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Vision-saving eye injections

Known as intravitreal jabs, these injections offer renewed hope for people suffering from a variety of retinal conditions.

For preventing vision loss due to retinal conditions, an injection is giving better outcomes than other alternatives, such as lasers.

A SNEC study found that injections of anti-VEGF (vascular endothelial growth factor) drugs could arrest vision decline in about 95% of patients with exudative age-related macular degeneration (AMD). Exudative AMD is said to occur when new blood vessels grow from beneath the macula, the central area of the retina, which is the light-sensing nerve tissue at the back of the eye. This irreversible condition is one of the leading causes of blindness in people aged 50 and above. The anti-VEGF drugs block the growth of these abnormal blood vessels. The study was published in the scientific journal Ophthalmology Retina in late 2019.

Before anti-VEGF drugs came on the scene, lasers were used to treat exudative AMD, but the results for patients were not great. “With the advent of anti-VEGF injections, we are able to preserve vision and maintain stability of their condition,” said Dr Shaun Sim, Consultant, Medical Retina Department, SNEC. “Anti-VEGF injections, the most common among intravitreal (IVT) jabs, or a shot of medicine into the eye, are a game-changer in treating exudative AMD.”

Besides exudative AMD, IVT injections of anti-VEGF can also be used to treat other retinal conditions, such as retinal vein occlusion (a blockage of the small veins that carry blood away from the retina) and diabetic retinopathy (an eye disease that affects people with diabetes). These two conditions can also be treated with IVT injections of steroids. This method is also suitable for certain patients with eye infections — just swap the drug to an antibiotic, antifungal or antiviral. About 19,000 IVT injections took place in SNEC in 2020, almost four times more than the approximately 5,000 that were conducted in 2013.

The remarkable thing about IVT injections is how quick and painless they are. The patient experiences minimal pain — thanks to anaesthetic eye drops used to numb the eye — and the entire process lasts approximately five to 10 minutes, Dr Sim assured.

Another plus for IVT injections is the rarity of infections and severe side effects, although Dr Sim advised that some patients may experience dry eyes and discomfort, which may simply be relieved with eye drops; they may even resolve on their own. Other patients may experience a tiny blood clot at the needle entry point, but this will usually heal within one to two weeks.

Adapted from ‘Eye injections can save vision’, Singapore Health (Nov/Dec 2021).

Photo by Mark Lee, for Singapore Health

Click here to check out other articles in SINGVISION Issue 2/2021.