Safety and Efficacy of Ziv-Aflibercept in the Treatment of Refractory Diabetic Macular Edema

BACKGROUND AND OBJECTIVE: To evaluate the safety and efficacy of ziv-aflibercept (Zaltrap; SanofiAventis, Bridgewater, NJ/Regeneron Pharmaceuticals, Tarrytown, NY) in the treatment of refractory diabetic macular edema (DME). PATIENTS AND METHODS: Retrospective case series looking at the safety of ziv-aflibercept in patients with DME refractory to previous anti-vascular endothelial growth factor (VEGF) therapy. Detailed ophthalmologic examination, best-corrected visual acuity, and optical coherence tomography measurements were performed pre-switch, as well as at each monthly follow-up visit. RESULTS: The study included 34 eyes of 26 patients. The mean number of ziv-aflibercept injections posts-witch was 2.03 injections. Visual acuity improved from a mean of 0.63 logMAR pre-switch to 0.51 logMAR after the first visit and 0.46 logMAR after the second visit post-switch (P <.084). Macular thickness improved from a mean of 513.79 mu m to 411.79 mu m (P =.006) on the first visit and 426.76 mu m (P =.029) after the second visit post-switch. No adverse ocular or systemic side effects were reported on any of the follow visits. CONCLUSION: Ziv-aflibercept appears to be safe and effective in patients with refractory DME previously treated with other anti-VEGF agents in the short term.