Topical Use of Corticosteroid to Prevent Epiretinal Membrane Following Retinal Tear
Primary Purpose
Epiretinal Membrane
Status
Completed
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Prednisolone acetate
Sponsored by
About this trial
This is an interventional prevention trial for Epiretinal Membrane
Eligibility Criteria
Inclusion Criteria:
- Between ages 18 to 80 (inclusive)
- English-speaking
- Undergoing non-pneumatic laser retinopexy procedure for horseshoe retinal tear (without retinal detachment)
Exclusion Criteria:
- Patient refusal or delay of retinopexy procedure for more than 48 hours after diagnosis
- Patients who are pseudophakic or aphakic
- Medical conditions contraindicated with prednisolone: viral diseases of the cornea and conjunctiva including herpes simplex, vaccinia, varicella; fundal diseases of ocular structures; mycobacterial infections; hypercortisolism.
- Previous history of epiretinal membrane, retinal surgery (cryo or laser)
- Patients with hypersensitivity or contraindication for corticosteroids (viral diseases of the cornea and conjunctiva including herpes simplex, vaccinia, varicella; fungal diseases of ocular structures; mycobacterial infections; hypercortisolism).
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
No Intervention
Arm Label
Prednisolone
Control
Arm Description
Pred Forte (prednisolone acetate ophthalmic suspension, USP) 1% sterile
Patients in control group will not be given a corticosteroid as per usual standard of care.
Outcomes
Primary Outcome Measures
Incidence of epiretinal membrane
Secondary Outcome Measures
Full Information
NCT ID
NCT02412059
First Posted
April 3, 2015
Last Updated
January 28, 2016
Sponsor
Unity Health Toronto
Collaborators
University of Toronto
1. Study Identification
Unique Protocol Identification Number
NCT02412059
Brief Title
Topical Use of Corticosteroid to Prevent Epiretinal Membrane Following Retinal Tear
Official Title
Topical Use of Corticosteroid to Prevent Epiretinal Membrane Formation in Eyes With Retinal Tear Undergoing Laser Retinopexy: a Pilot Prospective Clinical Study
Study Type
Interventional
2. Study Status
Record Verification Date
January 2016
Overall Recruitment Status
Completed
Study Start Date
August 2015 (undefined)
Primary Completion Date
January 2016 (Actual)
Study Completion Date
January 2016 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Unity Health Toronto
Collaborators
University of Toronto
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
In this prospective randomized controlled double blind pilot clinical study, we aim to assess whether administration of a topical corticosteroid would attenuate epiretinal membrane formation following development of retinal tears treated with laser retionpexy.
Detailed Description
Epiretinal membrane (ERM) is a frequent, sight-threatening eye condition occurring in 1.02% - 28.9% of eyes in persons aged 40 years or older. [1] While often idiopathic in nature, ERM formation has been associated with retinal tears, possibly due to a breakdown of the blood-retinal barrier [1-3]. Pathological analysis of ERM content shows inflammatory mediators such as cytokines, growth factors and interleukins, which can promote fibroblast remodelling that leads to a contractile scar formation on the retinal surface. [1, 4-8] For this reason, ERM formation has been suggested to be an aberrant tissue repair or wound-healing process driven by inflammatory reactions. Since corticosteroids inhibit the inflammatory cascade and fibroblast transdifferentiation, administration of a corticosteroid following retinal tears should theoretically reduce the risk of ERM formation. [9-10] In this study, we aim to assess whether administration of a topical corticosteroid would attenuate ERM formation following laser retinopexy of retinal tears.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Epiretinal Membrane
7. Study Design
Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantOutcomes Assessor
Allocation
Randomized
Enrollment
200 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Prednisolone
Arm Type
Experimental
Arm Description
Pred Forte (prednisolone acetate ophthalmic suspension, USP) 1% sterile
Arm Title
Control
Arm Type
No Intervention
Arm Description
Patients in control group will not be given a corticosteroid as per usual standard of care.
Intervention Type
Drug
Intervention Name(s)
Prednisolone acetate
Other Intervention Name(s)
Pred Forte
Primary Outcome Measure Information:
Title
Incidence of epiretinal membrane
Time Frame
6-months following administration of corticosteroid
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Between ages 18 to 80 (inclusive)
English-speaking
Undergoing non-pneumatic laser retinopexy procedure for horseshoe retinal tear (without retinal detachment)
Exclusion Criteria:
Patient refusal or delay of retinopexy procedure for more than 48 hours after diagnosis
Patients who are pseudophakic or aphakic
Medical conditions contraindicated with prednisolone: viral diseases of the cornea and conjunctiva including herpes simplex, vaccinia, varicella; fundal diseases of ocular structures; mycobacterial infections; hypercortisolism.
Previous history of epiretinal membrane, retinal surgery (cryo or laser)
Patients with hypersensitivity or contraindication for corticosteroids (viral diseases of the cornea and conjunctiva including herpes simplex, vaccinia, varicella; fungal diseases of ocular structures; mycobacterial infections; hypercortisolism).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Myrna Lichter, MD, FRCSC
Organizational Affiliation
University of Toronto Department of Ophthalmology
Official's Role
Principal Investigator
12. IPD Sharing Statement
Citations:
PubMed Identifier
25360790
Citation
Bu SC, Kuijer R, Li XR, Hooymans JM, Los LI. Idiopathic epiretinal membrane. Retina. 2014 Dec;34(12):2317-35. doi: 10.1097/IAE.0000000000000349.
Results Reference
background
PubMed Identifier
7573306
Citation
Saran BR, Brucker AJ. Macular epiretinal membrane formation and treated retinal breaks. Am J Ophthalmol. 1995 Oct;120(4):480-5. doi: 10.1016/s0002-9394(14)72662-5. Erratum In: Am J Ophthalmol 1996 Mar;121(3):334.
Results Reference
background
PubMed Identifier
18344963
Citation
Snead DR, James S, Snead MP. Pathological changes in the vitreoretinal junction 1: epiretinal membrane formation. Eye (Lond). 2008 Oct;22(10):1310-7. doi: 10.1038/eye.2008.36. Epub 2008 Mar 14.
Results Reference
background
PubMed Identifier
24324293
Citation
Joshi M, Agrawal S, Christoforidis JB. Inflammatory mechanisms of idiopathic epiretinal membrane formation. Mediators Inflamm. 2013;2013:192582. doi: 10.1155/2013/192582. Epub 2013 Nov 11.
Results Reference
background
PubMed Identifier
3076143
Citation
Gilbert C, Hiscott P, Unger W, Grierson I, McLeod D. Inflammation and the formation of epiretinal membranes. Eye (Lond). 1988;2 Suppl:S140-56. doi: 10.1038/eye.1988.140.
Results Reference
background
PubMed Identifier
3180837
Citation
Hiscott PS, Unger WG, Grierson I, McLeod D. The role of inflammation in the development of epiretinal membranes. Curr Eye Res. 1988 Sep;7(9):877-92. doi: 10.3109/02713688808997245.
Results Reference
background
PubMed Identifier
8106541
Citation
Grinnell F. Fibroblasts, myofibroblasts, and wound contraction. J Cell Biol. 1994 Feb;124(4):401-4. doi: 10.1083/jcb.124.4.401. No abstract available.
Results Reference
background
PubMed Identifier
23406256
Citation
Banerjee PJ, Woodcock MG, Bunce C, Scott R, Charteris DG. A pilot study of intraocular use of intensive anti-inflammatory; triamcinolone acetonide to prevent proliferative vitreoretinopathy in eyes undergoing vitreoretinal surgery for open globe trauma; the Adjuncts in Ocular Trauma (AOT) Trial: study protocol for a randomised controlled trial. Trials. 2013 Feb 13;14:42. doi: 10.1186/1745-6215-14-42.
Results Reference
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PubMed Identifier
6153251
Citation
Tano Y, Sugita G, Abrams G, Machemer R. Inhibition of intraocular proliferations with intravitreal corticosteroids. Am J Ophthalmol. 1980 Jan;89(1):131-6. doi: 10.1016/0002-9394(80)90239-1.
Results Reference
background
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Topical Use of Corticosteroid to Prevent Epiretinal Membrane Following Retinal Tear
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