Department of Ophthalmology, Eye Foundation Hospital, Lagos State, Nigeria.
Department of Ophthalmology, Eye Foundation Hospital, Ogun State, Nigeria.
Niger J Clin Pract. 2023 Jul;26(7):1011-1016. doi: 10.4103/njcp.njcp_911_22.
Optical coherence tomography (OCT) is widely used as the standard of care in evaluating macular and retinovascular diseases. However, the degree of OCT utilization is yet to be researched in a resource-limited country where wide gaps exist in access to healthcare.
To determine the rate of utilization of the OCT in diagnosis, pre-treatment, and post-treatment evaluation of macular and retinovascular diseases treated with intravitreal anti-vascular endothelial growth factor injection (IVI).
Retrospective, consecutive, and non-comparative case series of eyes diagnosed and treated from Jan 2017 to Jan 2022 for seven macular and retinovascular diseases in five eye clinics in Nigeria. Data extracted include demographics, indication for IVI, eye treated, use or non-use of OCT at the diagnosis (pre-treatment) and after the last IVI (post-treatment), and central macular thickness (CMT) of pre-treatment OCT scans.
Seven hundred and forty two eyes were diagnosed with retinovascular and macular diseases (389 right eyes and 353 left eyes).The male to female ratio was 430: 312 eyes. The mean age was, 63.89 years (SD 12.58). Four hundred and fifty two eyes (60.9%) had a pre-treatment OCT, 235 eyes (31.7%) had a post-treatment OCT, and 190 eyes (25.6%) had both pre- and post-treatment OCTs. The rate of pre-treatment OCT varied with the diagnosis (P = 0.000); DME had the highest rate, 74.4%, and HRVO had the lowest, 40%. Post-treatment OCT rate varied with the diagnosis (P = 0.009); non-AMD CNVM had the highest rate, 49.1%, and PCV had the lowest, 24.6%. Pre-treatment OCT rate was influenced by clinic location (P = 0.000); higher in clinics having an OCT. Post-treatment OCT was not influenced by clinic location (P = 0.37). A CRVO eye had the highest maximum CMT (1031 microns) of all the pre treatment eyes and the lowest minimum CMT of all the pre treatment eyes was in a BRVO eye (138 microns). Mean CMT was highest in HRVO (475.33 microns) and lowest in CNVM (307.62 microns).
Though OCT is the standard of care for managing retinovascular and macular diseases, this research quantifies the extent of its use in Nigeria and finds it to be low. A post-treatment OCT rate of 32% suggests that urgent steps are required to improve access to OCT for IVI patients.
光学相干断层扫描（OCT）被广泛用作评估黄斑和视网膜血管疾病的标准护理方法。然而，在医疗保健获取方面存在巨大差距的资源有限的国家，OCT 的使用程度尚未得到研究。
确定在接受玻璃体内抗血管内皮生长因子注射（IVI）治疗的黄斑和视网膜血管疾病的诊断、治疗前和治疗后评估中 OCT 的使用情况。
回顾性、连续、非对照的病例系列，纳入了 2017 年 1 月至 2022 年 1 月在尼日利亚的五家眼科诊所诊断和治疗的七种黄斑和视网膜血管疾病的患者。提取的数据包括人口统计学资料、IVI 适应证、治疗眼、在诊断（治疗前）和最后一次 IVI 后（治疗后）是否使用 OCT，以及治疗前 OCT 扫描的中央视网膜厚度（CMT）。
742 只眼被诊断为视网膜血管和黄斑疾病（389 只右眼和 353 只左眼）。男女比例为 430:312 只眼。平均年龄为 63.89 岁（SD 12.58）。452 只眼（60.9%）进行了治疗前 OCT 检查，235 只眼（31.7%）进行了治疗后 OCT 检查，190 只眼（25.6%）进行了治疗前和治疗后 OCT 检查。治疗前 OCT 的检查率因诊断而异（P = 0.000）；DME 的检查率最高，为 74.4%，HRVO 的检查率最低，为 40%。治疗后 OCT 的检查率因诊断而异（P = 0.009）；非 AMD CNVM 的检查率最高，为 49.1%，PCV 的检查率最低，为 24.6%。治疗前 OCT 检查率受诊所位置的影响（P = 0.000）；位于有 OCT 的诊所的检查率更高。治疗后 OCT 检查率不受诊所位置的影响（P = 0.37）。CRVO 眼的最高最大 CMT（1031 微米）和 BRVO 眼的最低最小 CMT（138 微米）均出现在所有治疗前的眼中。所有治疗前的眼中，HRVO 的平均 CMT 最高（475.33 微米），CNVM 的平均 CMT 最低（307.62 微米）。
尽管 OCT 是治疗视网膜血管和黄斑疾病的标准护理方法，但本研究量化了它在尼日利亚的使用程度，并发现其使用程度较低。治疗后 OCT 的检查率为 32%，这表明需要采取紧急措施，改善 IVI 患者获取 OCT 的机会。
