Intravitreal Injections of Sirolimus in the Treatment of Geographic Atrophy (Sirolimus)

This is an interventional treatment trial for Geographic Atrophy Read More

Inclusion Criteria:

• Age 55 years of age or older. Prior participation in the Age-Related Eye Disease Study 2 (AREDS2) is not required.
• Participant must understand and sign the protocol's informed consent document.
• Participant must have central or non-central geographic atrophy (GA) in at least one eye. GA should be at least 0.75 disk areas (DA) in size but no more than 8 disk areas (DA); approximately 2.54 mm2 is 1 DA. GA is defined as one or more well-defined, usually more or less circular patches of partial or complete de-pigmentation of the retinal pigment epithelium (RPE), typically with exposure of underlying choroidal blood vessels. Even if much of the RPE appears to be preserved and large choroidal vessels are not visible, a round patch of RPE partial de-pigmentation may still be classified as early GA.
• Participant must have a steady fixation in the study eye in the foveal or parafoveal area and media clear enough for good quality photographs.
• Participant must have visual acuity between 20/25 and 20/200 in the study eye.
• Female participants must be post-menopausal.
• Male participants with female partners capable of conceiving children will be required to use contraception during the study and for four months after their last sirolimus injection.

Exclusion Criteria:

• Participant is in another investigational study other than AREDS2 and actively receiving study therapy for geographic atrophy or choroidal neovascularization (CNV).
• Participant is unable to comply with study procedures or follow-up visits.
• Participant has evidence of ocular disease other than AMD in either eye that may confound the outcome of the study (e.g., glaucoma, diabetic retinopathy with 10 or more hemorrhages or microaneurysms, uveitis, pseudovitelliform macular degeneration, moderate/severe myopia).
• Participant has received treatment for AMD, such as macular laser, photodynamic therapy (PDT) or anti-vascular endothelial growth factor (anti-VEGF) therapy injection. Or the participant received an IVT injection of any agent (e.g., triamcinolone) other than an anti-VEGF agent within the last four months prior to study enrollment. Vitamin supplementation for AMD is not considered an exclusionary criterion.
• Participant has had a vitrectomy.
• Participant is expected to need ocular surgery during the course of the trial.
• Participant has undergone lens removal in the last three months or Yttrium Aluminium Garnet (YAG) laser capsulotomy within the last month.
• Participant is on chemotherapy.
• Participant is on immunosuppressive medication or is immunosuppressed.
• Participant is on ocular or systemic medications known to be toxic to the lens, retina or optic nerve.
• Participant with a history of malignancy that would compromise the 2-year study survival.
• Participant with a history of ocular herpes simplex virus (HSV).
• A condition that, in the opinion of the investigator, would preclude participation in the study (e.g., unstable medical status including blood pressure and glycemic control).
• History of cancer (other than a non-melanoma skin cancer) diagnosed within the past five years that could be worsened by immunosuppression. (The risk of immunosuppression must be determined by an oncology consultation prior to enrollment.)
• Ocular or periocular inflammation or infection in either eye.
• Presence of active or inactive toxoplasmosis in the study eye.