Dr Moïse Tourabaly · Anti-VEGF

Intravitreal injection (anti-VEGF): how it works

1 · The procedure: an injection into the vitreous

Cross-section of the eye showing an anti-VEGF injection through the sclera into the vitreous. A syringe with a fine needle passes through the white of the eye 3 to 4 mm from the edge of the cornea, at the level of the pars plana, directed towards the centre of the eye. The drug diffuses into the vitreous up to the macula. The eye is anaesthetised locally with eye drops. macula optic nerve vitreous Pars plana 3 to 4 mm from the limbus Anaesthesia local (eye drops)

Carried out in the office under local anaesthesia with eye drops, the injection is given with a very fine needle, through the pars plana (the white of the eye, 3-4 mm from the limbus). Directed towards the centre of the eye, it deposits the drug in the vitreous, which diffuses up to the macula.

2 · How the anti-VEGF works

Two cross-sections of the macula: before treatment with new vessels and oedema, after anti-VEGF with regression. On the left, before treatment: abnormal new vessels and oedema lift the macula. On the right, after the anti-VEGF injections: the abnormal vessels regress and the oedema decreases, and the macula flattens. Before treatment new vessels + oedema After anti-VEGF oedema resolved

VEGF is a protein that promotes abnormal, leaky vessels. By blocking it, the anti-VEGF makes these vessels regress and the oedema resolve. Several injections, spaced out and monitored by OCT, are generally needed.

Indicative diagram, with no diagnostic value. The indications, the rhythm of the injections and the results vary from one patient to another and with the condition (wet AMD, diabetic macular oedema, vein occlusion).