Back to resultsAdjunctive Steroid Combination in Ocular Trauma (ASCOT) Study (ASCOT)
Primary Purpose
Eye Injury Trauma
Status
Completed
Phase
Phase 3
Locations
United Kingdom
Study Type
Interventional
Intervention
Triamcinolone Acetonide
Sponsored by
About this trial
This is an interventional treatment trial for Eye Injury Trauma
Eligibility Criteria
Inclusion Criteria:
- Adult subjects (Aged 18 years or over at the time of enrolment)
- Full thickness, open-globe ocular trauma undergoing vitrectomy
- Ability to give written informed consent
- Willingness to accept randomization and attend follow-up for 6 months.
Exclusion Criteria:
- Children (Age less than 18 years old at time of enrollment)
- Pre-existing uncontrolled uveitis - Patients with pre-existing uveitis are likely to be rare in the study population however they have a pre-disposition to a more aggressive form of proliferative vitreoretinopathy and will therefore be excluded. (This does not include patients whose uveitis is secondary to their injury or retinal detachment)
- Definitive diagnosis of previous steroid induced glaucoma - these patients are at risk of steroid related pressure rise and will be excluded (this does not include patients in whom a query of previous steroid-induced raised IOP has been postulated)
- Pregnant or Breastfeeding females (Females of childbearing potential must be willing to use an effective method of contraception (hormonal or barrier method of birth control; true abstinence) from the time consent is signed until 6 weeks after their completion of the trial. Females of childbearing potential must have a negative urinary pregnancy test within 7 days prior to being registered for trial treatment (Subjects are considered not of child bearing potential if they are permanently sterile (i.e. they have undergone a hysterectomy, bilateral tubal occlusion, or bilateral salpingectomy) or they are postmenopausal)
- Allergy or previous known adverse reaction to triamcinolone acetonide
- Inability to attend regular follow up
- Unable to give written informed consent
- Current or planned systemic corticosteroid use of a dose above physiological levels (e.g. >10mg prednisolone)
Sites / Locations
- Moorfields Eye Hospital
Arms of the Study
Arm 1
Arm 2
Arm Type
No Intervention
Experimental
Arm Label
Standard care
Triamcinolone acetonide
Arm Description
The patient will receive the standard care given to all patients that have received a vitrectomy following open globe trauma.
Triamcinolone Acetonide 4mg/0.1ml intravitreal cavity and 40mg/1ml subtenons to be injected at the time of the vitrectomy. Patients will then receive standard care following operation.
Outcomes
Primary Outcome Measures
Improvement of visual acuity at 6 months
The proportion of patients with an improvement from baseline to 6 months of at least 10 on the corrected visual acuity in the study eye (total ETDRS letter score measured at 4 metres and 1 metre)
Secondary Outcome Measures
Total visual acuity score at 6 months
Total EDTRS score in the study eye at the 6 months follow up appointment
Full Information
NCT ID
NCT02873026
First Posted
June 13, 2016
Last Updated
September 16, 2021
Sponsor
Moorfields Eye Hospital NHS Foundation Trust
1. Study Identification
Unique Protocol Identification Number
NCT02873026
Brief Title
Adjunctive Steroid Combination in Ocular Trauma (ASCOT) Study
Acronym
ASCOT
Official Title
A Phase 3 Multi-centre Double-masked Randomised Controlled Trial of Adjunctive Intraocular and Periocular Steroid (Triamcinolone Acetonide) Versus Standard Treatment in Eyes Undergoing Vitreoretinal Surgery for Open Globe Trauma.
Study Type
Interventional
2. Study Status
Record Verification Date
September 2021
Overall Recruitment Status
Completed
Study Start Date
October 2014 (Actual)
Primary Completion Date
March 31, 2020 (Actual)
Study Completion Date
January 31, 2021 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Moorfields Eye Hospital NHS Foundation Trust
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Eye trauma is a leading cause of blindness and visual impairment. Penetrating injuries of the eye are more likely to result in poor vision and the main cause of this is a scarring response on the retina (proliferative vitreoretinopathy, PVR) The purpose of this study is to investigate the potential of an anti-inflammatory treatment (triamcinolone acetonide) to improve the outcome of surgery in eyes that have suffered severe trauma.There is good evidence from laboratory studies that additional steroid treatment into and around the eye at the time of surgery could reduce scarring by reducing inflammation and improve visual outcomes.
Detailed Description
Trauma is an important cause of visual impairment and blindness worldwide and a leading cause of blindness in young adult males.Globally it has been estimated that 1.6 million people are blind as a result of ocular trauma with 2.3 million suffering bilateral low vision. Ocular trauma is the commonest cause of unilateral blindness in the world today with up to 19 million with unilateral blindness or low vision. It is estimated that almost one million people in the United States live with trauma-related visual impairment. Ocular trauma has extensive socio-economic costs - patients with open globe injuries lose a mean of 70 days of work. In the United States work related eye injuries cost over $300 million per year (www.prevent blindness.org) this equates to an annual cost to the UK economy (for which no comparable data exists) of £37.5 million.
In the UK it is estimated that 5000 patients per year sustain eye injuries serious enough to require hospital admission and of these 250 will be permanently blinded in the injured eye. Recent European studies document incidences of 2.4 and 3.2 per 100000 per year for open-globe injuries which suggests an annual incidence for the UK of between 1500 and 2000.
Ocular injuries which result in visual loss invariably affect the posterior segment of the eye and prevention of visual loss involves posterior segment (vitreoretinal) surgery. It is clear from recent published data that although vitreoretinal surgical techniques have improved, outcomes remain unsatisfactory and that development of the intraocular scarring response proliferative vitreoretinopathy (PVR) is the leading cause of this.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Eye Injury Trauma
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantOutcomes Assessor
Allocation
Randomized
Enrollment
300 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Standard care
Arm Type
No Intervention
Arm Description
The patient will receive the standard care given to all patients that have received a vitrectomy following open globe trauma.
Arm Title
Triamcinolone acetonide
Arm Type
Experimental
Arm Description
Triamcinolone Acetonide 4mg/0.1ml intravitreal cavity and 40mg/1ml subtenons to be injected at the time of the vitrectomy. Patients will then receive standard care following operation.
Intervention Type
Drug
Intervention Name(s)
Triamcinolone Acetonide
Other Intervention Name(s)
kenalog
Intervention Description
Following the repair of the open globe eye trauma, the use of Triamcinolone Acetonide will be investigated
Primary Outcome Measure Information:
Title
Improvement of visual acuity at 6 months
Description
The proportion of patients with an improvement from baseline to 6 months of at least 10 on the corrected visual acuity in the study eye (total ETDRS letter score measured at 4 metres and 1 metre)
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Total visual acuity score at 6 months
Description
Total EDTRS score in the study eye at the 6 months follow up appointment
Time Frame
6 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Adult subjects (Aged 18 years or over at the time of enrolment)
Full thickness, open-globe ocular trauma undergoing vitrectomy
Ability to give written informed consent
Willingness to accept randomization and attend follow-up for 6 months.
Exclusion Criteria:
Children (Age less than 18 years old at time of enrollment)
Pre-existing uncontrolled uveitis - Patients with pre-existing uveitis are likely to be rare in the study population however they have a pre-disposition to a more aggressive form of proliferative vitreoretinopathy and will therefore be excluded. (This does not include patients whose uveitis is secondary to their injury or retinal detachment)
Definitive diagnosis of previous steroid induced glaucoma - these patients are at risk of steroid related pressure rise and will be excluded (this does not include patients in whom a query of previous steroid-induced raised IOP has been postulated)
Pregnant or Breastfeeding females (Females of childbearing potential must be willing to use an effective method of contraception (hormonal or barrier method of birth control; true abstinence) from the time consent is signed until 6 weeks after their completion of the trial. Females of childbearing potential must have a negative urinary pregnancy test within 7 days prior to being registered for trial treatment (Subjects are considered not of child bearing potential if they are permanently sterile (i.e. they have undergone a hysterectomy, bilateral tubal occlusion, or bilateral salpingectomy) or they are postmenopausal)
Allergy or previous known adverse reaction to triamcinolone acetonide
Inability to attend regular follow up
Unable to give written informed consent
Current or planned systemic corticosteroid use of a dose above physiological levels (e.g. >10mg prednisolone)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David Charteris, MD
Organizational Affiliation
Moorfields Eye Hosptial
Official's Role
Principal Investigator
Facility Information:
Facility Name
Moorfields Eye Hospital
City
London
Country
United Kingdom
12. IPD Sharing Statement
Plan to Share IPD
Undecided
Learn more about this trial
Adjunctive Steroid Combination in Ocular Trauma (ASCOT) Study
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