Shaheen Fiza, Farooq Huzaifa, Amjad Muhammad
Ophthalmology, Al-Shifa Trust Eye Hospital, Rawalpindi, PAK.
Vitreoretina, Al-Shifa Trust Eye Hospital, Rawalpindi, PAK.
Cureus. 2024 Jul 23;16(7):e65199. doi: 10.7759/cureus.65199. eCollection 2024 Jul.
To report the impact of a 10-week-long nationwide ban on intra-vitreal bevacizumab (IVB) injection (Avastin®) at a tertiary care hospital in Pakistan.
This was a single-center, retrospective, cohort study. Patients scheduled for IVB injections from October 25, 2023 to October 29, 2023 who arrived in OPD between November 28, 2023 and December 15, 2023 for their assessment were included in this study.
Among the identified 412 patients, only 103 met the inclusion criteria. The mean age was 59.35 ± 9.5 (mean ± SD). About 60.2% were male (n = 62). Diabetic macular edema (DME) was the most common indication (n = 71, 68.9%). The mean total duration of treatment delay was 81.67 ± 17.15 days. While the delay due to the Avastin® ban was 67.47 ± 4.8 days. Eyes that had not received any prior injections were 46 (44.7%) while others had received at least 1 (n = 43, 41.7%) or 2 injections (n = 14, 13.6%) before. Mean central macular thickness (CMT) before and after treatment delay was 362.7 ± 113.4 μm and 398.38 ± 124 μm (p < 0.05), respectively. Among 20 patients with vitreous hemorrhage (VH), 14 patients showed marked improvement (70%), 5 showed no change in severity (20%) and 1 (5%) had further worsening. CMT difference was strongly correlated with the total duration of treatment delay (p < 0.01) and with the number of injections (p < 0.01).
The nationwide ban on Avastin® heightened the severity of disease in the patients highlighting the delicate balance between safety precautions and timely access to essential medical interventions.
报告在巴基斯坦一家三级护理医院实施的为期10周的全国性玻璃体内注射贝伐单抗（IVB，商品名阿瓦斯汀）禁令的影响。
这是一项单中心回顾性队列研究。纳入了2023年10月25日至2023年10月29日计划接受IVB注射、于2023年11月28日至2023年12月15日到门诊进行评估的患者。
在确定的412例患者中，只有103例符合纳入标准。平均年龄为59.35±9.5岁（均值±标准差）。约60.2%为男性（n = 62）。糖尿病性黄斑水肿（DME）是最常见的适应症（n = 71，68.9%）。治疗延迟的平均总时长为81.67±17.15天。因阿瓦斯汀禁令导致的延迟为67.47±4.8天。之前未接受过任何注射的眼睛有46只（44.7%），其他眼睛之前至少接受过1次（n = 43，41.7%）或2次注射（n = 14，13.6%）。治疗延迟前后的平均中心黄斑厚度（CMT）分别为362.7±113.4μm和398.38±124μm（p<0.05）。在20例玻璃体积血（VH）患者中，14例病情显著改善（70%），5例严重程度无变化（20%），1例（5%）病情进一步恶化。CMT差异与治疗延迟的总时长（p<0.01）和注射次数（p<0.01）密切相关。
全国性的阿瓦斯汀禁令加剧了患者病情的严重程度，凸显了安全预防措施与及时获得必要医疗干预之间的微妙平衡。
