![]() A greater visual acuity improvement occurred in eyes with worse baseline visual acuity (b=-1.01 p=0.00001). Preoperative BCVA was a positive factor for prognosis of BCVA at 12th month follow-up (b=0.42 p=0.006), while the negative factors were: previous panretinal photocoagulation (b=-0.24 p=0.04), presence of vitreomacular traction (b=-0.29 p=0.02) and preoperative CRT in the 1000 microm zone (b=-0.24 p=0.07). The 23 (79.3%) eyes showed improvement in BCVA ≥0.2 logMAR, 5 (17.2%) eyes improvement or stabilization of BCVA and 1(3.5%) eye deterioration. The mean preoperative CRV in the 6 mm zone was 11.4☒.9 microL (7.85-17.93) and decreased postoperatively at the last control to 7.92☑.0 microL (5.62-10.97) p=0.000003. The mean preoperative CRT in the 6 mm zone was 407☑05 microm (279-640) and decreased postoperatively at the last control to 282±40 µm (212-380) p=0.000004. The mean preoperative CRV in the 1mm zone was 0.39☐.14 microL (0.19-0.74) and decreased postoperatively at the last control to 0.17☐.06 microL (0.09-0.36) p=0.000003. The mean preoperative CRT in the 1mm zone was 516☑84 microm (256-950) and decreased postoperatively at the last control to 237☗5 microm (117-489) p=0.000003. The best-corrected visual acuity (BCVA) and central retinal thickness and volume (CRT and CRV) were recorded at 4, 8, 12, and 16 months after surgery. ![]() In this prospective, nonrandomized, interventional study we included 29 eyes of 26 patients with DDME. The aim of this study was to evaluate the visual acuity and structural outcomes of combined phacovitrectomy with ILM peeling, retinal endophotocoagulation and use of bevacizumab in patients with diffuse diabetic macular edema (DDME). We demonstrate that the combination of HER-2 and VEGF peptides induces potent anti-tumor and anti-angiogenic responses. Our results show that immunization with an HER-2 peptide epitope elicits high affinity HER-2 native antibodies that are effective in inhibiting tumor growth in vivo, an effect that is enhanced by VEGF peptide mimics. Tumor sections after treatment were stained for blood vessel density and actively dividing cells. A transplantable BALB/c mouse model challenged with TUBO cells was used to test the effects of the HER-2 peptide vaccine combined with VEGF peptide mimics. Moreover, a two-pronged approach was tested in vivo: (1) active immunotherapy with conformational HER-2 B-cell epitope vaccines and (2) anti-angiogenic therapy with a peptide structured to mimic VEGF. In vitro, HER-2 phosphorylation and antibody-dependent cellular toxicity were used to validate whether combining HER-2- and VEGF-targeting therapies would be effective. Here, we evaluate the dual antitumor effects of combining designed particular HER-2 peptide vaccine with VEGF peptide mimics. Many FDA-approved therapies targeting both HER-2 (Trastuzumab, Herceptin) and VEGF (Bevacizumab, Avastin) are expensive, have unacceptable toxicities and are often associated with the development of resistance. Overexpression of HER-2 and VEGF plays a key role in the development and metastasis of several human cancers. ![]() There is a trend toward greater efficacy for Lucentis over Avastin but this is not statistically significant and will need a head-to-head RCT to assess accurately. Conclusions: The synthesized clinical evidence to date supports both of these treatments as efficacious and safe for diabetic macular edema (DME). Vision threatening complications were rare but were reported regularly. ![]() The most common complications were vitreous hemorrhage, endophthalmitis and retinal detachment. The average decrease in thickness from Lucentis (161.9 μM) was larger than that for Avastin (96.5 μM) but this was not statistically significant (p = 0.23). For all anti-VEGF treatments, the average decrease in macular thickness was 114.4 microns (95% CI: 66.8 - 162 μM). Results: From 846 articles that were initially screened, 18 papers were included in the data extraction stage. Heterogeneous meta-analysis was performed on the primary outcome which was change in macular thickness from baseline after injection. ![]() A two-stage screening process was undertaken followed by a data extraction stage using the systematic review software EPPI. Grey literature that consisted of lectures, seminars and conferences was also retrieved. Methods: A systematic review was undertaken from the Medline, Biosis, CINAHL, Cochrane and Web of Science databases. Purpose: To synthesize the present clinical evidence of efficacy and adverse events of commonly used anti-VEGF drugs for Diabetic Macular Edema. ![]()
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