Initial Experience with Bevacizumab (AvastinTM) in the Treatment of Neovascular Age-related Macular Degeneration in Nigerian Patients

Abstract

Objective: To report on the early experience with the treatment of neovascular AMD with intravitreal injection of bevacizumab (Avastin) in Nigeria. Materials and Methods: Eight eyes (7 patients) with neovascular AMD who met the inclusion criteria were treated with intravitreal 1.25mg bevacizumab between September 2008 and May 2009. Injections were given every 4-6 weeks. In total, 2–4 injections were given. One patient had bilateral treatment. All the patients were regularly followed up until December 2009. Results: The presenting visual acuity ranged from light perception (LP) to counting fingers (CF). In 2 patients (2 eyes) their visual acuity improved 2 weeks after injection from CF to 6/36 and remained stable for 4 months. In another 2 patients (2 eyes) acuity improved from LP to CF. In yet 2 other patients (4 eyes) the visual acuity remained unchanged (HM in 2 eyes; CF in 2 eyes) after 9 months and 4 injections. Clinically the subretinal blood was observed to resolve, albeit slowly, in all the patients within 2 months from the start of treatment. Conclusions: This preliminary experience suggests that intravitreal bevacizumab is safe and beneficial in Nigerian Africans with neovascular AMD. However careful patient selection, regular follow up and aseptic injection techniques are advised when treating these patients.

Key words: age-related macular degeneration, vascular endothelial growth factor (VEGF) inhibitors, Nigeria