Specialist-led treatment for retinal and macular conditions
At The Retina Clinic London, intravitreal injections are an important treatment option for a number of retinal and macular conditions.
An intravitreal injection delivers medicine directly into the vitreous, the clear gel inside the eye. This allows treatment to reach the retina directly while limiting exposure elsewhere in the body.
Our approach combines specialist assessment with advanced retinal imaging so that the choice of medicine, treatment interval and ongoing monitoring can be tailored to each patient’s condition and response.
What Are Intravitreal Injections?
Intravitreal injections are commonly used to manage retinal conditions involving abnormal blood vessels, leakage, swelling or inflammation.
They may be used in conditions including:
- Wet Age-Related Macular Degeneration (Wet AMD)
- Diabetic Macular Oedema
- Retinal Vein Occlusion
- Uveitis and other inflammatory retinal conditions
- Certain infections inside the eye
- Geographic Atrophy through selected treatment pathways
- Certain inherited retinal diseases through clinical trials
At The Retina Clinic London, treatment is guided by a detailed examination and retinal imaging, including high-resolution Optical Coherence Tomography (OCT).
OCT is a non-invasive scan that provides highly detailed cross-sectional images of the retina, allowing our specialists to monitor fluid, swelling and other structural changes over time.
Why Might Intravitreal Treatment Be Used?
Some retinal diseases cause abnormal blood vessels to grow or leak fluid into the retina. Others cause inflammation or swelling that can affect the macula, the central part of the retina responsible for detailed vision.
Intravitreal medicines can target these processes directly inside the eye.
The most appropriate medicine will depend on the diagnosis, retinal imaging findings, previous treatment and the individual treatment plan agreed with your consultant.
The principal types of intravitreal treatment include:
- Anti-VEGF medicines, which reduce abnormal blood vessel growth and leakage
- Corticosteroids, which help control inflammation and retinal swelling
- Antibiotic or antifungal medicines, which may be required for serious infections inside the eye
- Other specialist or investigational treatments, including selected therapies delivered through clinical trials
Anti-VEGF Injections
VEGF stands for vascular endothelial growth factor. It is a naturally occurring protein involved in the formation of blood vessels.
In some retinal diseases, excessive VEGF contributes to abnormal blood vessel growth and leakage. Anti-VEGF medicines work by blocking this activity.
They are widely used in the treatment of conditions such as:
- Wet AMD
- Diabetic Macular Oedema
- Macular oedema associated with Retinal Vein Occlusion
- Other selected retinal vascular conditions
Anti-VEGF medicines used in retinal treatment include:
- Faricimab (Vabysmo)
- Aflibercept (Eylea)
- Aflibercept biosimilar (Afqlir)
- Ranibizumab (Lucentis)
- Bevacizumab gamma (Lytenava)
The choice of medicine is made by your consultant following assessment of your eyes, retinal imaging, previous treatment history and individual clinical requirements.
What Are Biosimilars?
Biosimilars are biological medicines that have been developed to be highly similar to an already approved biological medicine, known as the reference medicine.
Biological medicines are made using living cells or organisms and are more complex than conventional medicines. For this reason, a biosimilar is not described as an identical copy in the same way as a traditional generic tablet.
Instead, biosimilars undergo detailed regulatory assessment to demonstrate that they are highly similar to their reference medicine and that there are no clinically meaningful differences in their expected quality, safety or effectiveness.
Why Are Biosimilars Important?
One of the important advantages of biosimilars is cost.
Biosimilars are generally available at a lower cost than the original reference medicine. The introduction of biosimilars also creates greater competition between manufacturers, helping to make established biological treatments more cost-effective.
For patients who may require repeated injections over a prolonged period, this can be particularly important. Where clinically appropriate, the use of a biosimilar can allow treatment to be provided at a lower overall cost.
A lower price does not mean a lower regulatory standard. Biosimilars must meet rigorous requirements for quality, safety and effectiveness before they can be authorised for use.
They therefore offer patients and clinicians greater choice while maintaining the expected clinical standards of the reference biological treatment.
Afqlir: A Biosimilar of Eylea
At The Retina Clinic London, we currently offer Afqlir, a biosimilar of Eylea.
Both medicines contain the active substance aflibercept, an anti-VEGF medicine used to treat several retinal conditions.
Afqlir has been developed and assessed as a biosimilar to the established 2 mg formulation of Eylea. This means that it has demonstrated high similarity to the reference medicine, with no clinically meaningful differences expected in quality, safety or effectiveness.
For suitable patients, Afqlir can provide access to established aflibercept treatment at a lower overall cost than the reference medicine.
The decision to use Afqlir, Eylea or another anti-VEGF medicine is made by your consultant in conjunction with you, the patient, following a detailed assessment of your condition, retinal imaging, previous treatment history and individual treatment needs.
Steroid Injections and Implants
Corticosteroid treatments may be used to reduce inflammation and retinal swelling in conditions such as:
- Diabetic Macular Oedema
- Retinal Vein Occlusion
- Uveitis
- Other selected inflammatory retinal conditions
Treatment options can include:
Dexamethasone Implant (Ozurdex)
Ozurdex is a biodegradable implant designed to release corticosteroid treatment gradually inside the eye.
Fluocinolone Acetonide Implant (Iluvien)
Iluvien is a longer-acting corticosteroid implant that may be considered for selected patients.
Triamcinolone Acetonide
Triamcinolone is an injectable corticosteroid that can be used in selected circumstances.
Steroid treatment requires careful assessment and monitoring. Your consultant will discuss the potential benefits, limitations and appropriate follow-up if this treatment is being considered.
Antibiotic and Antifungal Injections
Serious infections inside the eye may require antibiotic or antifungal medicines to be delivered directly into the vitreous.
These conditions require prompt specialist assessment and treatment.
Other and Emerging Intravitreal Treatments
Intravitreal delivery is also used or being investigated for newer retinal therapies.
At The Retina Clinic London, selected patients may have access to innovative treatments or clinical research programmes where appropriate and subject to eligibility.
For Geographic Atrophy, a late form of Dry AMD, pegcetacoplan (Syfovre) may be available through selected pathways on a named-patient basis.
Participation in any clinical trial is voluntary and depends on the eligibility criteria of the individual study.
How Do I Prepare for an Intravitreal Injection?
Our team will provide specific instructions before treatment.
General preparation may include:
- Tell your consultant about your medical history, current medicines and any allergies.
- Let the clinic know if you develop an eye infection, significant redness or another acute illness before your appointment.
- Avoid eye make-up on the day of treatment.
- Follow any individual instructions provided by your clinical team.
- Be aware that your vision may be temporarily blurred following examination or treatment, particularly if dilating drops have been used.
What Happens on the Day?
Assessment and Imaging
Before treatment, your consultant will review your vision and examine the eye.
High-resolution OCT and, where appropriate, other advanced retinal imaging may be performed to assess the retina, monitor the response to previous treatment and determine whether further treatment is required.
Anaesthetic and Antiseptic Preparation
Anaesthetic drops are used to numb the surface of the eye.
The eye and surrounding area are then carefully prepared using antiseptic measures designed to minimise the risk of infection.
The Injection
A very fine needle is used to place the medicine into the vitreous cavity.
The injection itself is brief. Patients may notice pressure or a momentary sensation during the procedure, but anaesthetic is used to keep discomfort to a minimum.
Immediately Afterwards
The eye is checked as appropriate and our clinical team will provide clear aftercare instructions.
Some temporary blurring, small moving spots or mild irritation can occur following an injection.
When Should I Seek Advice After an Injection?
Although serious complications are uncommon, it is important to seek prompt advice if you experience a significant deterioration following treatment.
Symptoms requiring urgent assessment can include:
- Increasing or severe eye pain
- Increasing redness
- A marked or sudden reduction in vision
- Increasing sensitivity to light
- A sudden increase in floaters
- Flashes of light
- A curtain or shadow appearing across the vision
Our team will explain how to contact us if you have concerns following your procedure.
How Do We Monitor Treatment?
Intravitreal treatment is often part of an ongoing treatment pathway rather than a single isolated procedure.
At The Retina Clinic London, advanced retinal imaging allows us to monitor changes over time and assess how the retina is responding.
Depending on the condition, monitoring may include:
- Optical Coherence Tomography (OCT)
- OCT Angiography
- Ultra-widefield retinal imaging
- Visual acuity testing
- Detailed specialist retinal examination
Treatment frequency and follow-up are determined by your consultant according to the condition and its response.
Why Choose The Retina Clinic London?
Every intravitreal injection pathway at The Retina Clinic London is built around careful diagnosis, precise retinal imaging and specialist-led decision-making.
Comprehensive Assessment
Advanced retinal imaging allows us to evaluate structural changes and disease activity before making treatment decisions.
Personalised Choice of Treatment
We offer a broad range of established and newer retinal medicines, allowing treatment to be selected according to the individual clinical situation.
Access to Cost-Effective Biosimilar Treatment
Biosimilars provide an additional option within modern retinal treatment, combining established biological therapy with the potential for a lower overall treatment cost.
At The Retina Clinic London, we currently offer Afqlir, an aflibercept biosimilar of Eylea, for patients in whom this treatment is considered appropriate.
This gives our consultants and patients greater choice when developing a personalised anti-VEGF treatment plan.
Specialist Retinal Expertise
The Retina Clinic London is led by Professor Paulo Stanga and provides specialist assessment and treatment across a wide range of retinal and macular conditions.
Advanced Imaging and Monitoring
Treatment decisions can be supported by high-resolution OCT and other advanced retinal imaging technologies, enabling close monitoring of changes in the retina over time.
Comfort, Safety and Continuity of Care
Intravitreal injections are performed using established aseptic techniques, with careful preparation, monitoring and aftercare.
Our team remains available to support patients throughout their treatment pathway.
Book a Consultation
If you would like to discuss intravitreal injections, anti-VEGF treatment, biosimilars, Afqlir, Eylea or steroid treatment, the first step is a specialist consultation.
To book your consultation, please call us on +44 (0)20 4548 5310.
We’ll be glad to guide you through the next steps.