Anti-VEGF Injections for AMD: Effectiveness, Risks, and What to Expect

Learn how anti-VEGF injections help treat wet age-related macular degeneration (AMD), their effectiveness, safety profile, and what patients should know.

By Medha deb

Created on Sep 25, 2025

Anti-VEGF Injections: Success Rates for Age-Related Macular Degeneration (AMD)

Age-related macular degeneration (AMD) is one of the leading causes of severe vision loss among older adults. The advent of anti-vascular endothelial growth factor (anti-VEGF) injections has revolutionized treatment, especially for the more aggressive ‘wet’ form of AMD. This article offers a detailed look at how anti-VEGF injections work, their effectiveness, possible side effects, costs, and answers to frequently asked questions.

Understanding AMD and Blood Vessel Growth

Age-related macular degeneration affects the macula, the central part of the retina responsible for sharp, detailed vision. There are two types of AMD:

Dry AMD: The more common form; involves gradual thinning and degeneration of the macula, leading to slowly progressive blurring of central vision.
Wet AMD: Less common but more severe; results from excessive growth of fragile blood vessels under the macula, triggered by high levels of vascular endothelial growth factor (VEGF). These vessels leak fluid or blood, leading to rapid and significant vision loss.

While dry AMD progresses slowly, untreated wet AMD can cause sudden and serious vision impairment and is responsible for most advanced cases of blindness due to AMD.

What Is an Anti-VEGF Injection?

Anti-VEGF injections are currently the most effective and commonly used treatment for wet AMD. VEGF, a protein that stimulates blood vessel growth, is normally beneficial for healing and tissue growth in the body. However, excessive VEGF in the eyes leads to damaging, leaky blood vessels under the macula. Anti-VEGF drugs block this activity, helping control or reverse vision loss.

A trained ophthalmologist delivers anti-VEGF medication directly into the vitreous cavity of the eye, typically every 4 weeks for active disease.
The intravitreal route ensures the drug acts locally on the retina without affecting other organs where VEGF is needed.

By inhibiting abnormal blood vessel growth and leakage, anti-VEGF therapies can stabilize and sometimes improve vision for many patients.

What’s Inside an Anti-VEGF Injection?

Anti-VEGF injections contain specialized drugs in a sterile solution. There are currently five commonly used anti-VEGF agents for wet AMD:

Aflibercept (Eylea)
Bevacizumab (Avastin)
Brolucizumab (Beovu)
Ranibizumab (Lucentis)
Faricimab (Vabysmo)

Each contains a unique formulation to block VEGF activity. Some use aptamers—short RNA segments—to prevent VEGF from binding to its receptor on blood vessels, stopping the signal for new vessel growth.

Comparing Treatments: Anti-VEGF, Photodynamic Therapy, and Laser Photocoagulation

Other methods exist for treating wet AMD, but anti-VEGF remains the gold standard. Alternatives include:

Photodynamic therapy (PDT): Combines a light-sensitive drug with laser treatment to selectively close abnormal vessels.
Photocoagulation: Uses laser energy to seal or destroy leaky vessels under the retina, but may damage surrounding retinal cells.

Due to its high success rates and ability to preserve more of the central vision, anti-VEGF therapy is preferred for most patients with wet AMD.

How Successful Are Anti-VEGF Injections for AMD?

Research indicates that anti-VEGF therapies provide better efficacy than previous treatments for wet AMD. The majority of patients benefit in several ways:

Most experience stabilization or improvement in vision.
Key studies show 40% or more of patients report stable or improved visual acuity (sharpness of vision), with some gaining significant reading ability within the first two years of therapy.
Meta-analyses of randomized trials confirm that anti-VEGF drugs achieve superior outcomes compared to non-anti-VEGF treatments.

Anti-VEGF Drug	Brand (Common Name)	Notes
Aflibercept	Eylea	FDA-approved for wet AMD; used every 4-8 weeks after loading doses.
Bevacizumab	Avastin	Off-label; cost-effective; similar efficacy to FDA-approved agents in many studies.
Brolucizumab	Beovu	Latest generation; may allow for longer intervals between treatments.
Ranibizumab	Lucentis	Pioneering agent in AMD therapy; widely used and studied.
Faricimab	Vabysmo	Dual-action, targets two pathways; approved for extended dosing schedules.

Long-term data: Many patients require ongoing injections for several years. While initial improvements in vision are often observed within months, sustained treatment is needed to maintain these gains. Some studies show that visual improvement may stabilize or decline slightly over many years, depending on overall health and adherence to treatment schedules.

Risks and Side Effects

Anti-VEGF injections are generally considered safe, with most adverse effects being mild and transient. Potential side effects include:

Mild irritation, discomfort, or redness at the injection site
Temporary blurring of vision
Increased sensitivity to light for a short period after the injection

Rare but serious risks:

Eye infection (endophthalmitis)
Retinal detachment
Minor bleeding inside the eye
Elevated intraocular pressure

Some studies have noted infrequent systemic effects, such as high blood pressure or rare complications in organs like the kidneys, especially in individuals with preexisting conditions. However, these remain under investigation and are much rarer than localized side effects. Your ophthalmologist will review your risks and monitor you over time.

What Does the Injection Procedure Involve?

If you are receiving anti-VEGF therapy, here’s what you can expect:

A numbing agent or anesthetic drops will be applied to your eye to ensure comfort.
The area around your eye will be cleaned and a sterile drape placed.
Your ophthalmologist will use a very fine needle to inject the medication into the vitreous cavity.
The procedure usually takes only a few minutes and is done in an office setting.
You may be asked to avoid heavy activities for a day after the injection.

You might notice floaters or mild irritation that usually resolves quickly. Most people resume their normal activities within a day.

How Often Are Anti-VEGF Injections Needed?

For newly diagnosed wet AMD, treatment is often started monthly, then extended or customized based on the response:

Initial phase: Injections every 4 weeks for several months (the “loading dose” phase)
Maintenance phase: Frequency may be reduced to every 6-8 weeks, or as needed if disease is controlled

Your treatment plan will be determined by your doctor, based on the specific medication, your vision response, and your overall health.

Does the Treatment Work for Everyone?

While anti-VEGF injections help the majority of wet AMD patients, some may not respond as well or may see their vision worsen over time. Variables include:

Underlying health conditions affecting healing
Timeliness of treatment initiation (earlier treatment is usually more successful)
Individual variations in VEGF or vessel response

Long-term studies indicate that between 10% and 30% of patients can experience continued visual decline despite ongoing therapy. Ongoing research aims to improve outcomes and identify alternative or complementary treatments.

Cost of Anti-VEGF Injections

The price of anti-VEGF therapy varies:

Cost per injection differs by drug and healthcare system; some (such as Bevacizumab) are significantly less expensive but may be used “off-label” for AMD.
Insurance coverage varies; most plans cover medically necessary anti-VEGF injections, but you may have out-of-pocket expenses depending on deductibles and copays.
Discuss with your ophthalmology provider and insurance company to anticipate costs and coverage for your recommended drug.

Frequently Asked Questions (FAQs)

What is AMD, and how does it affect vision?

AMD, or age-related macular degeneration, is a common eye disorder causing damage to the macula, crucial for central vision. Wet AMD is the form associated with rapid vision loss due to abnormal blood vessel growth and leakage.

How do anti-VEGF injections work?

Anti-VEGF medications block the action of vascular endothelial growth factor, which stimulates abnormal blood vessel formation under the retina. By preventing this process, the drugs help preserve or improve vision in wet AMD patients.

Will my vision improve with anti-VEGF treatment?

Many people experience stabilized or improved vision, especially if treatment starts early. However, not everyone regains lost sight, and some patients’ vision may decline even with ongoing therapy.

Are there alternatives to anti-VEGF therapy?

Other options include photodynamic therapy and laser photocoagulation, but these are used less frequently and are less effective for most cases of wet AMD.

How long will I need to continue anti-VEGF injections?

Most patients require ongoing treatment—initially monthly, then less frequently—often for several years or the rest of their lives, to maintain vision benefits.

Are anti-VEGF injections painful?

The procedure is generally well tolerated after numbing drops. Some mild discomfort or a scratchy sensation may occur briefly after the injection.

What should I watch for after an injection?

Call your doctor if you experience severe eye pain, sudden decrease in vision, persistent redness, or discharge—these could be signs of a rare infection or complication.

Can I prevent AMD?

There is no guaranteed prevention, but not smoking, eating a healthy diet, managing blood pressure, and regular eye exams can help decrease risk or slow progression.

Summary

Anti-VEGF injections are currently the most effective means of managing vision loss from wet AMD. They offer the possibility of stabilizing or improving vision for a majority of patients. While not free of risks or limitations, especially regarding rare side effects and the need for ongoing treatments, anti-VEGF therapy has significantly improved the outlook for those diagnosed with this serious eye disease. Open, ongoing dialogue with your eye care specialist is essential for managing expectations and achieving the best possible vision outcomes.

References

Author

medha deb

Medha Deb is an editor with a master's degree in Applied Linguistics from the University of Hyderabad. She believes that her qualification has helped her develop a deep understanding of language and its application in various contexts.

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