EC Ophthalmology

Purpose: To evaluate the real-world outcomes of anti-VEGF treatment for neovascular age-related macular degeneration (NvAMD) in a low-income country setting.

Methods: A retrospective cohort study was conducted at Nisir Specialized Eye Clinic in Addis Ababa, Ethiopia, involving 159 eyes of 142 patients who received at least three intravitreal anti-VEGF injections from September 2021 to August 2023. The primary outcome was the change in central macular thickness (CMT); secondary outcomes included improvements in visual acuity (VA), the number of injections, and complications.

Results: A total of 159 eyes of 142 study participants were included in this study; the mean age of participants was 68.7 years; 52.8% were female. Bevacizumab was used in 79.2% of cases, with a mean of 3.42 injections per eye. Baseline mean CMT was 358.50 µm, reducing to 256.93 µm at 3 months and 258.55 µm at 12 months (mean reduction of 104.22 µm and 118.42 µm, respectively). Visual acuity improved from 20/400 - 20/630 at baseline to 20/50 - 20/200 in 46.5% of eyes by 3 and 12 months. Only baseline CMT was significantly associated with 3-month VA (p < 0.001). Most patients (83.6%) discontinued treatment after three injections, primarily due to financial constraints. Complications were observed in 4.4% of eyes, with endophthalmitis being the most common.

Conclusion: Anti-VEGF treatment in this low-income setting showed modest improvements in CMT and VA, but outcomes were limited by under-treatment, largely due to cost. This underscores the need for resource-adjusted treatment protocols and enhanced patient support to improve long-term outcomes.

Keywords: anti-VEGF; Nv AMD

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