Anti-VEGF therapy
Anti-VEGF therapy represents one of the greatest advances in the treatment of retinal disease in the past few decades. Anti-VEGF drugs block vascular endothelial growth factor (VEGF) - a protein that drives the formation of new, abnormal blood vessels in the eye. By stopping this process, the therapy protects remaining vision and in many patients contributes to its improvement.
When is it needed?
Anti-VEGF therapy is used in diseases of the macula and retina in which pathological blood vessel growth threatens central vision:
Wet form of age-related macular degeneration
Wet (exudative) AMD develops when the body, in response to reduced circulation and oxygen deficiency in the tissues, begins to form new blood vessels under the retina in the area of the macula - choroidal neovascularisation (CNV). These blood vessels are unstable and prone to leaking and bleeding, causing fluid to enter the tissue, creating oedema, and leading to rapid damage to central vision.
Anti-VEGF therapy is the most effective way to stop this process and the only therapy that can contribute to vision improvement in these patients.
Myopic macular degeneration
In high degrees of myopia (pathological myopia), the eyeball is enlarged, the retina is thinned, and prone to microtears. These microtears trigger the formation of new blood vessels under the macula (CNV), which - as in AMD - leak and bleed, causing image distortion, reduced sensitivity to colour and light, and loss of central vision.
Anti-VEGF therapy is the most effective way to stop the progression of this process.
Diabetic retinopathy with macular oedema
Prolonged high blood sugar damages the small blood vessels of the retina, which begin to leak and become blocked. The macula, as the most sensitive part of the retina, is particularly affected - macular oedema (diabetic maculopathy) develops, leading to blurred vision, difficulty reading, and image distortion. In advanced stages, new, unstable blood vessels develop, further threatening vision.
Anti-VEGF injections reduce the oedema and stop further growth of abnormal blood vessels.
Central retinal vein occlusion
Central retinal vein occlusion occurs when a clot blocks the central retinal vein and disrupts circulation - similar to a stroke, but in the eye. The resulting ischaemia triggers rapid development of new, unstable blood vessels that can bleed and lead to sudden vision loss or even neovascular glaucoma.
Anti-VEGF therapy, often combined with laser treatment, slows this process and reduces the risk of serious complications.
How is it performed?
The therapy is delivered as an intravitreal injection - the medication is injected directly into the vitreous body of the eye. The procedure is performed under sterile conditions with local anaesthetic drops and takes only a few seconds. Patients do not feel pain during the procedure.
What to expect?
There are several types of anti-VEGF drugs, and the choice of preparation depends on the diagnosis and the doctor's assessment. Each preparation has a somewhat different dosing protocol, but the common principle remains the same: therapy begins with more frequent injections, then intervals are gradually extended.
Typically, the first three doses are given monthly - this is the loading phase that establishes a stable therapeutic effect. After that, based on OCT imaging of the macula and clinical assessment, the doctor determines the further schedule: check-up most often after 6 months, then after one year. In some patients the intervals between injections can be longer; in others, more frequent maintenance is needed depending on the eye's response to therapy.
Anti-VEGF therapy stops disease progression but does not treat its cause. Regular check-ups are essential for long-term vision preservation.
At Milmedic Clinic, we are dedicated to following all developments in the field of retinal therapy and are proud to be pioneers in introducing innovative anti-VEGF drugs in Belgrade and Serbia.
Anti-VEGF therapy at Milmedic Clinic is delivered by an experienced team of specialists led by Prof. Dr Miroslav Vukosavljević, Prof. Dr Dragana Ristić, Dr Nenad Petrović, and Dr Elisaveta Stanić.
Frequently asked questions
Can anti-VEGF therapy improve vision or does it only stop deterioration?
For certain conditions, such as wet AMD, the therapy can contribute to real vision improvement, especially when started early. However, the primary goal is stabilisation and prevention of further vision loss. The outcome depends on the diagnosis, stage of disease, and the individual response of the eye to therapy.
What happens if I am late for my next injection?
Regularity of therapy is key - delaying injections can lead to renewed fluid accumulation and disease progression. If you are unable to come at the scheduled time, please contact the clinic so we can arrange a new appointment as soon as possible.
Do I need to bring someone with me?
Yes, after the procedure the eye will be covered for safety reasons until the mandatory follow-up the next day, so bringing a companion is essential.
An injection that takes seconds - and protects vision for years.
With regular treatment and check-ups, anti-VEGF therapy is the most effective way to stop retinal disease progression.