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Intravitreal Aflibercept or Ranibizumab for Rubeosis Iridis

Primary Purpose

Glaucoma, Rubeosis Iridis

Status
Completed
Phase
Phase 3
Locations
Brazil
Study Type
Interventional
Intervention
Aflibercept
Ranibizumab
Sponsored by
Instituto de Olhos de Goiania
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Glaucoma focused on measuring rubeosis iridis, glaucoma, ranibizumab, aflibercept

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Criteria:

Inclusion Criteria:

  • Ability to provide written informed consent and comply with study assessments for the full duration of the study
  • Age > 18 years
  • Ischemic central retina vein occlusion (CRVO) within 3 months of enrollment as per the following inclusion criteria
  • Three of the following clinical tests must be present to demonstrate ischemic CRVO
  • Visual Acuity 20/200 or worse
  • Loss of 1-2e isopter on Goldmann Visual field (Kwon et al. 2001)
  • Electroretinogram demonstrating b wave amplitude less than 60% of A wave.

Exclusion Criteria:

  • Angle neovascularization greater than 3 clock hours with IOP over 30 (Neovascular glaucoma)
  • Any previous retinal laser photocoagulation to the study eye
  • Any previous intravitreal injection in study eye (triamcinolone or other)
  • Any previous vitrectomy in study eye (posterior or anterior associated with vitreous loss in cataract surgery)
  • Intracapsular cataract extraction (posterior capsule needs to be present)
  • Previous history of retinal detachment in study eye
  • Any previous radiation treatments to head/ neck
  • Inability to assess iris neovascularization (corneal opacity precluding gonioscopy)
  • Significant cardiovascular disease or cancer that would prevent follow-up visits or completion of the 12 month study
  • Significant diabetic retinopathy in the fellow eye (diabetic macular edema, proliferative diabetic retinopathy, or high-risk non-proliferative diabetic retinopathy)
  • Pregnancy (positive pregnancy test)
  • Prior enrollment in any study for vein occlusion in the study eye
  • Participation in another simultaneous medical investigator or trial Ocular disorders in the study eye that may confound interpretation of study results, including retinal detachment, macular hole, or choroidal neovascularization of any cause (e.g., DME AMD, ocular histoplasmosis, or pathologic myopia)
  • Concurrent disease in the study eye that could compromise visual acuity or require medical or surgical intervention during the study period
  • Aphakia or absence of the posterior capsule in the study eye
  • Previous violation of the posterior capsule is also excluded unless it occurred as a result of YAG laser posterior capsulotomy in association with prior, posterior chamber intraocular lens implantation
  • History of idiopathic or autoimmune uveitis in either eye Structural damage to the center of the macula in the study eye preexisting to CRVO likely to preclude improvement in visual acuity following the resolution of macular edema, including atrophy of the retinal pigment epithelium, subretinal fibrosis, laser scar(s)
  • Vitreomacular traction or epiretinal membrane in the study eye evident biomicroscopically or by OCT
  • Ocular inflammation (including trace or above) in the study eye Uncontrolled glaucoma (defined as intraocular pressure ≥30 mm Hg despite treatment with anti- medications) or previous filtration surgery in the study eye Systemic Conditions
  • Uncontrolled Blood pressure exceeding diastolic pressure of 100 mm Hg (sitting) during the screening period
  • Uncontrolled diabetes mellitus
  • Renal failure requiring dialysis or renal transplant
  • Premenopausal women not using adequate contraception
  • Previous participation in other studies of investigational drugs (excluding vitamins and minerals) within 3 months preceding Day 0
  • History of other disease, metabolic dysfunction, physical examination finding, or other findings giving reasonable suspicion of a disease or condition that contraindicates the use an investigational drug, might affect interpretation of the results of the study, or render the subject at high risk from treatment complications.

Sites / Locations

  • Instituto de Olhos de Goiania

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Aflibercept x Ranibizumab

Arm Description

12 eyes received an intraocular injection of 2.00 mg of aflibercept (IA) and 12 eyes patients received an intraocular injection of 1.25mg ranibizumab

Outcomes

Primary Outcome Measures

Degree of rubeosis iridis by biomicroscope
Compare results of rubeosis iridis regression after aflibercept or ranibizumab intraocular injection with decrease neovascularization - 1 year follow up
Degree of rubeosis iridis assessed by intraocular pressure
Compare results of rubeosis iridis regression after aflibercept or ranibizumab intraocular injection with decrease intraocular pressure (IOP) - 1 year follow up

Secondary Outcome Measures

Full Information

First Posted
November 26, 2015
Last Updated
December 28, 2015
Sponsor
Instituto de Olhos de Goiania
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1. Study Identification

Unique Protocol Identification Number
NCT02641457
Brief Title
Intravitreal Aflibercept or Ranibizumab for Rubeosis Iridis
Official Title
Intravitreal Aflibercept or Ranibizumab for Rubeosis Iridis
Study Type
Interventional

2. Study Status

Record Verification Date
December 2015
Overall Recruitment Status
Completed
Study Start Date
March 2014 (undefined)
Primary Completion Date
March 2015 (Actual)
Study Completion Date
October 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Instituto de Olhos de Goiania

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Aflibercept (Eylea®) and ranibizumab (Lucentis®) are an anti-VEGF, but there are differences between the two drugs. To determine and compare whether intraocular aflibercept and ranibizumab decreases rubeosis iridis (RI) in patients with neovascular glaucoma (NVG).
Detailed Description
Aflibercept (Eylea®) and ranibizumab (Lucentis®) are an anti-VEGF, but there are differences between the two drugs. Lucentis is administered in the form of smaller molecules, which is thought to give Lucentis an advantage over Eylea in its ability to penetrate the eye's retina and halt abnormal blood vessel growth contributing to advanced macular degeneration and scarring that causes blindness. They may have a role in treating ocular disorders involving fibrovascular proliferation. To determine and compare whether intraocular aflibercept and ranibizumab decreases rubeosis iridis (RI) in patients with neovascular glaucoma (NVG).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Glaucoma, Rubeosis Iridis
Keywords
rubeosis iridis, glaucoma, ranibizumab, aflibercept

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
2 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Aflibercept x Ranibizumab
Arm Type
Experimental
Arm Description
12 eyes received an intraocular injection of 2.00 mg of aflibercept (IA) and 12 eyes patients received an intraocular injection of 1.25mg ranibizumab
Intervention Type
Drug
Intervention Name(s)
Aflibercept
Other Intervention Name(s)
Eylea
Intervention Description
12 eyes received an intraocular injection of 2.00 mg of aflibercept (IA) and IOP were measured by tonometer. The neovascularization was evaluated by biomicroscope.
Intervention Type
Drug
Intervention Name(s)
Ranibizumab
Other Intervention Name(s)
Lucentis
Intervention Description
12 eyes received an intraocular injection of 1.25mg ranibizumab and IOP were measured by tonometer. The neovascularization was evaluated by biomicroscope.
Primary Outcome Measure Information:
Title
Degree of rubeosis iridis by biomicroscope
Description
Compare results of rubeosis iridis regression after aflibercept or ranibizumab intraocular injection with decrease neovascularization - 1 year follow up
Time Frame
1 year follow up
Title
Degree of rubeosis iridis assessed by intraocular pressure
Description
Compare results of rubeosis iridis regression after aflibercept or ranibizumab intraocular injection with decrease intraocular pressure (IOP) - 1 year follow up
Time Frame
1 year follow up

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Criteria: Inclusion Criteria: Ability to provide written informed consent and comply with study assessments for the full duration of the study Age > 18 years Ischemic central retina vein occlusion (CRVO) within 3 months of enrollment as per the following inclusion criteria Three of the following clinical tests must be present to demonstrate ischemic CRVO Visual Acuity 20/200 or worse Loss of 1-2e isopter on Goldmann Visual field (Kwon et al. 2001) Electroretinogram demonstrating b wave amplitude less than 60% of A wave. Exclusion Criteria: Angle neovascularization greater than 3 clock hours with IOP over 30 (Neovascular glaucoma) Any previous retinal laser photocoagulation to the study eye Any previous intravitreal injection in study eye (triamcinolone or other) Any previous vitrectomy in study eye (posterior or anterior associated with vitreous loss in cataract surgery) Intracapsular cataract extraction (posterior capsule needs to be present) Previous history of retinal detachment in study eye Any previous radiation treatments to head/ neck Inability to assess iris neovascularization (corneal opacity precluding gonioscopy) Significant cardiovascular disease or cancer that would prevent follow-up visits or completion of the 12 month study Significant diabetic retinopathy in the fellow eye (diabetic macular edema, proliferative diabetic retinopathy, or high-risk non-proliferative diabetic retinopathy) Pregnancy (positive pregnancy test) Prior enrollment in any study for vein occlusion in the study eye Participation in another simultaneous medical investigator or trial Ocular disorders in the study eye that may confound interpretation of study results, including retinal detachment, macular hole, or choroidal neovascularization of any cause (e.g., DME AMD, ocular histoplasmosis, or pathologic myopia) Concurrent disease in the study eye that could compromise visual acuity or require medical or surgical intervention during the study period Aphakia or absence of the posterior capsule in the study eye Previous violation of the posterior capsule is also excluded unless it occurred as a result of YAG laser posterior capsulotomy in association with prior, posterior chamber intraocular lens implantation History of idiopathic or autoimmune uveitis in either eye Structural damage to the center of the macula in the study eye preexisting to CRVO likely to preclude improvement in visual acuity following the resolution of macular edema, including atrophy of the retinal pigment epithelium, subretinal fibrosis, laser scar(s) Vitreomacular traction or epiretinal membrane in the study eye evident biomicroscopically or by OCT Ocular inflammation (including trace or above) in the study eye Uncontrolled glaucoma (defined as intraocular pressure ≥30 mm Hg despite treatment with anti- medications) or previous filtration surgery in the study eye Systemic Conditions Uncontrolled Blood pressure exceeding diastolic pressure of 100 mm Hg (sitting) during the screening period Uncontrolled diabetes mellitus Renal failure requiring dialysis or renal transplant Premenopausal women not using adequate contraception Previous participation in other studies of investigational drugs (excluding vitamins and minerals) within 3 months preceding Day 0 History of other disease, metabolic dysfunction, physical examination finding, or other findings giving reasonable suspicion of a disease or condition that contraindicates the use an investigational drug, might affect interpretation of the results of the study, or render the subject at high risk from treatment complications.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Joao J Nassaralla, MD PhD
Organizational Affiliation
Instituto de Olhos de Goiânia
Official's Role
Study Chair
Facility Information:
Facility Name
Instituto de Olhos de Goiania
City
Goiania
State/Province
GO
ZIP/Postal Code
74110-120
Country
Brazil

12. IPD Sharing Statement

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Intravitreal Aflibercept or Ranibizumab for Rubeosis Iridis

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