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Safety and Efficacy of the Alpha AMS Subretinal Implant (OX-RI)

Primary Purpose

Retinitis Pigmentosa

Status
Completed
Phase
Not Applicable
Locations
United Kingdom
Study Type
Interventional
Intervention
Implant 'on' vs implant 'off'
Sponsored by
University of Oxford
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Retinitis Pigmentosa

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Participant is willing and able to give informed consent for participation in the trial.
  • Male or Female, aged 18 to 70 years old.
  • Hereditary retinal degeneration of the outer retinal layers i.e. photoreceptor rods & cones.
  • Angiography shows retinal vessels adequately perfused, despite pathological RP condition.
  • Severe visual impairment (at least monocular) i.e. visual functions insufficient for localization of objects, self-sustained navigation and orientation e.g. impaired light localization or worse.
  • Ability to read normal print in earlier life, optically corrected (without magnifying glass).
  • Able to participate in the study during the full time period of one year.
  • Pseudophakic in the eye to receive the implant.
  • Stable dose of current regular medication for at least four weeks prior to trial entry.
  • Female participants of child bearing potential must be willing to ensure that they or their partner use effective contraception during the trial.
  • Participant has clinically acceptable laboratory and ECG results as confirmed at - Screening Visit and upon review by consultant anaesthetist.
  • In the Investigator's opinion, is able and willing to comply with all trial requirements.
  • Willing to allow his or her General Practitioner and consultant, if appropriate, to be notified of participation in the trial.

Exclusion Criteria:

  • Period of appropriate visual functions < 12 years / lifetime.
  • Optical coherence tomography (OCT) shows significant retina oedema &/or scar tissue within target region for implant.
  • Retina detected as too thin to expect required functionality of inner retina as shown via OCT.
  • Lack of inner-retinal function, as determined by Electrically Evoked Phosphenes (EEP).
  • Heavy clumped pigmentation at posterior pole.
  • Any other ophthalmologic disease with relevant effect upon visual function (e.g. glaucoma, optic neuropathies, trauma, diabetic retinopathy, retinal detachment).
  • Amblyopia reported earlier in life for eye to be implanted.
  • Systemic diseases that might imply considerable risks with regard to the surgical interventions and anesthesia (e.g. cardiovascular/ pulmonary diseases, significant metabolic diseases e.g. diabetes).
  • Neurological and/or psychiatric diseases (e.g. Parkinson, epilepsy, depression).
  • Hyperthyroidism or hypersensitivity to iodine.
  • Hypersensitivity to fluorescent dye (fluorescence angiography).
  • Women who are pregnant or nursing, or women of childbearing age who are not willing to use a medically acceptable means of birth control for the duration of the study, or women unwilling to perform a pregnancy test before entering the study.
  • Participation in another interventional clinical trial within the past 12 weeks.
  • Scheduled elective surgery or other procedures requiring general anaesthesia during the trial.
  • Any other significant disease or disorder which, in the opinion of the Investigator, may either put the participants at risk because of participation in the trial, or may influence the result of the trial, or the participant's ability to participate in the trial.

Sites / Locations

  • Oxford University Hospitals NHS Foundation Trust

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Implant 'on' vs implant 'off'

Arm Description

Intra-individual comparison of implant 'on' vs implant 'off'

Outcomes

Primary Outcome Measures

Efficacy of the Alpha AMS retinal implant system used for activities of daily living tasks.
Activities of daily living are assessed with implant ON versus OFF via: • Activities of daily living tasks

Secondary Outcome Measures

Efficacy of the Alpha AMS retinal implant system used for partial restoration of visual acuity.
Visual acuity or light-perception and/or object-recognition assessed with implant ON versus OFF via • Freiburg visual Acuity and Contrast Test (FrACT)
Efficacy of the Alpha AMS retinal implant system used for partial restoration of basic light detection..
Visual acuity or light-perception and/or object-recognition assessed with implant ON versus OFF via: • Basic Light and Motion test (BaLM)
Efficacy of the Alpha AMS retinal implant system used for partial restoration of grating acuity.
Visual acuity or light-perception and/or object-recognition assessed with implant ON versus OFF via: • Basic Grating Acuity test (BaGA).
Safety of the Alpha AMS retinal implant.
The number of participant with Adverse Events and/or Serious Adverse Events, as defined by the Study Protocol, will be reported.

Full Information

First Posted
December 4, 2015
Last Updated
November 16, 2017
Sponsor
University of Oxford
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1. Study Identification

Unique Protocol Identification Number
NCT02720640
Brief Title
Safety and Efficacy of the Alpha AMS Subretinal Implant
Acronym
OX-RI
Official Title
Safety and Efficacy of the Alpha AMS Subretinal Implant for Partial Restoration of Vision in Visually Impaired Participants With Degenerative Retinal Disease
Study Type
Interventional

2. Study Status

Record Verification Date
November 2017
Overall Recruitment Status
Completed
Study Start Date
May 2015 (undefined)
Primary Completion Date
October 2017 (Actual)
Study Completion Date
October 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Oxford

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The aim of this single-centre study is to assess the safety and efficacy of the Retina Implant Alpha AMS (Retina Implant AG, Reutlingen, Germany) in participants with severe visual impairment secondary to outer retinal degeneration caused by retinitis pigmentosa (RP). The study is sponsored by the University of Oxford and funded by the National Institute for Health Research (UK).
Detailed Description
The specific research questions are, i) can the implant partially restore vision to an eye with no light perception and ii) what are the safety implications for the ocular and periorbital tissues of the implanted eye? In advanced RP the light detecting photoreceptor cells of the retina degenerate slowly over time, and may eventually lead to blindness. The subretinal implant replaces the degenerate photoreceptor layer and stimulates the residual overlying healthy retinal layers in response to a light stimulus. These signals are then carried on to the brain along the normal visual pathway. Investigators are seeking to recruit six participants who fulfill the eligibility criteria, which include advanced RP with no useful light perception vision in the eye to receive the implant. Participants must be aged between 18 and 70 years old, be highly motivated, and be well enough for a general anaesthetic. The eye must have also had cataract surgery. The project will be conducted at the Oxford Eye Hospital. Those participants selected to receive the implant will be followed for 12 months from the date of surgery. Between week 1 and month 12 there will be at least 7 outpatient clinic visits for a range of visual tests and eye assessments. After 12 months the trial will officially end, however investigators will continue to review all research participants in clinic as would be standard care for a patient with RP. The implant may be removed at any stage e.g. when it ceases to function or at the participant's request.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Retinitis Pigmentosa

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
6 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Implant 'on' vs implant 'off'
Arm Type
Experimental
Arm Description
Intra-individual comparison of implant 'on' vs implant 'off'
Intervention Type
Device
Intervention Name(s)
Implant 'on' vs implant 'off'
Other Intervention Name(s)
Alpha AMS, Retinal Implant Alpha AMS, Retinal implant, Bionic eye, Retinal prosthesis, Sub retinal chip
Intervention Description
Single group assignment
Primary Outcome Measure Information:
Title
Efficacy of the Alpha AMS retinal implant system used for activities of daily living tasks.
Description
Activities of daily living are assessed with implant ON versus OFF via: • Activities of daily living tasks
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Efficacy of the Alpha AMS retinal implant system used for partial restoration of visual acuity.
Description
Visual acuity or light-perception and/or object-recognition assessed with implant ON versus OFF via • Freiburg visual Acuity and Contrast Test (FrACT)
Time Frame
12 months
Title
Efficacy of the Alpha AMS retinal implant system used for partial restoration of basic light detection..
Description
Visual acuity or light-perception and/or object-recognition assessed with implant ON versus OFF via: • Basic Light and Motion test (BaLM)
Time Frame
12 months
Title
Efficacy of the Alpha AMS retinal implant system used for partial restoration of grating acuity.
Description
Visual acuity or light-perception and/or object-recognition assessed with implant ON versus OFF via: • Basic Grating Acuity test (BaGA).
Time Frame
12 months
Title
Safety of the Alpha AMS retinal implant.
Description
The number of participant with Adverse Events and/or Serious Adverse Events, as defined by the Study Protocol, will be reported.
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Participant is willing and able to give informed consent for participation in the trial. Male or Female, aged 18 to 70 years old. Hereditary retinal degeneration of the outer retinal layers i.e. photoreceptor rods & cones. Angiography shows retinal vessels adequately perfused, despite pathological RP condition. Severe visual impairment (at least monocular) i.e. visual functions insufficient for localization of objects, self-sustained navigation and orientation e.g. impaired light localization or worse. Ability to read normal print in earlier life, optically corrected (without magnifying glass). Able to participate in the study during the full time period of one year. Pseudophakic in the eye to receive the implant. Stable dose of current regular medication for at least four weeks prior to trial entry. Female participants of child bearing potential must be willing to ensure that they or their partner use effective contraception during the trial. Participant has clinically acceptable laboratory and ECG results as confirmed at - Screening Visit and upon review by consultant anaesthetist. In the Investigator's opinion, is able and willing to comply with all trial requirements. Willing to allow his or her General Practitioner and consultant, if appropriate, to be notified of participation in the trial. Exclusion Criteria: Period of appropriate visual functions < 12 years / lifetime. Optical coherence tomography (OCT) shows significant retina oedema &/or scar tissue within target region for implant. Retina detected as too thin to expect required functionality of inner retina as shown via OCT. Lack of inner-retinal function, as determined by Electrically Evoked Phosphenes (EEP). Heavy clumped pigmentation at posterior pole. Any other ophthalmologic disease with relevant effect upon visual function (e.g. glaucoma, optic neuropathies, trauma, diabetic retinopathy, retinal detachment). Amblyopia reported earlier in life for eye to be implanted. Systemic diseases that might imply considerable risks with regard to the surgical interventions and anesthesia (e.g. cardiovascular/ pulmonary diseases, significant metabolic diseases e.g. diabetes). Neurological and/or psychiatric diseases (e.g. Parkinson, epilepsy, depression). Hyperthyroidism or hypersensitivity to iodine. Hypersensitivity to fluorescent dye (fluorescence angiography). Women who are pregnant or nursing, or women of childbearing age who are not willing to use a medically acceptable means of birth control for the duration of the study, or women unwilling to perform a pregnancy test before entering the study. Participation in another interventional clinical trial within the past 12 weeks. Scheduled elective surgery or other procedures requiring general anaesthesia during the trial. Any other significant disease or disorder which, in the opinion of the Investigator, may either put the participants at risk because of participation in the trial, or may influence the result of the trial, or the participant's ability to participate in the trial.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Robert E MacLaren, DPhil FRCS
Organizational Affiliation
1. Nuffield Laboratory of Ophthalmology, Department of Clinical Neurosciences, University of Oxford; 2. Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust; 3. Moorfields Eye Hospital NHS Foundation Trust, London
Official's Role
Principal Investigator
Facility Information:
Facility Name
Oxford University Hospitals NHS Foundation Trust
City
Oxford
State/Province
Oxfordshire
ZIP/Postal Code
OX3 9DU
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
32343050
Citation
Cehajic Kapetanovic J, Troelenberg N, Edwards TL, Xue K, Ramsden JD, Stett A, Zrenner E, MacLaren RE. Highest reported visual acuity after electronic retinal implantation. Acta Ophthalmol. 2020 Nov;98(7):736-740. doi: 10.1111/aos.14443. Epub 2020 Apr 28.
Results Reference
derived
PubMed Identifier
28878616
Citation
Stingl K, Schippert R, Bartz-Schmidt KU, Besch D, Cottriall CL, Edwards TL, Gekeler F, Greppmaier U, Kiel K, Koitschev A, Kuhlewein L, MacLaren RE, Ramsden JD, Roider J, Rothermel A, Sachs H, Schroder GS, Tode J, Troelenberg N, Zrenner E. Interim Results of a Multicenter Trial with the New Electronic Subretinal Implant Alpha AMS in 15 Patients Blind from Inherited Retinal Degenerations. Front Neurosci. 2017 Aug 23;11:445. doi: 10.3389/fnins.2017.00445. eCollection 2017.
Results Reference
derived

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Safety and Efficacy of the Alpha AMS Subretinal Implant

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