Department of Ophthalmology, University College Hospital, Ibadan, Nigeria.
Ann Afr Med. 2021 Oct-Dec;20(4):276-281. doi: 10.4103/aam.aam_61_20.
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.
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.
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.
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.
本研究旨在评估在撒哈拉以南非洲的一个眼科单位中，玻璃体内抗血管内皮生长因子（抗-VEGF）治疗的 1 年疗效。
这是一项回顾性研究，纳入了 2016 年至 2019 年间在玻璃体视网膜科接受治疗的 172 名患者的 182 只眼，这些患者接受了玻璃体内注射抗-VEGF 贝伐单抗（1.25mg/0.05ml）治疗，随访时间至少为 1 年。观察指标包括 1 年随访期间最佳矫正视力（BCVA）的变化、注射次数和并发症。
患者的平均年龄为 61.1 ± 16.3 岁（男女比例为 1:1.1），其中 62.1%以上年龄>60 岁。在审核期间共进行了 330 次注射。平均注射次数为 1.8 ± 0.93。94 只（51.7%）眼仅注射 1 次，33 只（18.1%）、50 只（27.5%）和 5 只（2.7%）眼分别注射 2、3 和 4 次。约 78.5%的患者在基线时有中度至重度视力障碍，分别有 44.5%、16.4%、12.6%和 7.1%在注射后 1、3、6 和 12 个月时出现视力障碍。所有患者的平均 BCVA均从基线时的 1.67 ± 0.91 对数最小角度分辨率（logMAR）改善至 1 年后的 1.50 ± 1.27 logMAR。1 个月时增加的 logMAR 字母数为 23，1 年后为 8.25；注射 3 次的眼增加了 10 个字母，而注射 1 次的眼增加了 3 个字母。年龄相关性黄斑变性和特发性息肉状脉络膜血管病变患者在至少接受 3 次注射后，分别在 1 年时获得了 7.5 和 9 个字母的视力提高。注射次数的增加与视力改善呈显著相关（P=0.043）。注射后各有 1 例发生眼内炎（0.6%）和视网膜下脱离（0.6%）。
在接受玻璃体内抗-VEGF 注射的患者中，1 年内记录到视力提高。建议患者应进行多次注射。
