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Abstract

IDENTIFICATION OF THE POTENTIAL INDICATIONS AND SHORTTERM OUTCOME OF INTRAVITREAL INJECTION OF BEVACIZUMAB AT REGIONAL REFERRED EYE HOSPITAL IN MADINAH, SAUDI ARABIA 2016

Ghaida A. Mohammed Aziz*, Ghaida M. Alahmadi, Haifa A. Mohammed Aziz, Mohammed A. Jabri, Abdulaziz A. Alhosaini and Maan Al-barry

ABSTRACT

Background: Bevacizumab is a monoclonal antibody that binds to all kinds of vascular endothelial growth factor (VEGF) and is successfully used as a systemic drug in treatment of cancers.[1] Several previous studies have revealed the usefulness of the intravitreal injection of bevacizumab in treatment neovascularization and macular edema secondary to several eye diseases.[2-11] Purpose: To point out the indications and assess short-term outcome of bevacizumab intravitreal injection at Regional Referred Eye Hospital in Madinah Area, Saudi Arabia. Methods: The study included 59 eyes of the studied patients submitted to intravitreal injection of bevacizumab at Regional Referred Eye Hospital in Madinah Area, Saudi Arabia, during the period from June to December 2015. At baseline, visual acuity and optical coherencetomography (OCT) were measured and data sheet was filled for each studied patient. The outcome variables in terms OCT thickness in micrometers and visual acuity were measured three months after injection. The data were analyzed by appropriate statistical tests. Results: Of the 59 studied eyes, the majority 35 (59.3%) were diagnosed as diabetic macular edema (DME), 9 (15.3%) as proliferative diabetic retinopathy (PDR), 5 (8.5%) as combined PDR and vitreous hemorrhage (VH), 4 (6.8%) as combined DME and PDR, 2 (3.4%) as choroidal neovascularization (CNV)secondary to age-related macular degeneration, 2 (3.4%) as macular edema secondary to central retinal vein occlusion (CRVO), 1 (1.7%) as macular edema secondary to branch retinal vein occlusion (BRVO) and 1 (1.7%) as neovascular glaucoma. Compared to baseline mean OCT thickness, there was a statistically significant decrease in mean OCT thickness measured three months after injection. It was markedly decreased in patients aged ≤ 60 years (54.2%), male patients (37.2%), type II diabetics (52.5), best corrected visual acuity of ≥ 0.1 (45.7%), non-hypertensive (42.3%), and those with DME (38.9%), with PDR (8.4%), with PDR and VH (8.4%) and those with DME and PDR (6.7%) more than 10%. Moreover, the visual acuity was improved in 9 (43%) out of 21 eyes with baseline visual acuity < 0.1 Decimal. Conclusions: Diabetic macular edema was the commonest indication followed by proliferative diabetic retinopathy. In addition, the study confirms the accumulating evidence of the usefulness and short-term efficacy of intravitreal injection of bevacizumab. The study suggests the need for further investigations with larger multicenter randomized studies in our region and a longer follow up to verify if this improvement is sustainable or not. However, the major concern is the need for increasing awareness about the importance of diabetes control and its impact in our region.

Keywords: Intravitreal, Macular edema, Bevacizumab, Diabetes mellitus, Saudi Arabia.


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