Intravitreal

Intravitreal refers to the vitreous body of the eye, the gel-like substance between the lens and the retina. In medical practice, the term is most often used to describe injections or implants delivered directly into the vitreous cavity to treat retinal or sight-threatening conditions.

Most commonly, intravitreal procedures involve injecting medication through the pars plana into the vitreous humor using a fine needle. The injections are performed under sterile conditions, usually with local anesthesia and meticulous antisepsis, often with povidone-iodine prep. The volume is small, and injections are typically repeated at intervals determined by the underlying condition and therapeutic response.

Intravitreal therapy is a cornerstone for treating retinal diseases. Anti-VEGF agents such as bevacizumab, ranibizumab, and aflibercept are widely used for neovascular age-related macular degeneration, diabetic macular edema, and retinal vein occlusions. Corticosteroids, including triamcinolone injections or dexamethasone and fluocinolone implants, may be employed for inflammatory conditions or for persistent edema. Antibiotics can be delivered intravitreally in cases of endophthalmitis or suspected infection. In addition to injections, sustained-release intravitreal implants provide longer-lasting medication delivery for chronic conditions.

Risks are generally low but can be vision-threatening. Potential complications include endophthalmitis (eye infection), transient or sustained elevation of intraocular pressure, cataract progression with repeated injections, vitreous hemorrhage, retinal detachment, and local inflammation. Patients may experience transient discomfort, floaters, or conjunctival hemorrhage. Proper technique and monitoring are essential to minimize risks. Intravitreal therapy remains a primary method for delivering drugs directly to the retina, enabling targeted treatment with relatively rapid effects.