Therapeutic Injections for Retinal Vascular Diseases
Triamcinolone acetonide is a type of corticosteroid hormone that has been used for years to treat many diseases, including eye disease, allergic reactions, arthritis and skin diseases. This medication, which is administered as an intravitreal injection, can be very successful in reducing swelling in the eye, such as macular edema, one complication associated with retinal vascular diseases including branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO). More than one treatment may be required to treat your macular edema.
The FDA (Food & Drug Administration) has approved use of a long acting Dexamethasone intraocular implant for the treatment of macular edema from CRVO and BRVO. On a case-by-case basis, some patients may benefit from this long-acting steroid implant. Another promising treatment for retinal vascular disease is intravitreal Avastin (bevacizumab) and intravitreal Lucentis (ranibizumab). Avastin was approved by the FDA for use in treating certain types of colorectal and lung cancer. These cancers are stimulated by vascular endothelial growth factor or VEGF. VEGF also stimulates neovascularization and capillary leakage leading to macular edema in patients with BRVO and CRVO. The use of Avastin and Lucentis as an intravitreal injection has been demonstrated to cause a reduction in macular edema and neovascularization for patients with BRVO and CRVO. In some cases, this intravitreal injection may also be used in conjunction with pan-retinal laser photocoagulation in patients with ischemic CRVO. More than one treatment may be required to treat your macular edema.
Our highly skilled retinal specialist performs these therapeutic injections in our clinic on an outpatient basis. Your eye will be numbed for the procedure and the medication will be injected.
Following the procedure, you may experience some mild discomfort in the eye. Most patients will also experience “floaters”, black spots floating across the eye for a couple of days. The most common side effects are blurry vision, redness, and sensitivity to light. Eye injections can also increase your eye pressure. However, the positive effect of reducing the swelling in the macula or decreasing neovascularization and preventing further vision loss more than outweigh the risks.
Although infection rarely results from an eye injection, you should notify your doctor immediately if your symptoms should worsen rather than improve in the days following treatment. While floaters are normal for a few days following the treatment, if you experience flashes of light or a dark veil coming over the eye, this can be an indication of a detached retina. This requires immediate attention. Therefore, do not delay in contacting your doctor.
