Retina specialists have had more than a decade of success using reconstituted bevacizumab (Avastin, Genentech)—an IV cancer drug—for ophthalmic use. Outside the US, some are using a similar approach with ziv-aflibercept (Zaltrap, Regeneron), a chemo drug for colorectal cancer that bears some commonalities with aflibercept (Eylea, Regeneron).

Upon assessing the visual outcomes of intravitreal ziv-aflibercept, Lebanese researchers found it safe and efficacious in the treatment of macular diseases through two years.

This study evaluated 107 eyes of 91 patients who received the drug. Forty-two eyes had neovascular macular degeneration, 32 had diabetic macular oedema and 11 had macular oedema secondary to retinal vein occlusion. Fifty of the eyes were naive, and 57 were previously treated. The team measured best-corrected visual acuity (BCVA) and central macular thickness (CMT).

The researchers found that after two years, CMT had decreased significantly by 133.0 ±153.0µm and BCVA had increased by 0.35 ±0.37 after an average of 8.5 injections at month 12, 2.4 between 12 and 18 months and 1.7 between 18 and 24 months. They note that ocular and systemic adverse effects included one episode of transient uveitis and one instance of central retinal artery occlusion.

Mansour AM, Ashraf M, Charbaji A, et al. Two-year outcomes of intravitreal ziv-aflibercept. Br J Ophthalmol. 2018;102(10):1387-90.