Bilateral concomitant intravitreal anti‑vascular endothelial growth factor injection: Experience in a Nigerian tertiary private eye care facility

Abstract

Objectives: To evaluate the indication and safety profile of same‑session bilateral intravitreal injection of anti‑vascular endothelial growth factor (anti‑VEGF).

Methods: This is a retrospective case series of all the patients that received same‑session bilateral intravitreal anti‑VEGF in Eye Foundation Hospital, Ikeja, Lagos, from March 2013 to March 2015. Data retrieved from the patients’ medical records includes demographics, indications for injections, complications, and systemic comorbidities.

Results: During the study period, a total of 442 injections were performed on 126 eyes of 63 patients (M:F ratio; 1.4:1) whose mean age was 55.7 ± 15.6 standard deviation years. The modal age group was 51–70 years. All the patients received injection Bevacizumab (Avastin; Genentech Inc., South San Francisco, California, USA‑1.25 mg). The most common primary indication for initiating bilateral intravitreal therapy was diabetic macular edema 23 (36.5%). Mean follow‑up period was 40.6 days (range: 1–364 days). A combined diabetes mellitus and hypertension accounted for most of the systemic comorbidities 28 (44.4%). Subconjunctival hemorrhage was the only complication seen in these patients with 6 (9.5%) occurring intraoperatively and 9 (14.3%) postoperatively. There was no association between intraoperative complication and age (P = 0.66) or gender (P = 0.96). Furthermore, there exist no association between postoperative complication and age (P = 0.49) or gender (P = 0.99).

Conclusions: No major systemic or ocular adverse events were noted. Given that there are potentially serious complications following anti‑VEGF injection, further study with a larger number of patients will be necessary to definitively prove the safety of this treatment modality.

Keywords: Bilateral concomitant, humans, intravitreal bevacizumab