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Intravitreal ziv-aflibercept for macular edema following retinal vein occlusion

Authors Paulose R, Chhablani J, Dedhia C, Stewart M, Mansour A

Received 3 July 2016

Accepted for publication 30 July 2016

Published 22 September 2016 Volume 2016:10 Pages 1853—1858


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

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

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