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When you have diabetic macular edema (DME), the blood vessels in your eye start to leak fluid into the macula. This part of the eye is responsible for sharp, clear vision. When DME progresses, you start to get blurry or distorted vision. If untreated, it can lead to permanent vision loss. So, when diagnosed, treatment will start right away. The first-line approach is called anti-VEGF therapy. These medications help limit the protein in your body that forms new blood vessels. When effective, anti-VEGF can reduce swelling and improve vision! Here is an overview of how these drugs work, the most common forms, and potential side effects.
VEGF and Anti-VEGF Therapy
VEGF stands for vascular endothelial growth factor. It is a protein that your body naturally makes to help form new blood vessels when needed. This can be when you have an injury or to help your muscles grow after a workout. They also are particularly important in babies as they grow and develop in the womb. However, in certain eye diseases like DME, the body starts to make too much VEGF. This can cause abnormal blood vessels to grow in the retina. These fragile blood vessels leak fluid and blood, leading to swelling and vision problems.
Anti-VEGF therapy is a treatment that blocks VEGF to stop these abnormal blood vessels from growing in the retina. This helps reduce swelling, stops further vision loss, and, in some cases, even improve vision. The therapy is given through injections directly into the eye.
How Are Anti-VEGF Treatments Given?
First, your ophthalmologist will give you numbing eye drops to help with any pain. Then, the doctor will insert the needle into the white part of your eye called the sclera. Within the sclera is a substance called the vitreous, which is the gel-like substance inside your eye. This is where the anti-VEGF drug is injected. Although it sounds frightening, this is actually a very safe and painless procedure and only takes a few seconds. Your doctor may give you instructions to avoid rubbing your eye or getting it wet for a day or two. Some people have mild discomfort, redness, or floaters, but these symptoms usually go away within a few days.
Types of Anti-VEGF Medications
There are quite a few anti-VEGF medications used to treat DME. These include:
- Avastin (Bevacizumab)
- Lucentis (Ranibizumab)
- Eylea (Aflibercept)
- Beovu (Brolucizumab)
- Vabysmo (Faricimab)
All of these medications work by blocking VEGF, though they may have differences in the timing in which they're administered, cost, and effectiveness. Your doctor will choose the best option based on your condition and how you respond to the treatment.
How Effective is Anti-VEGF Treatment?
Anti-VEGF therapy has been shown to significantly improve vision for many people with diabetic macular edema (DME). Clinical Studies have found Anti-VEGF medications can reduce swelling in the retina and help restore clarity of vision — especially when treatment is started early and followed consistently. While individual responses vary, most patients experience meaningful benefits over time. However, real-world outcomes don’t always match clinical trial results, often because patients miss appointments or face challenges with cost and access. Sticking to the recommended treatment plan gives the best chance of protecting and improving your vision.
Are There Any Side Effects?
Anti-VEGF injections are generally safe, but there are some side effects to be aware of. The most common are:
- Mild eye discomfort.
- Redness in the eye.
- Floaters (small dark shapes in vision).
It is rare, but sometimes there can be serious complications from anti-VEGF therapy. Infection or retinal detachment can happen to some patients. There is also a higher risk of stroke in people taking certain anti-VEGF therapies.
If you’ve been diagnosed with DME, it is important to work with your doctor to find the best treatment plan. Anti-VEGF therapy has helped many people keep their vision and even regain some lost sight. By staying on top of treatments and managing your diabetes, you can protect your eye health for years to come. If you have any concerns about DME or anti-VEGF therapy, talk to your doctor to learn more about your options.
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