Wakala wa Anti VEGF
VEGF ni nini?
Sababu ya Ukuaji wa Mishipa ya Endothelial (VEGF) ni protini inayozalishwa katika mwili wa binadamu ambayo inawajibika kwa utengenezaji wa mishipa mpya na kuitunza. Chini ya hali isiyo ya kawaida kama vile retinopathy ya kisukari, kuziba kwa mishipa ya damu na kuzorota kwa seli zinazohusiana na umri husababisha uundaji wa mishipa isiyo ya kawaida ambayo huvuja damu, kuvuja na hatimaye kusababisha malezi ya kovu na kupoteza uwezo wa kuona.
Mawakala wa anti VEGF ni nini
Anti Vascular endothelial Growth factor (anti VEGF) mawakala kundi la dawa zinazozuia shughuli ya VEGF na hivyo kupunguza athari zisizo za kawaida za VEGF.
How are these anti VEGF agents different from one another
|
|
Bevacizumab |
Ranibizumab |
Aflibercept |
Brolucizumab |
|
Molecule |
Monoclonal antibody |
Antibody fragment |
Fusion protein |
Single chain antibody |
|
Molecular weight |
149 kDa |
48kDa |
97-115 kDa |
26 kDa |
|
Clinical dose |
1.25 mg |
0.5 mg |
2 mg |
6 mg |
|
FDA approval |
Not approved |
Approved |
Approved |
Approved |
|
Intravitreal anti VEGF activity |
4 weeks |
4 weeks |
Upto 12 weeks |
Upto 12 weeks |
Je, matibabu ya anti VEGF yameathiri vipi usimamizi wa hali mbalimbali za macho
Anti VEGF agents when administered under appropriate conditions act at molecular level countering the action of VEGF and thereby reducing the morbidity.
Many diseases which were considered untreatable earlier like age related macular degeneration are rendered treatable, enabling patients maintain quality vision and subsequent improvement in quality of life
Ocular manifestation of systemic diseases with diabetes hypertension are also now treated with anti VEGF agents, with quality vision being restored and maintained.
What are the common conditions treated with anti VEGF agents and their benefits
|
Disease |
Pathology |
Benefits |
|
Wet age related macular degeneration |
Abnormal vessels at the back of the eye leak fluid and blood, leads to drop in vision |
Abnormal vessels regress with resorption of fluids with subsequent improvement of vision |
|
Leakage of fluid due at the back of the eye leading to swelling and vision drop |
Prevent leakage and reduce swelling |
|
|
Abnormal vessels on the retina which bleed |
Regression of abnormal vessels |
|
|
Retinal vein occlusion |
Swelling of retina due to obstruction of retinal blood vessels |
Resolution of swelling with improvement of vision |
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Je, ninachaguaje aina ya wakala wa anti VEGF
Daktari anayekuchunguza atakuteua mawakala wanaofaa kulingana na mchakato wa ugonjwa na ugonjwa wa kimfumo. Kuvuja damu au majimaji mengi nyuma ya jicho yanayoitwa macula inahitaji matibabu ya haraka. Daktari atafanya vipimo vinavyofaa ili kuthibitisha, kupima na kufuatilia maendeleo ya ugonjwa huo. Maono hupimwa na ni moja wapo ya kigezo cha ufuatiliaji mwitikio wa matibabu
How is the anti-VEGF agent administered
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After clinical examination and relevant scans and making a diagnosis, the doctor will discuss the available options with the patient
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The anti-VEGF agent is administered into the eye by means of a fine needle under sterile conditions in an operation theater.
-
The eyes are numbed with topical anaesthetic agent
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Cleaning of eyes and surrounding structures with an antiseptic solution is done
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Protective sheet called eye drape is applied around the eye
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Eyelids are opened with a clip called an eyelid speculum
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The doctor injects the drug through the white part of the eye through a fine needle
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After injection, gentle massage is done at the site of injection
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The eye clip is removed, and antibiotic drops are instilled in the eye
Antibiotic drops are prescribed for usage after injection in the eye.
What are the anti-VEGF agents available for treatment?
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Bevacizumab
-
Ranibizumab
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Aflibercept
-
Brolucizumab
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Imeandikwa na: Dkt. Mohanraj – Consultant Ophthalmologist, Coimbatore
Frequently Asked Questions (FAQs) about Anti VEGF Agents
1. What are some most common drawbacks of Anti-VEGF injections?
The chances of complications arising after the Anti-VEGF injections are extremely rare. Though most commonly, the problem arises from getting the injection in the eye, not the medicine. Some of the most common drawbacks are as follows-
- Mild pain or ache in the eye can last two or three days
- Floaters- will take a week minimum to get clear
- Sclera may appear bloodshot or bruised
- Eyes may feel rough, irritated, or puffy
These are common drawbacks of Anti-VEGF injections. However, if, in time, they don’t go away, then you should connect with your doctor and get a check-up done.
Je, ni lini sindano ya bevacizumab inatolewa kwa mgonjwa?
Bevacizumab injection is given to treat eye disease to block the abnormal growth of blood vessels in the back of the eye. The abnormal growth can block the vision and cause blood leaks in the eye resulting in vision loss.
The medicine takes approximately one month to show effect and improves vision. Though this depends upon your doctor and if they deem you fit for the eye injection. Patients with central retinal vein occlusion, myopic choroidal neovascularization, diabetic retinopathy, and other eye conditions are given bevacizumab injections.
How to prepare for getting an eye injection?
The procedure is conducted inside the room and under the supervision of an experienced ophthalmologist. The surgeon might ask you to read a chart to check your vision. They will give eye drops to numb your eye, making the process painless.
Upon this, your eye will be cleaned with an ointment to prevent infection. Once done, the surgeon will place a tool to hold your eye open, or it will be hard to inject based on a human’s reflex mechanism.
Then the bevacizumab injection will be inserted in the sclera of your eye (the white part of the eye). The needle is extremely thin so as not to damage the eye or the vessels. The procedure will be painless, considering the numbing eye drops have been applied.
Once the procedure is over, the antiseptic and anaesthetics are washed from the eye and an eye patch is applied. Though an eye patch might not be mandatory, in a few cases, it is advised.
You are advised to consult with your ophthalmologist about what to do and what not to do. Please do not put any eye makeup on, refrain from straining your eye, and do not rub it unnecessarily, or the process might not occur because of eye irritation.
Is bevacizumab and ranibizumab same?
Though both are the most commonly used VEGF agents and have similar active molecule parts, bevacizumab and ranibizumab are different. The Avastin Bevacizumab is the anti-VEGF, whereas ranibizumab is an antibody fragment.
In the systemic circulation, the bevacizumab has an extended half-life compared to ranibizumab. But the latter one is said to have better retina penetration and higher affinity than the Avastin Bevacizumab.
Note that ranibizumab is a monoclonal antibody that slows the abnormal eye blood vessel growth and decreases the leak from these vessels. It falls in the category of vascular endothelial growth factor antibody. It stops vision loss and penetrates the retina to stop the growth.
Will aflibercept injection will help in reading without discomfort?
The aflibercept injection helps in treating the age-related wet macular degeneration that causes the vision loss, or loss in seeing straight, causing discomfort in reading, driving, watching tv or other activities. The solution is injected into the eye sclera with a very thin needle. Once the proper dosage is injected, your eye will be cleaned. After the medicine takes effect, the vision loss will be restored, and you can read without discomfort.
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