Retinal Neuro-vascular Coupling in Patients With Multiple Sclerosis
Primary Purpose
Multiple Sclerosis, Relapsing-Remitting, Optic Neuritis
Status
Recruiting
Phase
Not Applicable
Locations
Austria
Study Type
Interventional
Intervention
Dynamic Vessel Analyzer (DVA)
Fourier Domain Doppler Optical Coherence Tomography (FDOCT)
Optical coherence tomography (OCT)
Optical coherence tomography angiography (OCTA)
Sponsored by
About this trial
This is an interventional basic science trial for Multiple Sclerosis, Relapsing-Remitting
Eligibility Criteria
Inclusion criteria for healthy subjects:
- Men and women aged over 18 years
- Non-smokers
- Normal findings in the medical history unless the investigator considers an abnormality to be clinically irrelevant
- Normal ophthalmic findings, ametropy < 6 Dpt.
Inclusion criteria for patients with MS:
- Men and women aged over 18 years
- Diagnosis of relapsing-remitting multiple sclerosis (RRMS) according to clinical evaluation and McDonald criteria (revision 2010)
- History of AON in one eye at least one year ago
- Non-smokers
- Normal ophthalmic findings, ametropy < 6 Dpt.
- Adequate visual acuity to allow participation in the ocular blood flow measurements
- A potential participant has to be on stable doses of all medications he/she is taking because of consisting illnesses according to medical history (except MS therapy itself which will be recorded separately) for at least 30 days prior inclusion, if considered relevant by the investigator.
Any of the following will exclude a healthy subject from the study:
- Diagnosis of "possible MS" according to the McDonald criteria (revision 2010)
- Presence or history of a severe medical condition as judged by the clinical investigator
- Untreated Arterial hypertension
- History or family history of epilepsy
- Presence of any abnormalities preventing reliable measurements in the study eye as judged by the investigator
- Family history of MS, optic neuritis, neuromyelitis optica (NMO, Devic disease) or NMO spectrum disorders
- History of inflammatory or infectious disease of central nervous system
- Best corrected visual acuity < 0.5 Snellen
- Ametropy ≥ 6Dpt
- Pregnancy or planned pregnancy
- Alcoholism or substance abuse
Any of the following will exclude a patient from the study:
- Presence or history of a severe medical condition other than MS as judged by the clinical investigator
- History of neuromyelitis optica (NMO, Devic disease) or NMO spectrum disorders
- History of inflammatory or infectious disease of central nervous system other than MS
- Untreated Arterial hypertension
- History or family history of epilepsy
- Presence of any abnormalities preventing reliable measurements in the study eye as judged by the investigator
- Best corrected visual acuity < 0.5 Snellen
- Ametropy ≥ 6 Dpt
- Pregnancy, planned pregnancy
- Significant neurological disease other than MS, if considered relevant by the investigator
- Alcoholism or substance abuse
Sites / Locations
- Department of Clinical Pharmacology, Medical University of ViennaRecruiting
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
Patients with MS
Healthy control subjects
Arm Description
Patients with Multiple Sclerosis
Healthy age- and sex- matched control subjects
Outcomes
Primary Outcome Measures
Flicker induced increase in retinal blood flow
Response of retinal blood flow to flicker light assessed with FDOCT
Secondary Outcome Measures
Retinal vessel diameters
Response of retinal vessel diameters to flicker light assessed with DVA
Retinal oxygen saturation
Retinal oxygen saturation measured with DVA
Retinal nerve fiber layer thickness
Retinal nerve fiber layer thickness measured using OCT
Layer specific flow signal
Retinal layer specific blood flow signal measured using OCTA
Full Information
NCT ID
NCT03401879
First Posted
January 10, 2018
Last Updated
April 6, 2022
Sponsor
Medical University of Vienna
1. Study Identification
Unique Protocol Identification Number
NCT03401879
Brief Title
Retinal Neuro-vascular Coupling in Patients With Multiple Sclerosis
Official Title
Retinal Neuro-vascular Coupling in Patients With Multiple Sclerosis
Study Type
Interventional
2. Study Status
Record Verification Date
April 2022
Overall Recruitment Status
Recruiting
Study Start Date
February 1, 2018 (Actual)
Primary Completion Date
March 2023 (Anticipated)
Study Completion Date
March 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Medical University of Vienna
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
Multiple sclerosis (MS) affects approximately 2.3 million patients worldwide, with a global median prevalence of 33 per 100,000. MS is diagnosed at an average of 30 years and affects twice as many women as men. MS is traditionally diagnosed by the presentation of lesions of the central nervous system, disseminated in time and in space, proven by clinical examination and magnetic resonance imaging. Several anatomical parameters in the eye, both vascular and neural, have been found to be altered in MS patients.
Because of its unique optical properties, the eye offers the possibility of the non-invasive assessment of both structural and functional alterations in neuronal tissue. As the neuro-retina is part of the brain, it does not come as a surprise that neuro-degenerative changes in the brain are accompanied by structural and possibly also functional changes in the neuro-retina and the ocular vasculature.
The current study seeks to test the hypothesis that beside the known anatomical changes, also functional changes can be detected in the retina of patients with MS. For this purpose, flicker light induced hyperemia will be measured in the retina as a functional test to assess the coupling between neural activity and blood flow. Further, structural parameters such as retinal nerve fiber layer thickness and function parameters such as ocular blood flow and retinal oxygenation will be assessed and compared to age and sex matched controls.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Sclerosis, Relapsing-Remitting, Optic Neuritis
7. Study Design
Primary Purpose
Basic Science
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
50 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Patients with MS
Arm Type
Experimental
Arm Description
Patients with Multiple Sclerosis
Arm Title
Healthy control subjects
Arm Type
Experimental
Arm Description
Healthy age- and sex- matched control subjects
Intervention Type
Device
Intervention Name(s)
Dynamic Vessel Analyzer (DVA)
Intervention Description
Retinal vessel diameters and oxygen saturation will be measured with the DVA device.
Intervention Type
Device
Intervention Name(s)
Fourier Domain Doppler Optical Coherence Tomography (FDOCT)
Intervention Description
Retinal blood flow will be assessed using FDOCT.
Intervention Type
Device
Intervention Name(s)
Optical coherence tomography (OCT)
Intervention Description
Nerve fiber layer thickness and central retinal thickness will be measured using OCT.
Intervention Type
Device
Intervention Name(s)
Optical coherence tomography angiography (OCTA)
Intervention Description
Retinal microvasculature will be assessed using OCTA.
Primary Outcome Measure Information:
Title
Flicker induced increase in retinal blood flow
Description
Response of retinal blood flow to flicker light assessed with FDOCT
Time Frame
1 day
Secondary Outcome Measure Information:
Title
Retinal vessel diameters
Description
Response of retinal vessel diameters to flicker light assessed with DVA
Time Frame
1 day
Title
Retinal oxygen saturation
Description
Retinal oxygen saturation measured with DVA
Time Frame
1 day
Title
Retinal nerve fiber layer thickness
Description
Retinal nerve fiber layer thickness measured using OCT
Time Frame
1 day
Title
Layer specific flow signal
Description
Retinal layer specific blood flow signal measured using OCTA
Time Frame
1 day
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion criteria for healthy subjects:
Men and women aged over 18 years
Non-smokers
Normal findings in the medical history unless the investigator considers an abnormality to be clinically irrelevant
Normal ophthalmic findings, ametropy < 6 Dpt.
Inclusion criteria for patients with MS:
Men and women aged over 18 years
Diagnosis of relapsing-remitting multiple sclerosis (RRMS) according to clinical evaluation and McDonald criteria (revision 2010)
History of AON in one eye at least one year ago
Non-smokers
Normal ophthalmic findings, ametropy < 6 Dpt.
Adequate visual acuity to allow participation in the ocular blood flow measurements
A potential participant has to be on stable doses of all medications he/she is taking because of consisting illnesses according to medical history (except MS therapy itself which will be recorded separately) for at least 30 days prior inclusion, if considered relevant by the investigator.
Any of the following will exclude a healthy subject from the study:
Diagnosis of "possible MS" according to the McDonald criteria (revision 2010)
Presence or history of a severe medical condition as judged by the clinical investigator
Untreated Arterial hypertension
History or family history of epilepsy
Presence of any abnormalities preventing reliable measurements in the study eye as judged by the investigator
Family history of MS, optic neuritis, neuromyelitis optica (NMO, Devic disease) or NMO spectrum disorders
History of inflammatory or infectious disease of central nervous system
Best corrected visual acuity < 0.5 Snellen
Ametropy ≥ 6Dpt
Pregnancy or planned pregnancy
Alcoholism or substance abuse
Any of the following will exclude a patient from the study:
Presence or history of a severe medical condition other than MS as judged by the clinical investigator
History of neuromyelitis optica (NMO, Devic disease) or NMO spectrum disorders
History of inflammatory or infectious disease of central nervous system other than MS
Untreated Arterial hypertension
History or family history of epilepsy
Presence of any abnormalities preventing reliable measurements in the study eye as judged by the investigator
Best corrected visual acuity < 0.5 Snellen
Ametropy ≥ 6 Dpt
Pregnancy, planned pregnancy
Significant neurological disease other than MS, if considered relevant by the investigator
Alcoholism or substance abuse
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Gerhard Garhöfer, MD
Phone
0043140400
Ext
29810
Email
gerhard.garhoefer@medunwien.ac.at
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gerhard Garhöfer, MD
Organizational Affiliation
Department of Clinical Pharmacology, Medical University of Vienna
Official's Role
Principal Investigator
Facility Information:
Facility Name
Department of Clinical Pharmacology, Medical University of Vienna
City
Vienna
ZIP/Postal Code
1090
Country
Austria
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Gerhard Garhöfer, MD
Phone
0043140400
Ext
29810
First Name & Middle Initial & Last Name & Degree
Gerhard Garhöfer, MD
12. IPD Sharing Statement
Citations:
PubMed Identifier
34712117
Citation
Kallab M, Hommer N, Schlatter A, Bsteh G, Altmann P, Popa-Cherecheanu A, Pfister M, Werkmeister RM, Schmidl D, Schmetterer L, Garhofer G. Retinal Oxygen Metabolism and Haemodynamics in Patients With Multiple Sclerosis and History of Optic Neuritis. Front Neurosci. 2021 Oct 12;15:761654. doi: 10.3389/fnins.2021.761654. eCollection 2021.
Results Reference
derived
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Retinal Neuro-vascular Coupling in Patients With Multiple Sclerosis
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