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Withdrawn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