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Two-year outcomes of intravitreal ziv-aflibercept
  1. Ahmad M Mansour1,2,
  2. Mohammed Ashraf3,
  3. Abdulrazzak Charbaji4,5,
  4. Muhammad H Younis1,2,
  5. Ahmed A Souka3,
  6. Avantika Dogra6,
  7. Hana A Mansour1,
  8. Jay Chhablani6
  9. On behalf of Ziv-aflibercept study group investigators
    1. 1 Department of Ophthalmology, American University of Beirut, Beirut, Lebanon
    2. 2 Department of Ophthalmology, Rafic Hariri University Hospital, Beirut, Lebanon
    3. 3 Department of Ophthalmology, Alexandria Faculty of Medicine, Alexandria University, Alexandria, Egypt
    4. 4 Department of Statistics and Research Methodology, Lebanese American University, Beirut, Lebanon
    5. 5 Department of Statistics and Research Methodology, Lebanese University, Beirut, Lebanon
    6. 6 Smt. Kanuri Santhamma Centre for Vitreoretinal Diseases, LV Prasad Eye Institute, Hyderabad, Andhra Pradesh, India
    1. Correspondence to Dr Jay Chhablani, Smt. Kanuri Santhamma Centre for Vitreoretinal Diseases, LV Prasad Eye Institute, Hyderabad, Andhra Pradesh 500034, India; jay.chhablani{at}


    Aim To assess the two-year outcome of intravitreal ziv-aflibercept (IVZ) in eyes with macular diseases.

    Methods Consecutive subjects with various macular diseases that received six or more of 0.05 mL IVZ (1.25 mg) injections with at least 1 year follow-up were included. Outcome measures were best-corrected visual acuity (BCVA) (logarithm of the minimum angle of resolution) and central macular thickness (CMT) on spectral domain optical coherence tomography. Paired comparison was done using Wilcoxon signed-rank test calculator.

    Results 107 eyes of 91 subjects received IVZ and were followed with mean±SD follow-up interval of 1.48±0.44 months following treat and extend or pro-re-nata protocol. The distribution included neovascular macular degeneration (42 eyes), diabetic macular oedema (32 eyes) and macular oedema secondary to retinal vein occlusion (11 eyes). Fifty eyes were naive, while 57 eyes were previously treated. Combining all disease categories, CMT decreased significantly by 133.0±153.0 µm at the 24-month follow-up (P<0.001) with BCVA gain of 0.35±0.37 at the 24-month follow-up (P<0.001) with mean number of injections of 8.5 at month 12, 2.4 between 12 and 18 month and 1.7 between 18 and 24 month. Ocular and systemic adverse effects included one episode of transient uveitis and one instance of central retinal artery occlusion after 1121 injections.

    Conclusions IVZ appears safe and efficacious in the therapy of macular diseases through 2 years.

    • retina
    • choroid
    • macula

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    • Contributors AMM, MA and JC were responsible for the design of the study and interpretation of the data. AMM, MA, AC, MHY, AAS, AD and JC were responsible for the conduct of the study. AMM, MA, AD and HAM were involved in the management. AMM did the analysis. AMM, AC, AAS and JC were responsible for the preparation. AMM, MA, AC, AAS, AD, HAM and JC reviewed the article. All authors equally contributed to the collection of data and the final approval of the manuscript.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval Rafic Hariri University Hospital, Alexandria University and L V Prasad Eye Institute Ethics Committee.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Collaborators Rajeev Reddy Pappuru, Taraprasad Das, Padmaja Kumari Rani, Mudit Tyagi, Raja Narayanan, Vivek Dave, Subhadra Jalali, Divya Balakrishnan, Bhushan Uplanchiwar, Kushal Agrawal, Hitesh Agrawal, Remya Paulose, Mahima Jhingan, Vishal Govindhari, Sumit Randhir Singh, Rushil Kumar, Komal Agrawal.

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