Common Side Effects of Anti-VEGF Injections

Anti-VEGF injections for macular degeneration, including medications like Lucentis, Eylea, and Avastin, have become the standard treatment for wet age-related macular degeneration (AMD). While generally well-tolerated, patients should be aware of several common side effects that typically resolve within days after the procedure.

The most frequently reported side effects include eye redness, increased sensitivity to light, and a feeling of having something in the eye. These symptoms usually subside within 24-48 hours. Some patients may also experience small subconjunctival hemorrhages (blood spots on the white of the eye) that clear up without treatment. Temporary increases in intraocular pressure can occur immediately after the injection but typically normalize within 30 minutes.

Serious Complications to Monitor

Though rare, more serious complications can develop following intravitreal injection procedures. The most concerning is endophthalmitis, an infection inside the eye that occurs in less than 0.1% of injections. Symptoms include increasing pain, redness, light sensitivity, and vision decline 1-5 days after injection. This requires immediate medical attention.

Retinal detachment represents another rare but serious complication. Patients might notice flashes of light, new floaters, or a curtain-like shadow across their vision. Inflammatory responses can also occur, with some patients experiencing uveitis (eye inflammation) or vitritis (inflammation of the vitreous). Traumatic cataract is a potential risk if the needle contacts the lens during injection, though modern techniques have minimized this complication.

Treatment Comparison and Side Effect Profiles

Different anti-VEGF medications used for macular degeneration have varying side effect profiles worth considering when choosing treatment options:

Lucentis (ranibizumab) by Genentech was specifically developed for eye conditions and has a well-established safety record. The Lucentis injection cost tends to be higher than some alternatives, but it has fewer systemic side effects.

Eylea (aflibercept) from Regeneron offers potentially fewer injections per year for some patients. In the Eylea vs Beovu comparison, Eylea has shown slightly lower rates of intraocular inflammation.

Beovu (brolucizumab) by Novartis requires fewer injections but has been associated with higher rates of intraocular inflammation and retinal vasculitis in some patients.

Vabysmo (faricimab) from Genentech represents a newer option with promising extended duration between treatments. The Vabysmo injection pricing reflects its newer status on the market.

Avastin (bevacizumab) by Genentech is used as an off-label AMD treatment and is considerably less expensive, though it wasn't specifically formulated for eye injection.

Emerging Treatments and Their Safety Profiles

The landscape of wet AMD treatment options continues to evolve with several promising developments that aim to reduce injection frequency while maintaining efficacy:

Long-acting anti-VEGF drugs are in development, potentially requiring only 2-4 injections per year instead of the current 6-12. These formulations must demonstrate comparable safety profiles to gain widespread adoption. Port delivery systems, such as Genentech's implantable reservoir, can deliver medication continuously for months but come with implantation-related risks.

For dry AMD, pegcetacoplan for dry macular degeneration from Apellis Pharmaceuticals targets a different pathway (complement cascade) with its own unique side effect profile. Gene therapy for macular degeneration represents another frontier, with several clinical trials underway evaluating one-time treatments. Early data shows promise, though long-term safety remains under investigation.

Biosimilars for AMD treatment are entering the market as patents expire on original medications. These alternatives must demonstrate similar safety and efficacy profiles to their reference products while potentially offering cost advantages.

Managing and Minimizing Side Effects

Several strategies can help reduce the risk and severity of side effects following macular degeneration injections:

Pre-injection preparation is crucial - patients should follow all instructions regarding antibiotic drops if prescribed. Proper sterilization techniques during the intravitreal injection procedure significantly reduce infection risk. Many retina specialists perform injections in specialized procedure rooms rather than operating rooms, maintaining strict sterile protocols.

Post-injection care matters greatly. Patients should avoid touching or rubbing the eye for at least 24 hours. Swimming and activities that might contaminate the eye should be avoided for several days. Many doctors recommend avoiding eye makeup for at least a day after injection.

Monitoring for warning signs is essential. Patients should immediately report increasing pain, vision loss, extreme light sensitivity, or discharge to their physician. Most retina specialists provide emergency contact information for after-hours concerns related to recent injections.

Conclusion

While macular degeneration injections can cause side effects ranging from mild discomfort to rare serious complications, they remain the most effective treatment for preserving vision in wet AMD. The benefits typically outweigh the risks for most patients. Ongoing research into longer-acting formulations and alternative delivery methods aims to reduce both injection frequency and associated side effects. Patients should maintain open communication with their retina specialists about any concerns and report unusual symptoms promptly. With proper care before and after injections, most side effects can be minimized or managed effectively, allowing patients to receive the vision-preserving benefits these treatments provide.

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This content was written by AI and reviewed by a human for quality and compliance.