The Safety, Effectiveness and Prognostic Factors of Intravitreal Avastin (Bevacizumab) Injection for the Treatment of Macular Edema at the University of Gondar Tertiary Eye Care and Training Center, NW Ethiopia

Abstract

Introduction: The current management of macular edema (ME) is intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) drugs and this represents an important advance in the treatment of ME. Studies done in the western eye care settings have confirmed that intravitreal injection of Avastin is effective for the treatment of ME. However, data on this drugs efficacy and safety in African eye care settings are very scarce. Objective: To assess the Safety and Effectiveness of intravitreal Bevacizumab (Avastin) injection for the treatment of Macular Edema (ME) due to retina vascular diseases at university of Gondar tertiary eye care and training center, NW Ethiopia. Method: A retrospective study was done on patients who were given intravitreal avastin (IVA) for the treatment of diabetic macular edema (DME), retinal vein occlusion (RVO) and Neovascular Age related macular degeneration (AMD). The main outcome measure was visual acuity (VA) and central macular thickness (CMT) measured by spectral domain OCT. Results: Medical records of 50 patients (66 eyes) were reviewed of which 46 (69.7%) were males and mean age of 54.2 years (range 20-80). The means of baseline VA and CMT were 1.0logMAR and 379.4 micron respectively. At the end of follow up and after mean injection of 2.5 times per eye, the mean VA improved to 0.7 logMAR (p=0.001) and the mean CMT reduced to 295 micron (p=0.0001). Baseline mean VA was significant prognostic factor for VA improvement (p=0.0001). Baseline mean CMT (P=0.007), number of injection (P=0.009) and diffuse macular edema (P=0.03) were significant factors for CMT reduction. Conclusions: IVA injection for ME edema due to retinal vascular diseases resulted in a significant improvement in mean VA (p=0.001) and CMT (p=0.0001) at the end of follow up. There was no any ocular or systemic complication of IVA injection.