Anti-VEGF Injections

Intravitreal drugs that block vascular endothelial growth factor

Overview

Anti VEGF injections are treatments in which drugs that block vascular endothelial growth factor, a signaling protein that promotes blood vessel growth and leakage, are injected directly into the vitreous of the eye. Agents include ranibizumab, aflibercept, brolucizumab, and faricimab, which also blocks angiopoietin 2, while bevacizumab, a cancer drug, is widely used off label. They are standard treatment for neovascular age related macular degeneration, diabetic macular edema, and macular edema from retinal vein occlusion, and are also used in proliferative diabetic retinopathy and retinopathy of prematurity. Before these drugs, wet AMD frequently led to severe central vision loss. The first anti VEGF agent approved for eye use was pegaptanib in 2004, followed by ranibizumab in 2006, and the class transformed outcomes in neovascular retinal disease. Injections are given in a clinic under topical anesthesia and antiseptic preparation and are typically repeated over long periods, so the treatment burden is substantial, and longer acting agents and sustained delivery systems aim to reduce it. Rare risks include endophthalmitis, intraocular inflammation, and retinal detachment.