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Micropulse 577 nm Laser Photocoagulation Versus Conventional 532 nm Laser Photocoagulation for Diabetic Macular Oedema (UMDMO)

Primary Purpose

Diabetic Macular Edema

Status
Unknown status
Phase
Phase 2
Locations
Malaysia
Study Type
Interventional
Intervention
Micropulse 577 nm yellow diode laser
532 nm green diode laser
Sponsored by
University of Malaya
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetic Macular Edema focused on measuring Diabetic macular edema, Diabetic macular oedema, micropulse laser, laser treatment, macular thickness

Eligibility Criteria

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

Inclusion Criteria:

  • Diabetes mellitus (type 1 or 2)
  • Diabetic macular edema in study eye associated to diabetic retinopathy
  • Diffuse macular edema defined as macular thickening determined by biomicroscopy, OCT and/or fluorescein angiography.
  • Best corrected visual acuity between 34 (20/200) and 68 letters (20/50).
  • Macular thickness greater than 300 mcm on OCT.

Exclusion Criteria:

  • Significant renal disease, defined as a history of chronic renal failure requiring dialysis or kidney transplant.
  • A condition that, in the opinion of the investigator, would preclude participation in the study (e.g., unstable medical status including blood pressure, cardiovascular disease, and glycemic control).
  • Blood pressure > 180/110 (systolic above 180 OR diastolic above 110).
  • Subject is expecting to move out of the area of the clinical center to an area not covered by another clinical center during the next 6 months.

The following exclusions apply to the study eye only (i.e., they may be present for the nonstudy eye):

  • Macular edema is considered to be due to a cause other than diabetic macular edema.
  • Presence of vitreomacular traction.
  • Concurrent proliferative diabetic retinopathy.
  • An ocular condition is present such that, in the opinion of the investigator, visual acuity loss would not improve from resolution of macular edema (e.g., foveal atrophy, pigment abnormalities, dense subfoveal hard exudates, significant macular ischemia, nonretinal condition).
  • An ocular condition is present (other than diabetes) that, in the opinion of the investigator, might affect macular edema or alter visual acuity during the course of the study (e.g., vein occlusion, uveitis epiretinal membrane, or other ocular inflammatory disease, neovascular glaucoma, etc.).
  • Substantial cataract that, in the opinion of the investigator, is likely to be decreasing visual acuity by 3 lines or more (i.e., cataract would be reducing acuity to 20/40 or worse if eye was otherwise normal).
  • History of treatment for DME at any time in the past 4 months (such as focal/grid macular photocoagulation, intravitreal or peribulbar corticosteroids, anti-VEGF drugs, or any other treatment).
  • History of panretinal (scatter) photocoagulation (PRP) prior to enrollment or anticipated to be performed within next 6 months.
  • History of major ocular surgery (including vitrectomy, cataract extraction, scleral buckle, any intraocular surgery, etc.) within prior 12 months or anticipated within the next 6 months.
  • History of YAG capsulotomy performed within 2 months prior to enrollment.

Sites / Locations

  • University Malaya Eye Research CentreRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Micropulse 577 nm yellow diode laser

532 nm green diode laser

Arm Description

Outcomes

Primary Outcome Measures

Best corrected visual acuity by logarithm of the minimum angle of resolution (LogMAR)

Secondary Outcome Measures

Macular thickness measured by optical coherence tomography (OCT)
Photocoagulation scars on fundus photograph

Full Information

First Posted
January 7, 2010
Last Updated
January 7, 2010
Sponsor
University of Malaya
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1. Study Identification

Unique Protocol Identification Number
NCT01045239
Brief Title
Micropulse 577 nm Laser Photocoagulation Versus Conventional 532 nm Laser Photocoagulation for Diabetic Macular Oedema
Acronym
UMDMO
Official Title
A Randomized, Controlled Trial Comparing Micropulse 577 nm Laser Photocoagulation And Conventional 532 nm Laser Photocoagulation for Diabetic Macular Oedema
Study Type
Interventional

2. Study Status

Record Verification Date
January 2010
Overall Recruitment Status
Unknown status
Study Start Date
October 2009 (undefined)
Primary Completion Date
October 2011 (Anticipated)
Study Completion Date
January 2012 (Anticipated)

3. Sponsor/Collaborators

Name of the Sponsor
University of Malaya

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine whether the new micropulse 577 nm yellow laser is a better treatment option compared to the conventional 532 nm green laser for diabetic macular edema.
Detailed Description
Diabetes mellitus (DM) is a serious debilitating and deadly disease causing significant mortality and morbidity globally. Diabetic macular oedema is the most common cause of visual loss in the working population. In 1985, the Early Treatment Diabetic Retinopathy Study (ETDRS) demonstrated that focal (direct/grid) laser photocoagulation reduces moderate vision loss from diabetic macular oedema (DMO) by 50% or more. However, further studies have shown that photocoagulation can eventually result in complications leading to loss of central vision and decreased colour vision. Thus, many newer laser machines that claim to reduce the rate of complications have been developed over the years. In this project, we plan to evaluate the usage of the micropulse 577 nm laser, which is a yellow light laser, and compare it to the conventional 532 nm green laser that is widely used. The 577 nm laser has a high affinity for oxyhemoglobin, a slightly lower affinity for melanin and almost no affinity for macular xanthophylls, as shown in the graph below.22,23,24,25 The yellow 577 nm light also scatters very little and does not cause photochemical reactions in the tissues. The theoretical advantage of using the micropulse 577 nm yellow laser would be the reduced energy requirement to obtain the same results as with green 532 nm. This leads to less retinal toxicity and damage due to reduced absorption by the xanthophylls. Our aim in this project is to observe whether the theoretical advantage translates to a more effective treatment in reality.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetic Macular Edema
Keywords
Diabetic macular edema, Diabetic macular oedema, micropulse laser, laser treatment, macular thickness

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
100 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Micropulse 577 nm yellow diode laser
Arm Type
Experimental
Arm Title
532 nm green diode laser
Arm Type
Active Comparator
Intervention Type
Device
Intervention Name(s)
Micropulse 577 nm yellow diode laser
Other Intervention Name(s)
Quantel Supra 577nm laser
Intervention Description
Laser administered at beginning of study and may be repeated at 16 weeks if needed
Intervention Type
Device
Intervention Name(s)
532 nm green diode laser
Intervention Description
Laser administered at beginning of study and may be repeated at 16 weeks if needed
Primary Outcome Measure Information:
Title
Best corrected visual acuity by logarithm of the minimum angle of resolution (LogMAR)
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Macular thickness measured by optical coherence tomography (OCT)
Time Frame
12 months
Title
Photocoagulation scars on fundus photograph
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diabetes mellitus (type 1 or 2) Diabetic macular edema in study eye associated to diabetic retinopathy Diffuse macular edema defined as macular thickening determined by biomicroscopy, OCT and/or fluorescein angiography. Best corrected visual acuity between 34 (20/200) and 68 letters (20/50). Macular thickness greater than 300 mcm on OCT. Exclusion Criteria: Significant renal disease, defined as a history of chronic renal failure requiring dialysis or kidney transplant. A condition that, in the opinion of the investigator, would preclude participation in the study (e.g., unstable medical status including blood pressure, cardiovascular disease, and glycemic control). Blood pressure > 180/110 (systolic above 180 OR diastolic above 110). Subject is expecting to move out of the area of the clinical center to an area not covered by another clinical center during the next 6 months. The following exclusions apply to the study eye only (i.e., they may be present for the nonstudy eye): Macular edema is considered to be due to a cause other than diabetic macular edema. Presence of vitreomacular traction. Concurrent proliferative diabetic retinopathy. An ocular condition is present such that, in the opinion of the investigator, visual acuity loss would not improve from resolution of macular edema (e.g., foveal atrophy, pigment abnormalities, dense subfoveal hard exudates, significant macular ischemia, nonretinal condition). An ocular condition is present (other than diabetes) that, in the opinion of the investigator, might affect macular edema or alter visual acuity during the course of the study (e.g., vein occlusion, uveitis epiretinal membrane, or other ocular inflammatory disease, neovascular glaucoma, etc.). Substantial cataract that, in the opinion of the investigator, is likely to be decreasing visual acuity by 3 lines or more (i.e., cataract would be reducing acuity to 20/40 or worse if eye was otherwise normal). History of treatment for DME at any time in the past 4 months (such as focal/grid macular photocoagulation, intravitreal or peribulbar corticosteroids, anti-VEGF drugs, or any other treatment). History of panretinal (scatter) photocoagulation (PRP) prior to enrollment or anticipated to be performed within next 6 months. History of major ocular surgery (including vitrectomy, cataract extraction, scleral buckle, any intraocular surgery, etc.) within prior 12 months or anticipated within the next 6 months. History of YAG capsulotomy performed within 2 months prior to enrollment.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Linda Ong, MBBS
Phone
+603-79494422
Ext
2060
Email
lindaong@hotmail.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kenneth C Fong, FRCOphth
Organizational Affiliation
University of Malaya Eye Research Centre
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Tajunisah Iqbal, FRCS
Organizational Affiliation
University of Malaya Eye Research Centre
Official's Role
Principal Investigator
Facility Information:
Facility Name
University Malaya Eye Research Centre
City
Kuala Lumpur
ZIP/Postal Code
59100
Country
Malaysia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ng Joanne, BSc
Phone
+603-79494422
Ext
2060
Email
joanne.npj@gmail.com

12. IPD Sharing Statement

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Micropulse 577 nm Laser Photocoagulation Versus Conventional 532 nm Laser Photocoagulation for Diabetic Macular Oedema

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