Purpose: To assess the safety and effectiveness of 2 mg ziv-ablifercept (ZA) in different retinal diseases. Methods: Single arm, open-label, prospective study. A 2 mg (0.08 mL) ZA dose was administered following the hospital protocols for topical anesthesia. The following were considered adverse effects: IOP >3 mmHg from baseline, retinal detachment, vitreous hemorrhage, endophthalmitis, retinal vasculitis, retinal necrosis, cataract progression, anterior and posterior uveitis. Results: The study included 91 eyes of 55 patients and 50% were men, with a median age of 64.26 ± 11.86 years, a mean of 1.68 ± 0.91 injections; baseline central foveal thickness (CFT) of 390. 91 ± 162.01 microns compared to a final CFT of 319.02 ± 104.67 microns (p = 0.000). Baseline best corrected visual acuity (BCVA) in logMAR was 0.86 ± 0.49 compared to a final BCVA of 0.75 ± 0.48 (p = 0.000). No adverse effects were reported. Conclusions: ZA is a safe and effective medication for the treatment of macular edema, regardless of the etiology, and it is also an affordable medication. Long-term studies are needed to evaluate its effectiveness compared to those drugs already approved for intravitreal use.

Posterior capsulotomy is indicated when the visual acuity is committed so that impacts the performance of ordinary activities or exploring the posterior pole structures as in the evaluation of the retina or optic nerve is difficult. As expected is not free of complications. There are reports of intraocular lens (IOL) pitting, elevation of intraocular pressure (IOP), cystoid macular edema, retinal detachment, endophthalmitis, iritis, vitritis, corneal edema and macular holes. Multidisciplinary immediate management of complications of posterior capsulotomy Nd-YAG laser prevents loss of corneal clarity and diminishes or prevents optic neuropathy secondary to increased IOP. We report the case of 70-year-oldwoman who presents 48 h after performing posterior capsulotomy with Nd-YAG laser with ocular pain and IOP of 34 mmHg. The inicial management included topical and oral ocular hypotensive and inflammatory therapy achieving normal eye pressure. During slit lamp biomicroscopy we found microguttae in corneal endothelium, vitreous in the anterior chamber, IOL dislocation, retinal pigment epithelial detachment (RPED), subretinal fluid and corneal edema. A vitrectomy was performed. We decided conservative treatment of the IOL, close monitoring and treatment of IOP and specular microscopy as part of a comprehensive treatment. Finally, subretinal fluid reabsorption is achieved although RPED remains with no changes, we achieve resolution of corneal and IOP is 12 mmHg without ocular antihypertensives. The final visual acuity is 20/40−2.

Evaluar la seguridad y efectividad del uso de ziv-aflibercept (ZA) en diferentes enfermedades retinianas a dosis de 2 mg. Métodos: Estudio de un único grupo, abierto, prospectivo; se administró una dosis de 2 mg (0,08 ml) de ZA siguiendo los protocolos de la unidad hospitalaria con anestesia tópica. Se consideraron efectos adversos: aumento de presión intraocular >3 mmHg de la basal, desprendimiento de retina, hemorragia vítrea, endoftalmitis, vasculitis o necrosis retiniana, progresión de la catarata, uveitis anterior y posterior. Resultados: Se incluyeron 91 ojos de 55 pacientes, 50% hombres, edad media 64.26 ± 11.86 años, una media de 1.68 ± 0.91 inyecciones, grosor foveal central inicial (GFC) 390.91 ± 162.01 micras comparado con un GFC final de 319.02 ± 104.67 micras (p = 0.000), y una agudeza visual mejor corregida (AVMC) en logMAR de la 0.86 ± 0.49 comparada con una AVMC final de 0.75 ± 0.48 (p = 0.000). No se reportaron efectos adversos en ninguna de las 149 administraciones de ZA. Conclusiones: ZA es un medicamento seguro y eficiente para el tratamiento del edema macular, independientemente de la causa, además de su costo accesible. Se necesitan estudios a largo plazo para evaluar la efectividad de este medicamento en comparación con los fármacos ya aprobados para el uso intravítreo.

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