Department of Ophthalmoogy, Mbarara University of Science and Technology, Mbarara, Uganda.
International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, UK.
Eye (Lond). 2022 May;36(Suppl 1):45-50. doi: 10.1038/s41433-022-02006-5.
To determine the outcome of Intravitreal Avastin (IVA) injections in patients with Macular Oedema (MO) in Uganda.
We prospectively recruited patients presenting with MO at the Department of Ophthalmology of Mbarara University of Science and Technology in Southern Uganda from November 2018 to April 2019. We treated them with intravitreal injection of Bevacizumab (Avastin®) and followed them up for three consecutive months after the initial injection. We collected information on baseline clinical presentation and 3 month outcomes. We performed a Student's t-test to compare central macular thickness (CMT) and best corrected visual acuity (BCVA) at baseline and at 3 months after IVA injections. We performed linear regression to test for predictors of change in CMT and BCVA at 3 months.
We enroled 32 patients (35 eyes) of which 29 patients (32 eyes) completed the follow up. The mean age was 62.8 ± 11.8 years, and 53% were male. At 3 months after IVA, the mean CMT improved significantly from 426.90 ± 135.9 µm at baseline to 311.20 ± 134.80 µm (p = 0.0008). The mean BCVA improved from 0.70 ± 0.38 at baseline to 0.38 ± 0.36 logMAR units (p = 0.003). The improvement in CMT and BCVA were more marked in patients who had Diabetic ME compared to other causes. A high baseline CMT was a strong predictor of improvement in CMT at 3 months after IVA therapy. A worse baseline visual acuity was a predictor of improvement in vision at 3 months after IVA.
IVA therapy results in anatomical and visual improvement at 3 months especially in patients with Diabetic MO. Having a high baseline CMT was a predictor of good CMT outcome at 3 months while a worse vision at baseline was a predictor of better visual outcome at 3 months.
评估乌干达黄斑水肿（MO）患者玻璃体内注射阿伐斯汀（IVA）的治疗结果。
本研究前瞻性招募了 2018 年 11 月至 2019 年 4 月期间在乌干达姆巴拉拉科技大学眼科就诊的 MO 患者。我们采用玻璃体内注射贝伐单抗（Avastin®）对患者进行治疗，并在初次注射后连续随访 3 个月。我们收集了基线临床特征和 3 个月随访结果的数据。采用学生 t 检验比较 IVA 注射前后中央黄斑厚度（CMT）和最佳矫正视力（BCVA）。采用线性回归分析 3 个月时 CMT 和 BCVA 变化的预测因素。
共纳入 32 例（35 只眼）患者，其中 29 例（32 只眼）完成了随访。患者平均年龄为 62.8±11.8 岁，53%为男性。IVA 治疗后 3 个月，CMT 均值从基线时的 426.90±135.90μm显著改善至 311.20±134.80μm（p=0.0008）。BCVA 均值从基线时的 0.70±0.38 对数视力矫正（logMAR）单位改善至 0.38±0.36 logMAR 单位（p=0.003）。与其他病因引起的 MO 相比，糖尿病性 ME 患者的 CMT 和 BCVA 改善更显著。基线 CMT 较高是 IVA 治疗后 3 个月 CMT 改善的强预测因素。基线视力较差是 IVA 治疗后 3 个月视力改善的预测因素。
IVA 治疗在 3 个月时可改善患者的解剖学和视觉效果，尤其是糖尿病性 MO 患者。基线 CMT 较高是 3 个月时 CMT 结局良好的预测因素，而基线视力较差是 3 个月时视力结局良好的预测因素。
