group is people over 50 years of age.

Lesions of the center of the retina in people with diabetes mellitus – diabetic macular edema (DME). The worse the sugar and blood pressure are compensated, the greater the risks of retinal, kidney, and foot damage (diabetic retinopathy, diabetic nephropathy, diabetic foot). Approximately one-third of patients have diabetic retinopathy. One-third of them develop DME. And in one third of them, macular edema has a prolonged character.

The disturbance of blood circulation in the retina, or retinal vein thrombosis, is a consequence of common vascular problems. First of all, hypertension. It is a kind of infarction in the eye. When the macula is affected, only timely treatment can guarantee success.

High degree myopia (MVS) requires elimination of any high overload. Physical, visual, and psycho-emotional. Heavy physical work, work with prolonged bending over the legs, concussions, and blows are extremely undesirable. Formation of pathological vessels in the macula if left untreated leads to formation of a scar (Fuchs’s spot) and irreversible loss of central vision.

Patient testimonials

British Ophthalmology Center

Shul'zhenko Irina Nikolayevna

Strabismus treatment

Можно я скажу, что в современном мире есть безукоризненный медицинский центр – «Британский офтальмологический центр». Огромная благодарность Щадных Марине Александровне. Вы с ювелирным профессионализмом и человеческим теплом вернули мне возможность уверенного взгляда в будущее. Всем сотрудникам, которые сопровождали до и во время операции, я желаю здоровья и личных побед.