Anti-VEGF injections into the eye are the most recent and successful treatment for certain retinal diseases including wet macular degeneration, diabetic retinopathy, and retinal vein occlusion. They are the most commonly performed intravitreal injections.
Anti-VEGF injections work by blocking VEGF (vascular endothelial growth factor) a protein that stimulates formation of new blood vessels. This means that the anti-VEGF injections inhibit the growth of abnormal new blood vessels.
Anti-VEGF injection treatments can help to slow visual loss in some retinal diseases, and in some cases may improve sight.
The anti-VEGF injection treatments in current use are Lucentis, Eylea and Avastin.
Avastin: Avastin is an antibody against vascular endothelial growth factor (VEGF), a protein responsible for angiogenesis (new blood vessel growth). Avastin was designed to prevent abnormal blood vessel growth and leakage, and was originally developed to treat some types of cancer. Although Avastin is not approved by the TGA for ocular use, it has proved to be highly efficacious for use in cases of wet macular degeneration and macular oedema. It has been in routine "off label" use for eye disease since 2005.
Lucentis: Lucentis is a modified version of Avastin, designed to be used to treat eye diseases. Like Avastin, it prevents new blood vessel growth and leakage. Lucentis is a smaller molecule than Avastin and may better penetrate into the retina. Numerous large multicentre clinical trials have shown Lucentis to be highly effective in treating wet macular degeneration and other retinal diseases. The CATT trial has shown that Lucentis and Avastin work to about the same degree for patients with wet macular degeneration.
Eylea: Eylea is another designer protein which works by trapping VEGF, and binds tighter to VEGF than Avastin or Lucentis. This tighter binding means that Eylea tends to be active in the eye longer, approximately twice as long as Avastin or Lucentis. Eylea has specifically been designed for use in the eye to treat neovascular (wet) macular degeneration, among other retinal disease, and is approved for this use by the FDA.