Switching Anti-VEGF Injections

Last updated: September 2022

Yippee! I’m switching to Eylea for my next injection. I’ve read that some people can be helped by a change. When one thing stops working, you try something else.

Time to try something new

At my most recent visit, I remembered to ask my retinal specialist (RS) if it was time to switch to a different medication or if a different medication might help.

After researching what credible options were available, I discovered an article that stated that aflibercept (Eylea) therapy appears to be beneficial in a subset of patients who exhibit recurrent or resistant intraretinal or subretinal fluid following multiple injections with either bevacizumab (Avastin) or ranibizumab (Lucentis). That’s me!1

Waiting a bit before a new medication

When one thing stops working, you try something else. Do I sound like I’m getting my hopes too high? Perhaps, but even my allergist recommends switching antihistamines every so often to have the most benefit.

My retina specialist says it’s not quite the same, as the anti-VEGF injections are different but similar in their makeup. He gave me a quick science lesson on it, but different but similar is my takeaway, or what I can remember of it.

My RS also prefers to wait a bit after a new medication is approved to see if any adverse effects occur. Which has happened in the past.

I’ve had injections of Avastin in my left eye for almost 6 years with great success initially. It worked so well that for a time the injections were spaced out to 12 weeks. Then came the visit where the computer screen showed the choroidal neovascularization was not responding to treatment.

Minimizing the number of injections

As I’ve written about previously, we shortened the time between injections. But at 5-week intervals, that fluid spot showing on the optical coherence tomography (OCT) picture is still there, even looking like it might be slightly bigger and closer to the macula. And my vision is still slowly declining.

The geographic atrophy in my right eye is slowly increasing as well. The Amsler grid which I check regularly has become rather depressing. With no real help for geographic atrophy, I’ve become more reliant on this wet left eye.

Unpredictable progression timelines

I take my AREDS 2, as I know my right eye can advance to wet anytime. After 5 years, the odds of the second eye advancing are high.

I should have asked if the second eye advances to wet, would my body be so accustomed to Avastin that I would need to start on a different medication. Hopefully, I will never need to find out.

Deciding to switch to Eylea

I am constantly researching what is new, or what new information has been discovered from a previous study. There is not a lot new available for choroidal neovascularization.

But my retinal specialist says there are ongoing clinical trials that look promising. As well as some fairly new to the market which may have unexpected consequences in the future.

After discussing what was available, my RS suggested Eylea. He felt it showed the best results when another wasn’t helping as it previously had. Just what my research had found! Although I didn’t take up his time telling him that. I am just thankful he takes the time to listen, show me on the computer, and explain.

The saga continues.

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