Visual Outcome of Anti-vascular Endothelial Growth Factor Injections at the University College Hospital, Ibadan

Abstract

Aim: The aim of the study was to evaluate the 1-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 1 year of follow-up. The outcome measures were change in best-corrected visual acuity (BCVA) over 1 year of follow-up, the number of injections taken, and complications. Results: The mean age was 61.1 ± 16.3 years (male-to-female ratio of 1:1.1) and about 62.1% above >60 years. A total of 330 injections were given during the period audited. The mean number of injections was 1.8 ± 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-to-severe visual impairment 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 ± 0.91 logarithm of minimum angle of resolution (logMAR) at baseline to 1.50 ± 1.27 logMAR at 1 year. The logMAR letters gained was 23 at 1 month and 8.25 at 1 year; the eyes that had three injections gained 10 letters, while those that had one injection gained three letters. Eyes with age-related macular degeneration and idiopathic polypoidal choroidopathy gained 7.5 and 9 letters, respectively, at 1 year after at least three injections. There was a statistically significant association between an increasing number of injections and improved visual outcome (P = 0.043). 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 intravitreal anti-VEGF injections in 1 year. It is recommended that patients should have more than one injection.