To evaluate the safety of intravitreal ziv-aflibercept (Zaltrap®) in the treatment choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD).


Eligible eyes with CNV secondary to AMD each received a single intravitreal injection of ziv-aflibercept. Comprehensive ophthalmic examinations and detailed systemic evaluations were performed at baseline, and days 1, 7, and 30 after injection, and International Society for Clinical Electrophysiology of Vision (ISCEV) standard electroretinography was performed at baseline and day 30. Primary outcome measures were safety parameters that included signs of clinical and electroretinographic toxicity. Secondary outcome measures included changes in best-corrected visual acuity (BCVA) and central subfield thickness (CST).


Twelve eyes of 12 patients were treated. None of the patients complained of blurred vision, ocular pain, or bulbar injection at any of the follow-up visits, nor was intraocular inflammation noted. There were no significant differences in implicit times, “a” and “b” wave amplitudes, or b/a ratios at one month when compared to baseline (P = 0.4). None of the patients experienced serious ocular or systemic adverse events. Mean BCVA improved only slightly at 30 days (LogMAR 0.45 ± 0.31 (Snellen equivalent: 20/60)) compared to baseline (LogMAR 0.37 ± 0.24 (Snellen equivalent: 20/50); P = 0.51).


Single intravitreal injections of ziv-aflibercept into eyes with neovascular AMD appear to be safe through one month. Ziv-aflibercept could become a safe, low-cost therapy for macular diseases but more testing is required.

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Michael W Stewart