Audit of anti-vascular endothelial growth factor medication use in Ekiti, Southwestern Nigeria


Department of Ophthalmology, Ekiti State University Teaching Hospital,
Ado-Ekiti, Nigeria.
Background: The use of anti-vascular endothelial growth factor (anti-VEGF) agents has increased in recent years.
This is because of the increasing detection of vitreo-retinal disorders associated with vascular abnormalities. The
indications vary from one location to another. Visual outcome following treatment with these agents also vary
with disease severity and promptness of intervention.
Methodology: A prospective observational study was carried out on all patients with retinal disorders who had
intravitreal injection between November 2013 and November 2019. Data on demographic characteristics,
presenting visual acuity, diagnosis, type of anti-VEGF agent used, post-treatment visual acuity and complications
were retrieved and entered into Statistical Package for Social Sciences (SPSS) version 25 and analysed for
frequency and proportions.
Results: Seven hundred and thirty two patients with retinal pathologies were seen during the study period. A total
of 251 intravitreal anti-VEGF agent injections were administered to 95 patients during the period under review.
The mean age of the patients was 64.3 ±12.7 years. The number of injections per eye varied from 2 to 6 with an
average of 2.6 per eye. Bevacizumab was the more commonly utilized anti-VEGF medication as it was used for
231(92%) injections. Wet age-related maculopathy was the commonest indication for intravitreal anti-VEGF
agent in 61(24.3%) followed by diabetic macula edema in 55(21.9%) and retinal vein occlusion with macular
edema in 54(21.5%) injections. Visual improvement was observed in 69 (72.6%) patients.
Conclusion: Anti-VEGF therapy was useful in the management of patients with retinal disorders. The need for
multiple injections and the attendant cost still constitutes a major challenge in the use of these medications.
Keywords: Intravitreal, Retina, Bevacizumab, Ranibizumab, Retina disorders, Antivascular endothelial growth
factor agents.
Contexte: L’utilisation d’agents anti-facteur de croissance endothélial vasculaire (anti-VEGF) a augmenté ces
dernières années. Ceci est dû à la détection croissante des troubles vitréo-rétiniens associés auxanomalies. Les
indications varient d’un endroit à l’autre. Le résultat visuel après le traitement avec ces agents varie également en
fonction de la gravité de la maladie et de la rapidité de l’intervention.
Méthodologie: Une étude observationnelle prospective a été menée sur tous les patients atteints de rétine
troubles ayant subi une injection intravitréenne entre novembre 2013 et novembre 2019. Données sur les
caractéristiques démographiques, présentant l’acuité visuelle, le diagnostic, le type de agent anti-VEGF utilisé,
l’acuité visuelle post-traitement et les complications ont été récupérées et entré dans le progiciel statistique pour
les sciences sociales (SPSS) version 25 et analysé pour fréquence et proportions.
Résultats: Sept cent trente-deux patients atteints de pathologies rétiniennes ont été vus au cours de la période
d’étude. Au total, 251 injections d’agent anti-VEGF intravitréen ont été administrées à 95 patients au cours de la
période sous revue. L’âge moyen des patients était de 64,3 ± 12,7 ans. Le nombre d’injections par œil variait de 2
à 6 avec une moyenne de 2,6 par œil. Le bévacizumab était le médicament anti-VEGF le plus couramment utilisé
car il était utilisé pour 231 injections (92%). La maculopathie humide liée à l’âge était l’indication la plus
courante de l’anti-VEGF intravitréen chez 61 (24,3%), suivie de l’œdème diabétique de la macula dans 55
(21,9%) et de l’occlusion veineuse rétinienne avec œdème maculaire dans 54 (21,5%) injections. Une
amélioration visuelle a été observée chez 69 patients (72,6%).
Conclusion: La thérapie anti-VEGF a été utile dans la prise en charge des patients atteints de troubles rétiniens. La
nécessité de multiples injections et le coût associé constituent toujours un défi majeur dans l’utilisation de ces
Mots clés: Intravitréen, Rétine, Bévacizumab, Ranibizumab, Troubles de la rétine, Agents de facteur de
croissance endothélial anti-vasculaire.
Correspondence: Dr. I.A. Ajayi, Department of Ophthalmology, Ekiti State University Teaching Hospital, Ado-Ekiti,



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