Intravitreal Anti Vascular Endothelial Growth Factor Agents in the Management of Retinal Diseases: An Audit

Vitreo-Retina

Abstract

Introduction: Vascular endothelial growth factors (VEGF) is a key contributor in angiogenesis, promoting vascular endothelial cell  proliferation1 . It increases vascular permeability and vasodilation required in physiological processes like lesion healing, but is also responsible for many intraocular pathologies involving new vessel formation and inflammation resulting in irreversible vision loss2,3.  These conditions include retinal disorders such as retinal vein occlusion(RVO), diabetic macula edema (DME), wet age related macular  degeneration (AMD), myopic neovascularisation and retinopathy of prematurity. The complications of neovascularisation include neovascular glaucoma, vitreous haemorrhage and retinal detachment which cause visual impairment that arise from these conditions3  . Anti-vascular endothelial growth factors (anti-VEGFs) have revolutionized the management of retinal diseases.  Bevacizumab, Ranibizumab, and Aflibercept have shown significant gain in visual acuity 4 . Together or alone with other conventional treatment, retina specialists now have an armamentarium of antiVEGF agents in the treatment of ocular neovascular disorders. The uptake of these agents have increased in developing countries 5 . Cost and duration of treatment are however major drawbacks that affect compliance in a poor resource setting.

Methods: Case records of patients attending the retina clinic of the University of Port Harcourt  Teaching Hospital between January  2012 to December 2016were reviewed. Data collected included patients’ demographics, indications for injection, type of intra vitreal  injection and risk factors. The Statistical Package for Social Sciences (SPSS) 20.0 was used for analysis. P values of <0.05 were  considered statistically significant.