Intravitreal Injection

Frequently asked questions

What are VEGF inhibitors?

VEGF stands for vascular endothelial growth factor, a substance released by the retina that promotes the growth of new blood vessels. While this is a normal process in the body and eye, in certain diseases, VEGF causes excessive and abnormal growth of blood vessels in the retina and surrounding tissue.

Three common conditions involving this process are wet macular degeneration, diabetic retinopathy, and retinal vein occlusions (often linked to high blood pressure). In these diseases, abnormal blood vessels grow and leak fluid into the retina, causing swelling and bleeding, especially in the macula, the area responsible for sharp central vision). Symptoms can include distorted or blurred vision, or loss of central vision.

For many years, these conditions had no effective treatment. However, about 20 years ago, the first VEGF inhibitor was developed, marking a major breakthrough.

VEGF inhibitors work by blocking the action of VEGF, preventing the growth of new abnormal blood vessels and shrinking diseased ones. Because these medications need to act directly where the problem occurs, they are injected into the eye to provide targeted treatment.

 

Which active substances are used?

In Switzerland, the most commonly used VEGF inhibitors are Lucentis (Ranibizumab) and Eylea (Aflibercept). Since 2024, Vabysmo (Faricimab) has also been available. It offers the potential benefit of longer intervals between treatments.

Are the costs covered by health insurance?

Yes, the costs for these medications are covered by health insurance when there is a recognised medical indication. In certain cases, the treating physician may need to submit a request for coverage.

How are the medications administered into the eye?

VEGF inhibitors are injected into the vitreous body of the eye to achieve the highest possible local concentration. The vitreous body is a gel-like substance located behind the lens, conjunctiva, and cornea, and in front of the retina.

To ensure a painless procedure, the eye is numbed using anaesthetic eye drops. The  injection is carried out under sterile conditions in our state-of-the-art, practice-based operating room in Goldau. Before the injection, the eye is carefully disinfected and covered to minimise the risk of infection.

This is an outpatient procedure, and patients can return home immediately afterwards.

Treatment must be repeated at specific intervals, following an established protocol. Typically, it begins with a series of three injections spaced four weeks apart. After each injection, a brief follow-up appointment is scheduled to monitor for potential complications. Around four weeks after the final injection in the initial series, a comprehensive examination is carried out to assess the treatment response and determine the next steps.

It is essential to attend all follow-up appointments and follow your ophthalmologist’s instructions closely to ensure the best possible outcome.

Possible side effects and complications

After the injection, you may experience temporary blurred vision or notice small floating spots or bubbles in your field of vision. In some cases, harmless conjunctival haemorrhages (small red spots on the white matter of the eye) may appear.

Rare complications include bleeding inside the eye, an increase in intraocular pressure, or injury to other structures of the eye. In very rare cases, an injury to the retina may lead to a partial or complete retinal detachment.

As with any injection, there is a risk of infection due to the introduction of introduced pathogens. A rare but serious complication is endophthalmitis, an infection inside the eye.

After the injection, it is important to be alert to specific symptoms such as black spots or shadows, flashes of light, distorted lines, or sudden loss of vision. If you experience any of these, seek immediate ophthalmological care.

In the first few days following the injection, the eye should be protected and allowed to rest. Wearing sunglasses may help, as increased light sensitivity may occur. It is also recommended not to drive on the day of the injection, as vision may be temporarily reduced. Mild discomfort or a foreign body sensation is common and can usually be relieved with lubricating eye drops.

Prognosis

The prognosis depends on the underlying condition and how it progresses over time. Untreated wet macular degeneration or inadequately managed diabetic retinal changes can result in worsening symptoms and a gradual loss of vision. An immediate improvement in vision is not always possible. In many cases, regular injections over an extended period are necessary to maintain visual function. Your ophthalmologist will work with you to determine the optimal interval between treatments based on your individual needs and response to therapy.

After treatment with VEGF inhibitors, regular follow-up examinations of visual acuity and the retina are essential to detect any further deterioration at an early stage and, if necessary, to initiate additional treatment promptly.

Conclusion

The introduction of VEGF inhibitors has marked a significant advancement in the treatment of retinal diseases, particularly macular degeneration, diabetic retinopathy, and retinal vein occlusions. If you are affected by one of these conditions or have questions about eye injections, we encourage you to make an appointment. We are here to support you with expert care and individualised treatment.