Fiebai Bassey, Odogu Victor
Department of Ophthalmology, University of Port Harcourt Teaching Hospital, , Nigeria.
Department of Ophthalmology, Niger Delta University Hospital, Yenagoa, Nigeria.
Open Ophthalmol J. 2017 Oct 31;11:315-321. doi: 10.2174/1874364101711010315. eCollection 2017.
The study aimed to describe our initial experience with the use of anti vascular endothelial growth factors (anti-VEGFs) in the treatment of retinal diseases.
The case records of all patients who had received at least 3 doses of intravitreal anti- VEGF injections between January 2012 to December 2016 were reviewed. Information culled from the data was age, sex, indications for treatment, type of injection, presenting visual acuity, post injection visual acuity, systemic and ocular co morbidities. Results were analyzed using Statistical Package for Social Sciences (SPSS) 20.0 for Windows statistical software.
A total of 190 injections were given during the study period, to 58 eyes of 50 patients. Twenty-eight females (56.00%) and twenty-two males (44.00%) were seen with a mean age of 59.6± 11.66. Bevacizumab was the most frequently administered anti- VEGF, 142 (74.74%) while only 48(25.26%) injections of Ranibizumab were given. Three eyes had both bevacizumab and ranibizumab (1.58%). Retinal vein occlusion 61(32.11%) was the commonest indication for the injections followed by diabetic macular edema 43(22.63%) and proliferative diabetic retinopathy 42(22.11%). Others were neovascular age related macular degeneration, neovascular glaucoma, vitreous hemorrhage, myopic choroidal neovascularization and cystoid macular edema. There was an association between age and disease, (p = 0.001). There was an improvement in visual acuity after intervention in cases with retinal vein occlusion and diabetic macular edema, and this was statistically significant. Hypertension was the commonest systemic disorder in this series 81(42.36%) and the supero-temporal quadrant 131(68.95%) was the most preferred position to administer the injection. Floaters was the commonest complication seen.
Anti VEGFs have become an invaluable tool in the management of a number of retinal diseases in our center. However, the cost implications are a hindrance to an increased uptake of this form of treatment. Cheaper alternative preparations should be made available to encourage the uptake. Government in developing countries should be encouraged to bear the health burden of the old aged pensioner (OAP).
本研究旨在描述我们在使用抗血管内皮生长因子（抗VEGF）治疗视网膜疾病方面的初步经验。
回顾了2012年1月至2016年12月期间所有接受至少3剂玻璃体内抗VEGF注射的患者的病例记录。从数据中筛选出的信息包括年龄、性别、治疗指征、注射类型、就诊时视力、注射后视力、全身和眼部合并症。使用Windows版社会科学统计软件包（SPSS）20.0对结果进行分析。
在研究期间共进行了190次注射，涉及50例患者的58只眼。其中女性28例（56.00%），男性22例（44.00%），平均年龄为59.6±11.66岁。贝伐单抗是最常用的抗VEGF药物，共注射142次（74.74%），而雷珠单抗仅注射48次（25.26%）。3只眼同时接受了贝伐单抗和雷珠单抗注射（1.58%）。视网膜静脉阻塞61例（32.11%）是注射的最常见指征，其次是糖尿病性黄斑水肿43例（22.63%）和增殖性糖尿病视网膜病变42例（22.11%）。其他包括新生血管性年龄相关性黄斑变性、新生血管性青光眼、玻璃体积血、近视性脉络膜新生血管和黄斑囊样水肿。年龄与疾病之间存在关联（p = 0.001）。视网膜静脉阻塞和糖尿病性黄斑水肿患者干预后视力有所改善，且具有统计学意义。高血压是本系列中最常见的全身性疾病，共81例（42.36%），注射最常选择的部位是颞上象限，共131例（68.95%）。飞蚊症是最常见的并发症。
抗VEGF已成为我们中心治疗多种视网膜疾病的宝贵工具。然而，成本问题阻碍了这种治疗方式的更广泛应用。应提供更便宜的替代制剂以鼓励采用。应鼓励发展中国家的政府承担老年养老金领取者（OAP）的健康负担。
