Intravitreal ziv-aflibercept for macular edema following retinal vein occlusion

• Main Authors: Paulose R, Chhablani J, Dedhia CJ, Stewart MW, Mansour AM
• Format: Article
• Language: English
• Published: Dove Medical Press 2016-09-01
• Series: Clinical Ophthalmology
• Subjects: ziv-aflibercept; retinal vein occlusion; cystoid macular edema
• Online Access: https://www.dovepress.com/intravitreal-ziv-aflibercept-for-macular-edema-following-retinal-vein--peer-reviewed-article-OPTH

Remya Paulose,1 Jay Chhablani,1 Chintan J Dedhia,1 Michael W Stewart,2 Ahmad M Mansour3,4 1Smt. Kanuri Santhamma Centre for Vitreoretinal Diseases, LV Prasad Eye Institute, Hyderabad, India; 2Department of Ophthalmology, Mayo Clinic, Jacksonville, FL, USA; 3Department of Ophthalmology, American University of Beirut, 4Department of Ophthalmology, Rafic Hariri University Hospital, Beirut, Lebanon Aim: To report the efficacy of intravitreal ziv-aflibercept injections in eyes with macular edema due to retinal vein occlusions (RVOs). Methods: Consecutive patients with persistent or recurrent macular edema (central macula thickness >250 µm) due to RVO were enrolled in this prospective study. Study eyes received intravitreal injections of ziv-aflibercept (1.25 mg/0.05 mL) at baseline. Patients were reassessed monthly for 4 months and given additional injections pro re nata for worsening best-corrected visual acuity (BCVA), intraretinal edema or subretinal fluid seen on spectral domain optical coherence tomography, or central macular thickness (CMT) measurements >250 µm. The primary endpoint was improvement in mean CMT at 4 months. Secondary endpoints included improvement in mean BCVA, and ocular and systemic safety signals. Results: Nine eyes (five central and four branch RVOs) of nine patients were enrolled. The mean ± standard deviation CMT decreased from 604±199 µm at baseline to 319±115 µm (P=0.001) at 1 month and to 351±205 µm (P=0.026) at 4 months. The mean BCVA did not improve significantly from baseline (1.00 LogMAR) to the 1-month (0.74 LogMAR; P=0.2) and 4-month (0.71 LogMAR; P=0.13) visits. No safety signals were noted. Conclusion: In this small prospective study, intravitreal ziv-aflibercept significantly improved mean CMT in eyes with persistent or recurrent macular edema due to RVOs. Prospective, randomized trials comparing ziv-aflibercept with standard pharmacotherapy are needed to better define efficacy and safety. Keywords: ziv-aflibercept, retinal vein occlusion, cystoid macular edema