Anti-VEGF drugs are administered intravitreally to treat wet age-related macular degeneration (wet AMD). They block abnormal new blood vessel growth while also preventing their leakage.

Anti-VEGF therapy has been shown to produce visual acuity gains in multiple real-world studies on patients suffering from either neovascular age-related macular degeneration or diabetic macular edema; however, frequent injections may become burdensome and burdensome to manage for some individuals.

What is VEGF?

Standard treatment for wet age-related macular degeneration typically entails monthly or bimonthly injections of anti-VEGF drugs that reduce leaky blood vessel growth and may prevent further vision loss, however these injections are inconvenient, expensive, and carry with them an inherent risk of infection or retinal detachment. Sodhi’s team has been exploring strategies to identify subgroups of patients that could safely reduce or discontinue injection therapies without suffering vision loss.

Study results led them to identify a naturally-occurring protein known as soluble neuropilin that could counteract the effects of VEGF and angiopoietin-like 4 (which are targets of current wet AMD drugs), effectively decreasing abnormal blood vessel growth leading to neovascularization of mice eyes.

VEGF stands for Vascular Endothelial Growth Factor and acts as a signaling protein to encourage angiogenesis by binding to its receptors VEGFR-1 and VEGFR-2. This interaction between proteins is vital for proper vascular development, wound healing, as well as diseases caused by excess blood vessel growth such as diabetic retinopathy or wet age-related macular degeneration.

Even with its complex makeup, scientists have an excellent grasp on the various components that comprise the VEGF system and how they work in unison to promote angiogenesis. One such VEGF family member known for inducing angiogenesis is VEGF-A; this protein activates receptors on endothelial cells to proliferate more quickly while increasing permeability; furthermore it stimulates blood vessel formation providing alternate circulation for damaged tissues and organs.

VEGF plays an essential role in many organs’ functioning, particularly the brain, where it acts as an autocrine or paracrine signal that tells neuronal stem cells to differentiate and grow into mature neurons. Unfortunately, however, there are very limited methods available to inhibit its expression without simultaneously impacting its role as an activator of neural stem cells – making it challenging to create drugs which specifically target its expression in the brain.

How is VEGF injected?

Anti-vascular endothelial growth factor (anti-VEGF) injections are administered into the eye using a fine needle by a physician, after numbing with topical anesthetic drops and sterilizing with brown-coloured povidone iodine. With patient lying on her back and needle inserted into vitreous at center retina. Most patients tolerate this process well with little discomfort experienced during injection procedure.

An injection can halt the formation of new abnormal blood vessels and stop fluid leakage that obscures central vision in wet age-related macular degeneration (neovascular or exudative AMD). Additionally, it may help treat macular edema caused by diabetic retinopathy and retinal vein occlusion. Ranibizumab and Aflibercept are two popular anti-VEGF drugs; ranibizumab being a monoclonal antibody fragment against VEGF-A while Aflibercept is a fusion protein composed of three VEGFR receptors joined together and its Fc fragment coupled to human IgG1.

VEGF injections are currently the only proven therapy available to treat wet AMD, and can significantly decrease its progression towards geographic atrophy and blindness. Unfortunately, however, they must be given on an ongoing basis due to increased intraocular pressure that could threaten their optic nerve.

To avoid complications, it is vital that regular ophthalmologist visits, at least every two months, are conducted and that an understanding is gained of why injections are required. Any increased pain or decreased vision should also be reported immediately since these could indicate serious side-effects from treatment.

Faricimab from Genentech has recently been approved by the FDA and will become available under its brand name Vabysmo in late 2017. It shows promise of decreasing monthly injections by inhibiting new abnormal blood vessel growth associated with wet AMD. When administered directly into eye, faricimab should prove more effective than current standard treatments; it remains unknown as yet how long this effect will persist.

What are the side effects of vegf injections?

As the only FDA-approved VEGF therapy drug, Aflibercept can significantly slow vision loss from wet age-related macular degeneration (AMD), while also protecting macula damage. Aflibercept works by inhibiting new blood vessel growth that leaks onto retina. Furthermore, this drug is being used to treat macular edema associated with diabetic retinopathy or retinal vein occlusions.

Aflibercept’s most commonly reported side effects include red spots in the center of your eye caused by broken blood vessels (conjunctival hemorrhage), eye pain, inflammation of the colored part of the eye (iritis), and feeling like something is in your eye (ocular discomfort). Patients may need regular follow-up visits at four week intervals where additional injections may be given as necessary.

Most anti-VEGF drugs carry minimal risk from injection itself. Treatment is administered via fine needle, with local anesthesia provided to reduce discomfort. Unfortunately, significant vision loss due to this treatment is extremely uncommon.

Ocular medications often cause mild systemic side effects, including fever, rash, itching, joint swelling or lips or tongue swelling. Your physician will discuss all potential adverse reactions with you as part of their therapy before starting therapy.

VISUDYNE is an intravitreal injection containing angiopoietin II inhibitor and vascular endothelial growth factor inhibitor used in adults suffering from wet age-related macular degeneration and diabetic macular edema caused by choroidal neovascularization. Faricimab should not be taken by patients with an active herpes simplex virus infection, uncontrolled high blood pressure or severe intraocular inflammation. A free-flowing intravenous (IV) line must first be established prior to starting therapy and it must be closely monitored throughout treatment. Furthermore, inform your healthcare provider if you are allergic to faricimab or any component of its formulation, including excipients and any components not directly used as medicine (anaphylactic reactions have been known).

How long do vegf injections last?

Anti-VEGF injections were once the only viable therapy available to treat wet AMD, yet their cost can become prohibitive over time, especially as regular follow up visits must take place to ensure symptoms do not resurface. With regular treatment now available to many, patients can often achieve stable or improved vision using anti-VEGF treatments; however their cost may become prohibitive due to multiple visits each year required for follow ups with eye specialists to make sure symptoms do not return.

New research conducted at the University of Miami Miller School of Medicine has found that single port delivery system (PDS) ranibizumab injections are significantly more costly than traditional injections when treating patients with neovascular age-related macular disease (nAMD). Their team presented these findings at the American Academy of Ophthalmology 2022 Annual Meeting.

PDS delivery of ranibizumab costs up to 16 times more than traditional injections administered with syringes, according to research conducted by their group. Furthermore, the PDS method may lead to more frequent visits with an eye care provider and thus more injections per year.

An intravitreal injection of monoclonal antibodies against Vascular Endothelial Growth Factor (VEGF) inhibits new blood vessel growth while decreasing their permeability, thus stopping fluid accumulation caused by retinal vein occlusion. It has proven more effective than laser photocoagulation as an initial therapy for diabetic retinopathy and wet macular degeneration caused by retinal vein occlusion.

Prior studies suggested that early responders to anti-VEGF therapy (defined as those who could achieve visual benefits from at least one injection within three months of beginning treatment) achieved superior best corrected visual acuity and central subfield thickness results than limited early responder eyes, or LERs. This study sought to establish whether differences between early responder (ER) eyes and limited early responder eyes (LERs) remained over a longer timeframe.

Study participants included 122 patients with neovascular wet AMD who received multiple anti-VEGF injections over two years for neovascular wet AMD. At the end of year two, up to one third were able to discontinue treatment when no macular hemorrhage occurred during slit lamp examination or photo documentation as evidence of disease activity per the Treat and Extend protocol; those who remained on treatment were monitored monthly until signs of disease activity no longer appeared – at which point their injections would gradually be weaned off when no signs of disease activity were seen.