Indications and treatment outcomes of intravitreal bevacizumab and ranibizumab for retinal diseases in Benin City, Nigeria

Abstract

Background: The emergence of intravitreal antivascular endothelial growth factors (antiVEGF) has revolutionalised the treatment and prognosis of many retinal diseases.

Aim: To determine the indications and treatment outcomes for use of intravitreal antiVEGF agents in retinal diseases among patients in a tertiary hospital in Benin City, Nigeria.

Materials and Methods: The case folders of patients, who had intravitreal injections of antiVEGF from January 2012 to December 2014, were analysed. Data retrieved included age, sex, indication, type of intravitreal antiVEGF used, number of injections, visual acuity, treatment outcomes, complications and follow-up duration.

Results: There were 27 patients, consisting of 12 males and 14 females, with a mean age of 61.8 ± 7.8 (range 46–76) years. Intravitreal antiVEGF were administered in both eyes of 14 (51.9%) patients. Bevacizumab and ranibizumab were utilised in 36 (87.8%) and 3 (7.3%) eyes, respectively. Two (4.9%) eyes had both bevacizumab and ranibizumab during treatment switching from ranibizumab to bevacizumab. A total of 72 injections were administered during the study period with a mean number of 2.4 ± 1.5 (range 1–8) injections administered per eye. The most common indication was diabetic macular oedema in 17 (40.5%) eyes. After treatment, vision improved in 21 (51.2%) eyes and was unchanged in 10 (24.4%) eyes. Eyes, which initially improved, worsened in 10 (24.4%) patients following cessation of treatment. The most common complication encountered was subconjunctival haemorrhage in 15 (36.6%) eyes. The mean duration of follow-up was 12.4 ± 6.8 (range 4–26) months.

Conclusion: Intravitreal antiVEGF are effective in the management of a vast array of retinal conditions. However, the burden of care including costs and the need for multiple injections are still drawbacks that require an alternative treatment strategy.

Keywords: Aflibercept, bevacizumab, intravitreal antiVEGF, ranibizumab