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Intravitreal anti-VEGF drugs have a low incidence of adverse side effects compared with intravitreal steroids, but are often requiring repeated injections. They are the treatment of choice for macular edema or neovascularization. The mechanism of action and duration of anti-VEGF effect on macular edema is currently unknown.
The causes of macular edema are numerous and different causes may be inter-related. It is commonly associated with diabetes.Chronic or uncontrolled diabetes type 2 can affect peripheral blood vessels including those of the retina which may leak fluid, blood and occasionally fats into the retina causing it to swell.
As an intravitreal injection, triamcinolone acetonide has been used to treat various eye diseases and has been found useful in reducing macular edema. [17] Drug trials have found it to be as efficient as anti- VEGF drugs in eyes with artificial lenses over a two-year period.
Intravitreal injection was first mentioned in a study in 1911, in which the injection of air was used to repair a detached retina. [6] [7] [8] There were also investigations evaluating intravitreal antibiotics injection using sulfanilamide and penicillin to treat endophthalmitis in the 1940s, yet due to the inconsistency of results and safety concerns, this form of drug delivery was only for ...
Ranibizumab, sold under the brand name Lucentis among others, is a monoclonal antibody fragment created from the same parent mouse antibody as bevacizumab.It is an anti-angiogenic [16] that is approved to treat the "wet" type of age-related macular degeneration (AMD, also ARMD), diabetic retinopathy, and macular edema due to branch retinal vein occlusion or central retinal vein occlusion.
The number of injections tripled to 15,000 in 2002 when triamcinolone injections were first used to treat diabetic macular oedema. [2] [3] This use continued to drive an increase to 83,000 injections in 2004. [2] In 2005 bevacizumab and ranibizumab intravitreal injections for the treatment of wet-AMD caused a rise in injections to 252,000. [2]
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