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Direct Selective Laser Trabeculoplasty in Ethnic Chinese Population The Zhuiguang Trial

Primary Purpose

Glaucoma, Open-Angle, Ocular Hypertension

Status
Withdrawn
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
DSLT
Sponsored by
BelkinVision
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Glaucoma, Open-Angle

Eligibility Criteria

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

Inclusion Criteria:

  1. Age 40 years or older, any gender, of Chinese Han ethnicity, with corrected visual acuity > 6/60 in both eyes
  2. Open angle glaucoma including exfoliative or pigmentary glaucoma or ocular hypertension.
  3. IOP ≥ 22mmHg to ≤35mmHg (after washout of any IOP-lowering medications) for participants.
  4. Gonioscopically visible scleral spur for 360 degrees without indentation
  5. Ability to visualize the peri-limbal sclera for 360 degrees (using a lid speculum)
  6. Willing and able to participate in the 12-month study, to comply with the study procedures and to adhere to the follow-up schedule.
  7. Participant capable of giving informed consent

Exclusion Criteria:

  1. Contraindications to conventional laser trabeculoplasty (e.g., corneal abnormalities, etc.)
  2. Angle Closure Glaucoma
  3. Congenital or developmental glaucoma
  4. Secondary glaucoma except exfoliative or pigmentary glaucoma
  5. Presence of any Peripheral Anterior Synechiae (PAS) in the study eye
  6. Inability to conduct a reliable visual field (defined as fixation losses, false positives or false negatives greater than 33%)
  7. Any of the following visual field findings using the Humphrey visual field analyzer the SITA-standard 24-2 program:

    1. A visual field MD of worse than -12dB
    2. Greater than or equal to 75% of points depressed below the 5% level and greater than or equal to 50% of points depressed below the 1% level on the PD plot.
    3. At least 50% of points (i.e 2 or more) within the central 5 degrees with a sensitivity ≤0dB on the decibel plot
    4. Points within the central 5 degrees of fixation with a sensitivity <15 dB in both hemifields on the decibel plot
  8. A visual field MD of worse than -12dB in the fellow eye
  9. Cup:Disc Ratio of more than 0.8
  10. More than three hypotensive medications required (combination drops are considered as 2 medications)
  11. Prior incisional or laser glaucoma surgery (including previous SLT or LPI) in the study eye.
  12. Prior corneal refractive surgery
  13. Complicated cataract surgery ≤ 6 months prior to enrollment
  14. Presence of visually significant cataract in the opinion of the investigator
  15. Clinically significant disease in either eye as determined by the Investigator.
  16. Clinically significant amblyopia in either eye
  17. Dense pigmentation or haemorrhage in the peri-limbal conjunctiva or anterior sclera
  18. Women who are pregnant or may become pregnant during the course of the study.
  19. In the opinion of the investigator the participant might require other ocular surgery within the 12-month follow-up period, unless for further reduction of their IOP
  20. Concurrent treatment with topical, nasal, inhaled or systemic steroids.
  21. Uncontrolled systemic disease that could impact the ability of the participant to attend follow up visits as per the discretion of the investigator.
  22. Participation in another clinical study, not including a GLAUrious sub-study

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    Direct Selective Laser Trabeculoplasty (DSLT)

    Selective Laser Trabeculoplasty (SLT)

    Arm Description

    Subjects will be treated with DSLT

    Subjects will be treated with SLT

    Outcomes

    Primary Outcome Measures

    IOP reduction from baseline to 6 months
    The primary effectiveness endpoint is the difference between the two treatment groups' change-from-baseline IOP, where change-from-baseline is defined as the difference between baseline (washed out for medicated patients) IOP and (washed out for medicated patients) IOP measured at 6 months for each subject.

    Secondary Outcome Measures

    Mean percentage IOP reduction
    Mean percentage reduction in IOP at 3, 6 and 12 months.
    Subjects with at least 20% IOP reduction
    Proportion of subjects with at least 20% reduction in IOP from baseline
    Change in medications
    Number of glaucoma medications at 12 months as compared to screening/visit 1 (before treatment) and compared between groups.
    Treatment failures
    Proportion of subjects in each group who are treatment failures (either had an incisional glaucoma surgery during the 6 months follow-up period, or are treated at the 6 months visit with hypotensive drugs in an equal or higher number than in the screening visit).
    Adverse events
    Proportion of ocular adverse events between the 2 arms at 6 and 12 months

    Full Information

    First Posted
    August 30, 2021
    Last Updated
    May 11, 2023
    Sponsor
    BelkinVision
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05043831
    Brief Title
    Direct Selective Laser Trabeculoplasty in Ethnic Chinese Population The Zhuiguang Trial
    Official Title
    Direct Selective Laser Trabeculoplasty for Primary Open Angle Glaucoma and Ocular Hypertension in Ethnic Chinese Population The Zhuiguang Trial
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    August 2021
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Study didnt start and will be re-designed
    Study Start Date
    October 15, 2021 (Anticipated)
    Primary Completion Date
    January 15, 2023 (Anticipated)
    Study Completion Date
    April 15, 2023 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    BelkinVision

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No
    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    The objective of this study is to evaluate the effectiveness (Intra-Ocular Pressure lowering) and safety of Direct Selective Laser Trabeculoplasty (DSLT) in ethnic Chinese subjects with Primary Open Angle Glaucoma or Ocular Hypertension.
    Detailed Description
    Glaucoma, which is very common disease in China, can result in blindness if left untreated and as such it is extremely important to diagnose and treat the condition. Usually doctors treat the first symptoms of glaucoma or ocular hypertension by prescribing eye drops. Unfortunately, there can be side effects associated with the use of these eye drops and there are reports of non-compliance due to difficulties in inserting these drops, all of which can impact on how effective this treatment regimen is. The purpose of this study is to assess how well the new automated DSLT device for laser treatment of glaucoma or ocular hypertension works in comparison with the standard SLT in ethnic Chinese population and determine that it is as effective in reducing intraocular pressure. DSLT or SLT will be performed in the study eye according to the randomization assignment. Eligible patients who sign the informed consent will be enrolled at each of the study sites, and undergo a washout (in the case of being medicated). After washout there will be a baseline visit, where continued eligibility is confirmed. Following confirmation of continued eligibility, 50% of patients being randomized to each treatment group. Randomization will be to a pre-determined randomization list. Only one eye per participant will be included in the study and they will be treated using either DSLT or SLT as per the randomized treatment allocation.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Glaucoma, Open-Angle, Ocular Hypertension

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Not Applicable
    Interventional Study Model
    Parallel Assignment
    Model Description
    1:1 randomization
    Masking
    Outcomes Assessor
    Masking Description
    Outcome assessor is not aware if subject is treated with SLT or DSLT
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Direct Selective Laser Trabeculoplasty (DSLT)
    Arm Type
    Experimental
    Arm Description
    Subjects will be treated with DSLT
    Arm Title
    Selective Laser Trabeculoplasty (SLT)
    Arm Type
    Active Comparator
    Arm Description
    Subjects will be treated with SLT
    Intervention Type
    Device
    Intervention Name(s)
    DSLT
    Other Intervention Name(s)
    SLT
    Intervention Description
    Direct-SLT is applied via the limbus to the trabecular meshwork
    Primary Outcome Measure Information:
    Title
    IOP reduction from baseline to 6 months
    Description
    The primary effectiveness endpoint is the difference between the two treatment groups' change-from-baseline IOP, where change-from-baseline is defined as the difference between baseline (washed out for medicated patients) IOP and (washed out for medicated patients) IOP measured at 6 months for each subject.
    Time Frame
    6 months
    Secondary Outcome Measure Information:
    Title
    Mean percentage IOP reduction
    Description
    Mean percentage reduction in IOP at 3, 6 and 12 months.
    Time Frame
    3, 6, 12 months
    Title
    Subjects with at least 20% IOP reduction
    Description
    Proportion of subjects with at least 20% reduction in IOP from baseline
    Time Frame
    6 months
    Title
    Change in medications
    Description
    Number of glaucoma medications at 12 months as compared to screening/visit 1 (before treatment) and compared between groups.
    Time Frame
    12 months
    Title
    Treatment failures
    Description
    Proportion of subjects in each group who are treatment failures (either had an incisional glaucoma surgery during the 6 months follow-up period, or are treated at the 6 months visit with hypotensive drugs in an equal or higher number than in the screening visit).
    Time Frame
    r months
    Title
    Adverse events
    Description
    Proportion of ocular adverse events between the 2 arms at 6 and 12 months
    Time Frame
    6, 12 months

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    40 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Age 40 years or older, any gender, of Chinese Han ethnicity, with corrected visual acuity > 6/60 in both eyes Open angle glaucoma including exfoliative or pigmentary glaucoma or ocular hypertension. IOP ≥ 22mmHg to ≤35mmHg (after washout of any IOP-lowering medications) for participants. Gonioscopically visible scleral spur for 360 degrees without indentation Ability to visualize the peri-limbal sclera for 360 degrees (using a lid speculum) Willing and able to participate in the 12-month study, to comply with the study procedures and to adhere to the follow-up schedule. Participant capable of giving informed consent Exclusion Criteria: Contraindications to conventional laser trabeculoplasty (e.g., corneal abnormalities, etc.) Angle Closure Glaucoma Congenital or developmental glaucoma Secondary glaucoma except exfoliative or pigmentary glaucoma Presence of any Peripheral Anterior Synechiae (PAS) in the study eye Inability to conduct a reliable visual field (defined as fixation losses, false positives or false negatives greater than 33%) Any of the following visual field findings using the Humphrey visual field analyzer the SITA-standard 24-2 program: A visual field MD of worse than -12dB Greater than or equal to 75% of points depressed below the 5% level and greater than or equal to 50% of points depressed below the 1% level on the PD plot. At least 50% of points (i.e 2 or more) within the central 5 degrees with a sensitivity ≤0dB on the decibel plot Points within the central 5 degrees of fixation with a sensitivity <15 dB in both hemifields on the decibel plot A visual field MD of worse than -12dB in the fellow eye Cup:Disc Ratio of more than 0.8 More than three hypotensive medications required (combination drops are considered as 2 medications) Prior incisional or laser glaucoma surgery (including previous SLT or LPI) in the study eye. Prior corneal refractive surgery Complicated cataract surgery ≤ 6 months prior to enrollment Presence of visually significant cataract in the opinion of the investigator Clinically significant disease in either eye as determined by the Investigator. Clinically significant amblyopia in either eye Dense pigmentation or haemorrhage in the peri-limbal conjunctiva or anterior sclera Women who are pregnant or may become pregnant during the course of the study. In the opinion of the investigator the participant might require other ocular surgery within the 12-month follow-up period, unless for further reduction of their IOP Concurrent treatment with topical, nasal, inhaled or systemic steroids. Uncontrolled systemic disease that could impact the ability of the participant to attend follow up visits as per the discretion of the investigator. Participation in another clinical study, not including a GLAUrious sub-study
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Sun Xinghuai, Prof.
    Organizational Affiliation
    Fundan University, Shanghai, China
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Plan to Share IPD
    No
    IPD Sharing Plan Description
    Study did not enrol

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    Direct Selective Laser Trabeculoplasty in Ethnic Chinese Population The Zhuiguang Trial

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