Effectiveness of the Use of Three-Dose Intravitreal Ziv-Aflibercept in the Management of Diabetic Macular Edema in a Real-Life Setting

Fernando Munayco-Guillén,1,2 Miguel Angel Vazquez-Membrillo,1,2 Marlon Rafael Garcia-Roa,1,2 Jhony Alberto De La Cruz-Vargas,3 Herney Andrés García-Perdomo,4 Rafael Pichardo-Rodriguez3 1Department of Retina and Vitreous Surgery, Instituto Mexicano de Oftalmología (IMO), Querétaro, México; 2Universidad Nacional Autónoma de México (UNAM), México City, México; 3Instituto de Investigaciones en Ciencias Biomédicas (INICIB), Universidad Ricardo Palma, Lima, Perú; 4Division of Urology/Urooncology, Deparment of Surgery, School of Medicine, Universidad del Valle, Cali, ColombiaCorrespondence: Fernando Munayco-Guillén, Fray Servando Teresa de Mier 202, Quintas del Marqués, Querétaro, México, Tel +51 985-558886, Email [email protected]: It has been reported that intravitreal Ziv-aflibercept is a safe and effective drug for the treatment of diabetes macular edema (DME). The objective of this study was to evaluate in a real-life setting, the efficacy of intravitreal Ziv-aflibercept in the treatment of DME after the administration of three consecutive monthly doses.Methods: A single arm, prospective cohort study. We included patients with DME who received three doses of intravitreal Ziv-aflibercept. Data such as best corrected visual acuity (BCVA) and tomographic biomarkers before treatment and a month after the third dose were collected. DME was staged using the Panozzo classification.Results: Thirty-eight patients participated for a total of 53 eyes. The mean age was 59 ± 8.1 years. We observed significant changes after the third dose in the parameters studied (BCVA in LogMAR pre-treatment (0.6 ± 0.33) and post-treatment (0.4 ± 0.29) [p< 0.001], macular thickness pre-treatment (501 ± 167 μm) and post-treatment (324 ± 114 μm) [p< 0.001], macular volume pre-treatment 10.8 (7.5– 17.8) mm3 and post-treatment 9.3 (0– 13.6) mm3 [p< 0.005]). And 73.6% of the patients presented an advanced severe stage during their pre-treatment evaluation and after post-treatment, 64.2% of the patients no longer presented edema. No systemic or ocular adverse events occurred.Conclusion: The use of three consecutive monthly doses of intravitreal Ziv-aflibercept in a real-life setting is effective and safe in the management of diabetic macular edema.Keywords: antiangiogenic, diabetes mellitus, intravitreal injection, macular edema, optical coherence tomography, Ziv-aflibercep