Visual outcome of Anti-Vascular Endothelial Growth Factor Injections at the University College Hospital, Ibadan

Abstract

Aim: To evaluate the four-year outcome of intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy in an eye unit in sub-Saharan Africa. Methodology: This retrospective study included 182 eyes of 172 patients managed in the vitreoretinal unit between 2016 and 2019 who were treated with intravitreal anti-VEGF Bevacizumab (1.25 mg/0.05 ml) with at least one year of follow up. The outcome measures were: change in best-corrected visual acuity (BCVA) over one year of follow-up, the number of injections taken and complications. Results: The mean age was 61.1 (SD=16.3) years (M: F of 1:1.1) and about 62.1% were > 60 years. A total of 330 injections were given during the period audited. The mean number of injections was 1.8 (SD=0.93). Ninety-four (51.7%) eyes had only one injection while 33 (18.1%), 50 (27.5%) and 5 (2.7%) had 2, 3 and 4 injections, respectively. About 78.5% had moderate-severe visual impairment (MSVI) at baseline and 44.5%, 16.4%,12.6% and 7.1% at 1, 3, 6- and 12-months post injections, respectively. The mean BCVA improved for all eyes from 1.67 (SD=0.91) logMAR at baseline to 1.50 (SD=1.27) logMAR at one year. The logMAR letters gained was 23 at 1 month and 8.25 at 1 year with a statistically significant association between increasing number of injections and improved visual outcome (p= 0.015). One patient each developed endophthalmitis (0.6%) and inferior retinal detachment (0.6%) post-injection. Conclusion: Visual acuity gain was recorded in patients who had at least two intravitreal Anti-VEGF injections in 1 year. Keywords: Intravitreal injections, bevacizumab (Avastin), ranibizumab (Lucentis), anti-VEGF, visual outcome

Evaluation of Visual Outcome and Clinical Response of Intravitreal Anti Vegf Agents in Various Indications

“…LogMAR further reduced to 1.21±0.50 after second injection. According to Tunji et al [6], the mean BCVA improved for all eyes from 1.67±0.91 at baseline to 1.21±1.01, 1.41±1.09, 1.44±1.17, and 1.50±1.27 at 1 month, 3 months, 6 months, and 1 year, respectively. Patients who had at least three injections were significantly more likely to have better visual outcomes than those who had <3 injections.…”