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Trial registered on ANZCTR
Registration number
ACTRN12616000737437
Ethics application status
Approved
Date submitted
18/04/2016
Date registered
3/06/2016
Date last updated
3/06/2016
Type of registration
Retrospectively registered
Titles & IDs
Public title
Regression of resilient neovessels with monthly anti-Vascular Endothelial Growth Factor (VEGF) treatment in laser treated proliferative diabetic retinopathy
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Scientific title
Regression of resilient neovessels with monthly anti-VEGF treatment in laser treated proliferative diabetic retinopathy
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Secondary ID [1]
289027
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none
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
diabetic retinopathy
298441
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proliferative diabetic retinopathy
298442
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Condition category
Condition code
Metabolic and Endocrine
298539
298539
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0
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Diabetes
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Eye
298540
298540
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0
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Diseases / disorders of the eye
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
monthly intravitreal injection of 0.05 cc or 1.25 mg of Bevacizumab by a retina specialist, the intravitreal injection is done in a minor operating room. After scrubbing the eyelids with betadine, and application of a sterile speculum, one drop of Cebesine 0.4% is instilled to ensure anesthesia. at 3.5 mm from limbus in the inferotemporal quadrant 0.05 cc of 125 mg of Bevacizumab are injected into the vitreous pointing the 30 gauge needle towards the macula.. This, in addition to stereo fundus photography are top be repeated on a monthly basis until either quiescence of neo-vascular activity happens or traction starts to develop or the period of study has finished., Both quiescence or traction are assessed the stereo photography and a Berzin viewer,
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Intervention code [1]
294510
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Treatment: Drugs
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Comparator / control treatment
no control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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quiescence of neo-vascular activity based on stereo fundus photography.
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Assessment method [1]
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Timepoint [1]
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12 months after the first injection, patients will be followed on a monthly basis
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Secondary outcome [1]
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visual acuity using the ETDRS chart
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Assessment method [1]
322969
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Timepoint [1]
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Each "session" is the brief evaluation during each visit, which comprises a visual acuity testing followed by dilatation then stereo fundus photography. This is done 12 times on a monthly basis after the first injection is given.
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Secondary outcome [2]
322970
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neovessel caliber, to be measured from digital fundus images using the onscreen calipers.
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Assessment method [2]
322970
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Timepoint [2]
322970
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15 minutes each visit,. These are monthly visits for 12 times after the first injection.
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Eligibility
Key inclusion criteria
Complete pan retinal photocoagulation laser treated proliferative diabetic retinopathy 6 months prior to presentation, with evidence of residual neovascular activity documented by stereo fundus photography. Willingness to sign consent form. Willingness to get an intravitreal injection (or multiple ones scheduled on a monthly basis); Willingness to come every month for evaluation.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
diagnosis of glaucoma, history of cerebrovascular accidents, evidence of retinal traction and the presence of media opacity hindering proper fundus photo imaging.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Phase 2 / Phase 3
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
There are no previous studies looking at resilient NV (only case reports). No sample size has been calculated. This however prompted us to aim at recruiting around 100 eyes to look into the efficacy and to look at possible 2 or 3 risk factors for such a response.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
11/06/2014
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Date of last participant enrolment
Anticipated
6/10/2016
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
100
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
7826
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Lebanon
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State/province [1]
7826
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Beirut
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Funding & Sponsors
Funding source category [1]
293401
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Self funded/Unfunded
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Name [1]
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Haytham Salti
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Address [1]
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American University of Beirut Medical Center
Maamari Street
Beirut, LEBANON- Riad El Solh
110236
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Country [1]
293401
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Lebanon
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Primary sponsor type
Individual
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Name
Haytham Salti
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Address
American University of Beirut Medical Center
Maamari Street
Beirut, LEBANON Riad El Solh
110236
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Country
Lebanon
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Secondary sponsor category [1]
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Hospital
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Name [1]
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American University of Beirut Medical Center
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Address [1]
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Maamari Street
Beirut Lebanon- Riad El Solh
110236
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Country [1]
292230
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Lebanon
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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IRB-Military Hospital Badaro street
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Ethics committee address [1]
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1 Badaro Street, Beirut LEBANON 11-7070
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Ethics committee country [1]
294852
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Lebanon
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Date submitted for ethics approval [1]
294852
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10/04/2013
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Approval date [1]
294852
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12/03/2014
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Ethics approval number [1]
294852
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Summary
Brief summary
Hypothesis: Injection of Bevacizumab into the eye can help in patients who did not respond completely to the laser treatment. Methods: Patient Recruitment: Patients with proliferative diabetic retinopathy who had undergone PRP therapy at least 6 months prior to study recruitment with documented residual NV activity are invited to participate in the study. Patients evaluation: The initial visit comprises a complete medical history and a comprehensive eye examination including posterior biomicroscopy and indirect ophthalmoscopy. Stereo fundus imaging to evaluate the neovascular activity. Intravitreal injection: standardized intravitreal injection is done _published protocols available online_ briefly, after wearing sterile gloves, scrubbing the eyelids with betadine, a sterile lid speculum is applied. Anesthesia is achieved with procaine eye drops (Cebesine 0.4% ). Bevacizumab, at a dose of 1.25mg in 0.05 cc is injected into the vitreous cavity 3.5 mm from the limbus in the superotemporal area using a 30 gauge needle. This procedure is repeated on a monthly basis aiming at NV regression, which is evaluated using stereo fundus photography. When the NV’s become smaller in size and caliber and inactive or if a tractional component starts to develop, the injections would be withheld and the fundus would be observed with serial monthly photography until study closure. If NV activity is re-documented, then injections would resume on a monthly basis as long as traction is not present.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Haytham Salti
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Address
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American University of Beirut Medical Center
Maamari Street Riad El Solh
110236
Beirut
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Country
65226
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Lebanon
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Phone
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+9613776683
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Fax
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+9611370837
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Email
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[email protected]
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Contact person for public queries
Name
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Maamoun Abdul Fattah
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Address
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American University of Beirut
Bliss street Riad El Solh
110236
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Country
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Lebanon
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Phone
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+96178845330
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Haytham Salti
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Address
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American University of Beirut Medical Center
Maamari Street,
Beirut Lebanon Riad El Solh
110236
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Country
65228
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Lebanon
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Phone
65228
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+9613776683
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Fax
65228
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Email
65228
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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