Visual Acuity outcome comparison of 3 Anti-VEGF injections for age related macular degeneration (AMD) and other retinal diseases and associated factors in patients who visited private health facilities in Addis Ababa, Ethiopia between 2020 - 2023

Abstract

Background: In Ethiopia, the prevalence of blindness (1.6%) and VI (3.7%) represents a substantial public health burden. Currently three anti-VEGF drugs are available to treat patients with retinal problems in private eye health facilities in Ethiopia. Why ophthalmologist inject expensive drugs while the effectiveness of the 3 drugs are comparable in many studies ? Objectives: To compare real life visual acuity outcomes at 2 & 6 months of three anti-VEGF injections for wet-AMD and other retinal diseases as well as identify factors associated with treatment response among patients visited private eye facilities in Addis Ababa. Methods: Study was conducted in two private eye health facilities in Addis Ababa who were injected with anti-VEGF injections for patients that are diagnosed b/n 2020 and 2023. A retrospective cohort study design was used. The sample size was calculated using a two-proportion formula and a total of 409 patients included. Visual outcomes variable categorized as benefited and worsened based on predefined definition. Results: The mean age was 70.5 ±9.18 with a range of 50 to 96 years. Males constituted 228 (51.9%) of the participants and females were 211 (48.1%). The finding of our research showed that the proportion of patients who benefited from treatment was 89.1%, 89.25% and 97.1% for BVZ, RBZ and AFL respectively. Multivariate logistic regression at 6 months baseline VA with AOR = 0.97, CI 0.95 .98 ( p = 0.000) and AFL drug with AOR = 6.1, CI 1.37 27.73 (p = 0.018) was statistically significant . Conclusion: Our findings showed that treatment with anti-VEGF agents benefit our patients in vast majority of the cases. There is no strong evidence to prefer between RBZ over BVZ. However, Aflibercept (AFL) showed better success rate and is preferred drug of choice in our case