A Retrospective Descriptive Coho Outcomes of intravitreal Bevacizumab injection on diabetic macular oedema patients of different ethnic groups in a Tertiary hospital setting in KwaZulu-Natal, South Africa:  A Retrospective Descriptive Cohort Study.

Dr. Isibonile  Ndamane; Dr. Bashir Hadi  Laheu

doi:10.51168/sjhrafrica.v7i4.2569

Authors

Dr. Isibonile Ndamane Department of Ophthalmology, University of KwaZulu-Natal
Dr. Bashir Hadi Laheu Department of Ophthalmology, Consultant Ophthalmic Surgeon, Vitreoretinal Surgeon, Inkosi Albert Luthuli Hospital

DOI:

https://doi.org/10.51168/sjhrafrica.v7i4.2569

Keywords:

Diabetic macular oedema, prognostic biomarker

Abstract

Background:

To investigate the variation in central macular thickness and visual acuity among different ethnic groups following three intravitreal injections of Bevacizumab at McCord Eye Hospital.

Methods:

A retrospective observational cohort study of patients with diabetic macular edema from different ethnic groups at McCord Eye Hospital. Patients were classified into Black, Caucasian, Coloured, and Indian ethnic groups. Baseline measurements included visual acuity, measured in decimal and reported in LogMAR, and central macular thickness (CMT) measured with optical coherence tomography (OCT). These measurements were taken before three intravitreal Bevacizumab injections spaced six weeks apart, with follow-up measurements two weeks after the third injection. The study compared changes in VA and CMT between ethnic groups and explored the influence of hypertension, dyslipidemia, and ocular prognostic markers on treatment outcomes.

Results:

349 eyes from 204 patients were enrolled. The number of eyes per ethnic group was 170 Indian, 129 Black, 22 Caucasian, and 22 Coloured. Indians showed the least improvement, with a VA change of 0.82 LogMAR (0.15) and a CMT reduction of -90 µm. Caucasian had a VA change of 0.57 LogMAR (0.27) and a CMT of -94 µm. Black experienced a VA change of 0.63 LogMAR (0.24) and CMT of -122 µm. Coloured performed best, with VA change of 0.47 LogMAR (0.34) and CMT of -125 µm (P=0.001). Hypertension and dyslipidemia prevalence in Indian 56%, Caucasian 32%, Black 15%, Coloured 18%.

Conclusion:

The Ethnic groups with the least VA improvement and CMT reduction had the highest prevalence of systemic risk factors and poor prognostic ocular biomarkers, highlighting their significant impact on treatment outcomes.

Recommendations

Diabetic macular oedema requires a multidisciplinary approach to manage systemic risk factors rigorously and early detection of poor prognostic indicators, which will allow for prompt escalation of treatment.

Author Biography

Dr. Isibonile Ndamane, Department of Ophthalmology, University of KwaZulu-Natal

Ophthalmology registrar (Resident), Department of Ophthalmology, Nelson R Mandela School of Medicine, Durban, KwaZulu-Natal, South Africa. His interests include vitreoretinal surgery and medical retina.

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