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Safety and Efficacy of Subretinal Implants for Partial Restoration of Vision in Blind Patients

Primary Purpose

Retinitis Pigmentosa, Retinal Degeneration

Status
Completed
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Device name: "Retina Implant model Alpha". Surgical implantation of medical device into eye
Sponsored by
Retina Implant AG
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Retinitis Pigmentosa focused on measuring Retina implant, Subretinal, Legal blindness, Genetic Diseases, Inborn, Eye Diseases, Retinitis Pigmentosa, Retinitis, Retinal Degeneration, Eye Diseases, Hereditary, Retinal Diseases

Eligibility Criteria

18 Years - 78 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Hereditary retinal degeneration of the outer retinal layers i.e. photoreceptor rods & cones.
  • Pseudophakia
  • Angiography shows retinal vessels adequately perfused, despite pathological RP condition.
  • Age between 18 and 78 years.
  • Blindness (at least monocular) i.e. visual functions not appropriate for localization of objects, self sustained navigation and orientation.
  • Ability to read normal print in earlier life, optically corrected without magnifying glass.
  • Willing and able to give written informed consent in accordance to EN ISO 14155 (section 6.7) and local legislation prior to participation in the study. Able to perform the study during the full time period of one year for Module-2.

Exclusion Criteria:

  • Period of appropriate visual functions approx. 12 years / lifetime.
  • Optical Coherence Tomography (OCT) shows significant retina edema &/or scar tissue within target region for implant.
  • Retina detected as too thin to expect required rest-functionality of inner retina as shown via Optical Coherence Tomography (OCT).
  • Lack of inner-retinal function, as determined by Electrically Evoked Phosphenes (EEP).
  • Heavy clumped pigmentation at posterior pole
  • Any other ophthalmologic disease with relevant effect upon visual function (e.g. glaucoma, optic neuropathies, trauma, diabetic retinopathy, retinal detachment).
  • Amblyopia reported earlier in life on eye to be implanted
  • Systemic diseases that might imply considerable risks with regard to the surgical interventions and anaesthesia (e.g. cardiovascular/ pulmonary diseases, severe metabolic diseases).
  • Neurological and/or psychiatric diseases (e.g. M. Parkinson, epilepsy, depression).
  • Hyperthyroidism or hypersensitivity to iodine
  • Women who are pregnant or nursing, or women of childbearing potential who are not willing to use a medically acceptable means of birth control for the duration of the study, or women unwilling to perform a pregnancy test before entering the study.
  • Participation in another interventional clinical trial within the past 30 days.

Sites / Locations

  • Helmut Sachs, MD, PD
  • Johann Roider, MD, Prof.
  • Karl-Ulrich Bartz-Schmidt, MD, Prof.
  • Miklos Resch, MD, PhD
  • Timothy L Jackson, MB.ChB, PhD, FRCOphth
  • Robert MacLaren, MD, Prof., DPhil DipEd FRCOphth FRCS

Outcomes

Primary Outcome Measures

Activities of daily living and mobility significantly improve with implant-ON shown via activities of daily living tasks, recognition tasks, mobility, or a combination thereof.

Secondary Outcome Measures

Visual acuity/light-perception and/or object-recognition are significantly improved with implant-ON versus OFF as shown via: FrACT/BaLM/BaGA/VFQ-25 or a combination thereof.
Patient long term safety and stability of implant function

Full Information

First Posted
November 26, 2009
Last Updated
September 3, 2018
Sponsor
Retina Implant AG
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1. Study Identification

Unique Protocol Identification Number
NCT01024803
Brief Title
Safety and Efficacy of Subretinal Implants for Partial Restoration of Vision in Blind Patients
Official Title
Safety and Efficacy of Subretinal Implants for Partial Restoration of Vision in Blind Patients: A Prospective Multicenter Clinical Study Based on Randomized Intra-individual Implant Activation in Patients With Degenerative Retinal Diseases
Study Type
Interventional

2. Study Status

Record Verification Date
September 2018
Overall Recruitment Status
Completed
Study Start Date
December 2009 (undefined)
Primary Completion Date
April 2017 (Actual)
Study Completion Date
April 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Retina Implant AG

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Patients suffering from hereditary retinal degeneration receive a retinal implant to restore sight. Subretinal implant "ON" results in significant visual acuity improvement, when compared to "OFF" condition.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Retinitis Pigmentosa, Retinal Degeneration
Keywords
Retina implant, Subretinal, Legal blindness, Genetic Diseases, Inborn, Eye Diseases, Retinitis Pigmentosa, Retinitis, Retinal Degeneration, Eye Diseases, Hereditary, Retinal Diseases

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
Participant
Allocation
Randomized
Enrollment
39 (Actual)

8. Arms, Groups, and Interventions

Intervention Type
Device
Intervention Name(s)
Device name: "Retina Implant model Alpha". Surgical implantation of medical device into eye
Other Intervention Name(s)
retinal implant, bionic eye, artificial vision, artificial eye, restoration of vision, eye chip, vision prosthesis, eye implant, retinal prosthesis
Intervention Description
Surgical implantation of medical device named "Retina Implant" into eye to restore vision partially. Randomized intra-individual implant activation in patient under test conditions such as: FrACT, BaLM, BaGA, maze, ADL.
Primary Outcome Measure Information:
Title
Activities of daily living and mobility significantly improve with implant-ON shown via activities of daily living tasks, recognition tasks, mobility, or a combination thereof.
Time Frame
every 3 months for a period of one year
Secondary Outcome Measure Information:
Title
Visual acuity/light-perception and/or object-recognition are significantly improved with implant-ON versus OFF as shown via: FrACT/BaLM/BaGA/VFQ-25 or a combination thereof.
Time Frame
every 3 months for a period of one year
Title
Patient long term safety and stability of implant function
Time Frame
every 3 months for a period of one year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
78 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Hereditary retinal degeneration of the outer retinal layers i.e. photoreceptor rods & cones. Pseudophakia Angiography shows retinal vessels adequately perfused, despite pathological RP condition. Age between 18 and 78 years. Blindness (at least monocular) i.e. visual functions not appropriate for localization of objects, self sustained navigation and orientation. Ability to read normal print in earlier life, optically corrected without magnifying glass. Willing and able to give written informed consent in accordance to EN ISO 14155 (section 6.7) and local legislation prior to participation in the study. Able to perform the study during the full time period of one year for Module-2. Exclusion Criteria: Period of appropriate visual functions approx. 12 years / lifetime. Optical Coherence Tomography (OCT) shows significant retina edema &/or scar tissue within target region for implant. Retina detected as too thin to expect required rest-functionality of inner retina as shown via Optical Coherence Tomography (OCT). Lack of inner-retinal function, as determined by Electrically Evoked Phosphenes (EEP). Heavy clumped pigmentation at posterior pole Any other ophthalmologic disease with relevant effect upon visual function (e.g. glaucoma, optic neuropathies, trauma, diabetic retinopathy, retinal detachment). Amblyopia reported earlier in life on eye to be implanted Systemic diseases that might imply considerable risks with regard to the surgical interventions and anaesthesia (e.g. cardiovascular/ pulmonary diseases, severe metabolic diseases). Neurological and/or psychiatric diseases (e.g. M. Parkinson, epilepsy, depression). Hyperthyroidism or hypersensitivity to iodine Women who are pregnant or nursing, or women of childbearing potential who are not willing to use a medically acceptable means of birth control for the duration of the study, or women unwilling to perform a pregnancy test before entering the study. Participation in another interventional clinical trial within the past 30 days.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Eberhart Zrenner, Prof. MD
Organizational Affiliation
Centre for Ophthalmology, Institute for Ophthalmic Research, University of Tuebingen, Germany
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Karl-Ulrich Bartz-Schmidt, Prof. MD
Organizational Affiliation
University Eye Hospital Tuebingen, Germany
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Timothy L Jackson, PhD FRCOphth
Organizational Affiliation
King's College Hospital NHS Trust
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
János Németh, Prof. MD PhD
Organizational Affiliation
Department of Ophthalmology Semmelweis University Budapest
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Robert E MacLaren, Prof. DPhil
Organizational Affiliation
Department of Ophthalmology, John Radcliffe Hospital, Oxford, UK
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Johann Roider, Prof. MD
Organizational Affiliation
University Eye Hospital, Kiel, Germany
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Helmut Sachs, PD, MD
Organizational Affiliation
Eye Hospital Dresden-Friedrichstadt, Germany
Official's Role
Principal Investigator
Facility Information:
Facility Name
Helmut Sachs, MD, PD
City
Dresden
ZIP/Postal Code
01067
Country
Germany
Facility Name
Johann Roider, MD, Prof.
City
Kiel
ZIP/Postal Code
24105
Country
Germany
Facility Name
Karl-Ulrich Bartz-Schmidt, MD, Prof.
City
Tuebingen
ZIP/Postal Code
72076
Country
Germany
Facility Name
Miklos Resch, MD, PhD
City
Budapest
ZIP/Postal Code
1083
Country
Hungary
Facility Name
Timothy L Jackson, MB.ChB, PhD, FRCOphth
City
London
ZIP/Postal Code
SE5 9RS
Country
United Kingdom
Facility Name
Robert MacLaren, MD, Prof., DPhil DipEd FRCOphth FRCS
City
Oxford
ZIP/Postal Code
OX3 9DU
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
26783453
Citation
Koitschev A, Stingl K, Bartz-Schmidt KU, Braun A, Gekeler F, Greppmaier U, Sachs H, Peters T, Wilhelm B, Zrenner E, Besch D. Extraocular Surgical Approach for Placement of Subretinal Implants in Blind Patients: Lessons from Cochlear-Implants. J Ophthalmol. 2015;2015:842518. doi: 10.1155/2015/842518. Epub 2015 Dec 10.
Results Reference
background
PubMed Identifier
25906684
Citation
Hafed ZM, Stingl K, Bartz-Schmidt KU, Gekeler F, Zrenner E. Oculomotor behavior of blind patients seeing with a subretinal visual implant. Vision Res. 2016 Jan;118:119-31. doi: 10.1016/j.visres.2015.04.006. Epub 2015 Apr 20.
Results Reference
background
PubMed Identifier
23410193
Citation
Stingl K, Gekeler F, Bartz-Schmidt KU, Kogel A, Zrenner E, Gelisken F. Fluorescein angiographic findings in eyes of patients with a subretinal electronic implant. Curr Eye Res. 2013 May;38(5):588-96. doi: 10.3109/02713683.2013.767349. Epub 2013 Feb 14.
Results Reference
background
PubMed Identifier
23427175
Citation
Stingl K, Bartz-Schmidt KU, Besch D, Braun A, Bruckmann A, Gekeler F, Greppmaier U, Hipp S, Hortdorfer G, Kernstock C, Koitschev A, Kusnyerik A, Sachs H, Schatz A, Stingl KT, Peters T, Wilhelm B, Zrenner E. Artificial vision with wirelessly powered subretinal electronic implant alpha-IMS. Proc Biol Sci. 2013 Feb 20;280(1757):20130077. doi: 10.1098/rspb.2013.0077. Print 2013 Apr 22.
Results Reference
background
PubMed Identifier
25812924
Citation
Stingl K, Bartz-Schmidt KU, Besch D, Chee CK, Cottriall CL, Gekeler F, Groppe M, Jackson TL, MacLaren RE, Koitschev A, Kusnyerik A, Neffendorf J, Nemeth J, Naeem MA, Peters T, Ramsden JD, Sachs H, Simpson A, Singh MS, Wilhelm B, Wong D, Zrenner E. Subretinal Visual Implant Alpha IMS--Clinical trial interim report. Vision Res. 2015 Jun;111(Pt B):149-60. doi: 10.1016/j.visres.2015.03.001. Epub 2015 Mar 23.
Results Reference
result
PubMed Identifier
25219982
Citation
Kitiratschky VB, Stingl K, Wilhelm B, Peters T, Besch D, Sachs H, Gekeler F, Bartz-Schmidt KU, Zrenner E. Safety evaluation of "retina implant alpha IMS"--a prospective clinical trial. Graefes Arch Clin Exp Ophthalmol. 2015 Mar;253(3):381-7. doi: 10.1007/s00417-014-2797-x. Epub 2014 Sep 16.
Results Reference
result
PubMed Identifier
24150759
Citation
Stingl K, Bartz-Schmidt KU, Gekeler F, Kusnyerik A, Sachs H, Zrenner E. Functional outcome in subretinal electronic implants depends on foveal eccentricity. Invest Ophthalmol Vis Sci. 2013 Nov 19;54(12):7658-65. doi: 10.1167/iovs.13-12835.
Results Reference
result
PubMed Identifier
28878616
Citation
Stingl K, Schippert R, Bartz-Schmidt KU, Besch D, Cottriall CL, Edwards TL, Gekeler F, Greppmaier U, Kiel K, Koitschev A, Kuhlewein L, MacLaren RE, Ramsden JD, Roider J, Rothermel A, Sachs H, Schroder GS, Tode J, Troelenberg N, Zrenner E. Interim Results of a Multicenter Trial with the New Electronic Subretinal Implant Alpha AMS in 15 Patients Blind from Inherited Retinal Degenerations. Front Neurosci. 2017 Aug 23;11:445. doi: 10.3389/fnins.2017.00445. eCollection 2017.
Results Reference
result
PubMed Identifier
32343050
Citation
Cehajic Kapetanovic J, Troelenberg N, Edwards TL, Xue K, Ramsden JD, Stett A, Zrenner E, MacLaren RE. Highest reported visual acuity after electronic retinal implantation. Acta Ophthalmol. 2020 Nov;98(7):736-740. doi: 10.1111/aos.14443. Epub 2020 Apr 28.
Results Reference
derived
PubMed Identifier
30816625
Citation
Kuehlewein L, Troelenberg N, Stingl K, Schleehauf S, Kusnyerik A, Jackson TL, MacLaren RE, Chee C, Roider J, Wilhelm B, Gekeler F, Bartz-Schmidt KU, Zrenner E, Stingl K. Changes in microchip position after implantation of a subretinal vision prosthesis in humans. Acta Ophthalmol. 2019 Sep;97(6):e871-e876. doi: 10.1111/aos.14077. Epub 2019 Feb 28.
Results Reference
derived
PubMed Identifier
25298411
Citation
Rock T, Bartz-Schmidt KU, Bramkamp M, Rock D. Influence of axial length on thickness measurements using spectral-domain optical coherence tomography. Invest Ophthalmol Vis Sci. 2014 Oct 8;55(11):7494-8. doi: 10.1167/iovs.14-14043.
Results Reference
derived
PubMed Identifier
22562517
Citation
Kusnyerik A, Greppmaier U, Wilke R, Gekeler F, Wilhelm B, Sachs HG, Bartz-Schmidt KU, Klose U, Stingl K, Resch MD, Hekmat A, Bruckmann A, Karacs K, Nemeth J, Suveges I, Zrenner E. Positioning of electronic subretinal implants in blind retinitis pigmentosa patients through multimodal assessment of retinal structures. Invest Ophthalmol Vis Sci. 2012 Jun 20;53(7):3748-55. doi: 10.1167/iovs.11-9409.
Results Reference
derived

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Safety and Efficacy of Subretinal Implants for Partial Restoration of Vision in Blind Patients

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