title: Three-month outcome of intravitreal ziv-aflibercept in eyes with diabetic macular oedema.
abstract: OBJECTIVE
  We report the 3-month efficacy of monthly intravitreal ziv-aflibercept in patients with diabetic macular oedema (DME).
  
  
  METHODS
  Prospectively, consecutive patients with DME underwent intravitreal injection of 0.05 ml of compounded ziv-aflibercept (1.25 mg) from March 2015 to November 2015. Monitoring of best-corrected visual acuity (BCVA), intraocular inflammation, cataract progression and retinal structure by spectral domain optical coherence tomography was carried out at baseline, 1 week, 1 month, 2 months and 3 months after 3 monthly injections.
  
  
  RESULTS
  A total of 17 eyes (11 right eyes and 6 left eyes) were treated. The participants were divided into 10 Caucasians and 6 Indians, 11 men and 5 women, and had a mean age of 61.5 years. Five eyes were treatment-naïve cases and 12 eyes were treatment non- naïve with last treatment received at least more than 4-month interval. Mean BCVA in log MAR (equivalent Snellen visual acuity) improved from baseline 0.70 (20/100) to 0.49 (20/60) at 1 month, 0.43 (20/50) at 2 months and 0.42 (20/50) at 3 months (p ≤ 0.003). Central macular thickness decreased from mean baseline 517.5 to 388.1 μm at 1 week, 355.4 μm at 1 month, 351.4 μm at 2 months and 322.2 μm at 3 months (p ≤ 0.001).
  
  
  CONCLUSIONS
  Off-label use of intravitreal ziv-aflibercept improves visual acuity, without detectable ocular toxicity or systemic side effects in DME. It offers a less expensive alternative to the approved intravitreal aflibercept (Eylea), especially in the low/middle-income countries and in countries where Eylea is not available.
authors.affiliation: Department of Ophthalmology, American University of Beirut, Beirut, Lebanon.|Department of Ophthalmology, Rafik Hariri University Hospital, Beirut, Lebanon.
authors.forename: Ahmad M
authors.initials: AM
authors.lastname: Mansour
authors.affiliation: Smt. Kanuri Santhamma Centre for Vitreo Retinal Diseases, LV Prasad Eye Institute, Hyderabad, India.
authors.forename: Chintan
authors.initials: C
authors.lastname: Dedhia
authors.affiliation: Smt. Kanuri Santhamma Centre for Vitreo Retinal Diseases, LV Prasad Eye Institute, Hyderabad, India.
authors.forename: Jay
authors.initials: J
authors.lastname: Chhablani
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D003930:Diabetic Retinopathy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D056687:Off-Label Use; D011446:Prospective Studies; D040262:Receptors, Vascular Endothelial Growth Factor / Q000008:administration & dosage*; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage*; D013997:Time Factors; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D011993:Recombinant Fusion Proteins; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor
keywords: Retina