Long-Term Outcomes of Intravitreal Anti-VEGF Therapy for Neovascular Age-Related Macular Degeneration at Tertiary Centres in South West Nigeria

Neovascular (wet) age-related macular degeneration (nAMD) is a sight-threatening condition managed primarily with intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections. While short-term efficacy is well established, long-term real-world outcomes of anti-VEGF therapy in the Nigerian context, including treatment adherence, injection frequency, and functional outcomes over five or more years, are entirely undocumented. This study evaluates long-term real-world outcomes of intravitreal anti-VEGF therapy for nAMD at Lagos University Teaching Hospital, University College Hospital Ibadan, and Obafemi Awolowo University Teaching Hospital Ile-Ife. A retrospective longitudinal cohort design will be employed, reviewing five years of clinical records from 200 nAMD eyes receiving intravitreal ranibizumab or bevacizumab. Primary outcomes include best-corrected visual acuity at years 1, 3, and 5, number of injections administered, OCT-documented lesion characteristics, and rates of conversion to geographic atrophy. Kaplan-Meier survival analysis will assess time to visual acuity loss, and multivariate mixed models will identify predictors of long-term outcomes. The study will produce the first five-year real-world anti-VEGF outcomes dataset from West Africa, constituting an original contribution to the retinal therapy literature in sub-Saharan Africa. Findings will be submitted to the Ophthalmic Society of Nigeria and global nAMD research consortia. Keywords: anti-VEGF therapy, age-related macular degeneration, long-term outcomes, South West Nigeria, intravitreal injection