eye injections
Periocular Eye injections
Periocular eye injections are injections given around the eye rather than directly into the eyeball. Injections of anti-inflammatory medications such as corticosteroids (e.g. dexamethasone, triamcinolone acetonide) can be given for inflammatory conditions of the eye including uveitis and iritis. These medications help to slowly release anti-inflammatory medications over time.
Intravitreal Eye Injections
Intravitreal eye injections are injected into the vitreous, which is the jelly-like substance inside the eye. It is performed to place medicines inside the eye, near the retina.
Intravitreal eye injections are effective treatments for many retinal disorders where there is bleeding or leaking fluid in the retina or macula, including wet macular degeneration, diabetic retinopathy, macular edema, retinal vein occlusions and choroidal neovascularization.
Intravitreal eye injections are usually given as course of treatment, meaning that patients may need ongoing treatment over the course of months to years. This is because the effect of the medication injected into the eye usually wears off after a few weeks and the eye injections may need to be repeated in order to control the bleeding or leaking fluid. Often patients may need more eye injections at the beginning of the course of treatment, however if the condition stabilises or improves, fewer eye injections may be required over time. Sometimes if intravitreal eye injections are stopped too quickly, the bleeding or leaking fluid may return and there is a risk of losing vision without eventual recovery. However, with appropriate treatment, intravitreal eye injections can stop blindness and improve vision.
Intravitreal eye injections are performed in our custom-designed procedure rooms under local anaesthetic. Patients do not usually need someone to accompany them to their eye injection appointment, however the vision can be blurred afterwards. If the other eye has poor vision, patients may prefer to have someone assist them home after their eye injection.
What medications are injected into the eye?
Ranibizumab (Lucentis)
Ranibizumab is an anti-VEGF agent (anti Vascular Endothelial Growth Factor) used to treat Wet Macular Degeneration. An anti-VEGF agent is a special immune component (monoclonal antibody) that acts as a chemical signal to the clump of abnormal blood vessels behind and within the retina and tells them to stop leaking fluid and to shrink away. Ranibizumab has been available in Australia since 2006.
Aflibercept (Eylea)
Aflibercept is a newer anti-VEGF agent (anti Vascular Endothelial Growth Factor) used to treat Wet Macular Degeneration. An anti-VEGF agent is a special immune component (monoclonal antibody) that acts as a chemical signal to the clump of abnormal blood vessels behind and within the retina and tells them to stop leaking fluid and to shrink away. Aflibercept has been available in Australia since 2012.
Bevacizumab (Avastin)
Bevacizumab is an anti-VEGF agent (anti-vascular endothelial growth factor). Bevacizumab has been used systemically to treat cancers such as bowel and breast cancer.
Bevacizumab was not designed for use in the eye, but can still be very effective in treating any form of bleeding or leaking of fluid in the eye. It has a similar mode of action to Ranibizumab and Aflibercept which are medications approved for use in Wet Macular Degeneration and around the world doctors have already used this treatment successfully in hundreds of thousands of people. Intravitreal Bevacizumab eye injections can be helpful for conditions such as Diabetic Retinopathy, Diabetic Macular Edema, Retinal Vein Occlusion, myopic macular degeneration, choroidal neovascularization and other forms of bleeding or fluid leaking in the retina, vitreous or macula.
Triamcinolone (Triesence)
Triamcinolone is a type of cortisone (steroid) used for treating fluid swelling or inflammation inside the eye. Intravitreal steroid eye injections are effective in drying up leaky blood vessels in the eye, targeting abnormal growth of the blood vessels and reducing inflammation. Intravitreal Triesence eye injections may be used in conditions such as Cystoid Macular Edema, Uveitis or ocular inflammation, Diabetic Macular Edema or Retinal Vein Occlusion.
Dexamethasone (Ozurdex)
Dexamethasone is a new biodegradable eye implant with sustained-release of cortisone (steroid) used for treating fluid swelling or inflammation inside the eye. The Intravitreal Dexamethasone eye implant is used for the treatment of Diabetic Macular Edema (DME).
Brolucizumab (Beovu)
Brolucizumab is the latest anti-VEGF (anti-Vasuclar Endothelial Growth Factor) agent used to treat Wet Macular Degeneration. An anti-VEGF agent is a special immune component (monoclonal antibody) that acts as a chemical signal to the clump of abnormal blood vessels behind and within the retina and tells them to stop leaking fluid and to shrink away. Brolucizumab was approved by the Therapeutic Goods Administration (TGA) in January 2020 for limited use under an early access scheme, of which our retinal specialists are taking part in. Brolucizumab is not currently listed on the Pharmaceutical Benefits Scheme (PBS).
Ocriplasmin (Jetrea RTU)
Ocriplasmin is a truncated form of the human enzyme plasmin and can be used to treat Vitreomacular Traction without the need for surgery. It works by chemically breaking form matrix proteins involved in the adhesion between the vitreous and the retina. Ocriplasmin in the form of a Ready to Use syringe was listed on the Pharmaceutical Benefits Scheme in January 2020.