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Trial registered on ANZCTR
Registration number
ACTRN12617001487303
Ethics application status
Approved
Date submitted
18/10/2017
Date registered
20/10/2017
Date last updated
11/01/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Intravitreal Aflibercept for the Treatment of Treatment Resistant Macular Oedema secondary to Retinal Vein Occlusions
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Scientific title
A prospective, open-labelled clinical trial to evaluate the efficacy of intravitreal aflibercept for the treatment of treatment resistant macular oedema secondary to retinal vein occlusion
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Secondary ID [1]
293153
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Nil
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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:
macular oedema secondary to retinal vein occlusion
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Condition category
Condition code
Eye
304452
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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
All subjects will initially receive 3 monthly doses of 2.0mg of intravitreal aflibercept injections and then have 2.0mg of intravitreal aflibercept at two monthly intervals for the subsequent 9 months.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
No control treatment
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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To evaluate the effectiveness of aflibercept in maintaining retinal thickness on spectral domain optical coherence tomography (SD-OCT)at week 24.
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Assessment method [1]
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Timepoint [1]
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Baseline and week 24
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Primary outcome [2]
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To evaluate the effectiveness of aflibercept in maintaining best corrected visual acuity (BCVA) at week 24.
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Assessment method [2]
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Timepoint [2]
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Baseline and week 24
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Secondary outcome [1]
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Proportion of patients who have no macular oedema on SD-OCT at weeks 12, 24 and 48.
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Assessment method [1]
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Timepoint [1]
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Baseline, week 12, week 24, week 48
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Secondary outcome [2]
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Mean change in visual acuity at weeks 12, 24 and 48 compared to the baseline as measured by best corrected visual acuity (BCVA) score.
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Assessment method [2]
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Timepoint [2]
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Baseline, week 12, week 24, week 48
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Secondary outcome [3]
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Proportion of patients who gain 5, 10 and 15 letters at weeks 12, 24 and 48 as measured on best corrected visual acuity (BCVA)
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Assessment method [3]
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Timepoint [3]
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Baseline, week 12, week 24, week 48
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Secondary outcome [4]
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Mean change in central foveal thickness measured by SD-OCT at weeks 12, 24 and 48 compared to the baseline.
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Assessment method [4]
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Timepoint [4]
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Baseline, week 12, week 24, week 48
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Secondary outcome [5]
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Mean change in macular fluorescein angiographic leakage at weeks 24 and 48 compared to the baseline.
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Assessment method [5]
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Timepoint [5]
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Baseline, week 24, week 48
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Secondary outcome [6]
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Mean change in peripheral capillary closure on wide-field fluorescein angiography on at weeks 24 and 48 compared to the baseline.
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Assessment method [6]
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Timepoint [6]
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Baseline, week 24, week 48
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Secondary outcome [7]
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Mean change of capillary diameters on wide-field photography at weeks 24 and 48 compared to the baseline.
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Assessment method [7]
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Timepoint [7]
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Baseline, week 24, week 48
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Secondary outcome [8]
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The change of retinal function measured by Macular Integrity Assessment (MAIA) at weeks 24 and 48 compared to the baseline.
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Assessment method [8]
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Timepoint [8]
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Baseline, week 24, week 48
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Secondary outcome [9]
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Mean change in National Eye Institute Visual Functioning Questionnaire-25 (NEI VFQ-25) score between baseline and weeks 24 and 48.
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Assessment method [9]
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Timepoint [9]
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Baseline, week 24, week 48
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Secondary outcome [10]
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Mean change in central foveal volume measured by SD-OCT at weeks 12, 24 and 48 compared to the baseline.
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Assessment method [10]
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Timepoint [10]
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Baseline, week 12, week 24, week 48.
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Eligibility
Key inclusion criteria
• Ability to provide informed consent and complete study assessments
• Age 18 years or older
• Macular oedema involving central macula secondary to ischemic or non-ischemic BRVO in study eye
• Best corrected baseline visual acuity between 20-73 letters on ETDRS chart (Snellen equivalent 6/12 to 6/120) in the study eye.
• Presence of central oedema (intra-retinal or sub-retinal fluid) on SD-OCT after at least 4 anti-VEGF treatments within 6 months.
• Documentation of the presence of macular oedema at least 30 days since last treatment.
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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
• Pregnancy or lactation.
• Premenopausal women not using contraception.
• Prior anti-VEGF injection in the study eye within 30 days of baseline.
• Prior treatment with triamcinolone in the study eye within 3 months of baseline.
• Intraocular surgery in the study eye within 2 months of baseline.
• Macular laser within 2 months or previous laser scar would prevent the improvement of macular function.
• Prior vitrectomy in the study eye.
• Current vitreous haemorrhage or inflammation in the study eye
• Uncontrolled glaucoma in the study eye defined as intraocular pressure greater than 30mmHg on maximal medical therapy
• grid or a foveal avascular zone greatest linear diameter of > 1000 microns
• Loss of vision or macular oedema due to other causes (e.g. age related macular degeneration, myopic macular degeneration, vitreous traction)
• An ocular condition that would prevent visual acuity improvement despite resolution of oedema (such as foveal atrophy).
• Severe media opacity impeding the view of the fundus.
• History of stroke, acute myocardial infarction and transient ischemic attack within 3 months of study enrolment.
• Allergy to fluorescein dye.
• Uncontrolled diabetes mellitus, as defined by haemoglobin A1C (HbA1c) > 12%.
• Uncontrolled high blood pressure (blood pressure > 180/110 mmHg)
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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)
Patients diagnosed with persistent macular oedema secondary to retinal vein occlusion who have been previously treated with intravitreal anti-VEGF therapy with a minimum of 4 consecutive injections within the 6 months, will be invited to participate at Sydney Retina Clinic and Day Surgery, Australia. All subjects will receive 2.0mg intravitreal aflibercept
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Non randomised trial
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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
Nil
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Phase
Phase 4
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
A power calculation has been performed on 50 participants. When mean change in visual acuity in the population is estimated to be 55 letters, with a 20% standard deviation and a 5% significance, the power to detect a change of 5 letters is 88%. When the mean central macular thickness is estimated to be 400 microns, with a 20% standard deviation and a 5% significance level, the power to detect a change of 50 microns is 99%.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
15/01/2018
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Actual
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Date of last participant enrolment
Anticipated
31/01/2018
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Actual
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Date of last data collection
Anticipated
31/01/2019
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Actual
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Sample size
Target
50
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Accrual to date
0
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Sydney Retina Clinic & Day Surgery - Sydney
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Recruitment postcode(s) [1]
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2000 - Sydney
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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Bayer Australia Limited
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Address [1]
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875 Pacific Highway, Pymble NSW 2073
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
A/Prof Andrew Chang
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Address
Level 13 Park House, 187 Macquarie Street Sydney NSW 2000
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Bellberry Human Research Ethics Committee
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Ethics committee address [1]
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129 Glen Osmond Road Eastwood, SA 5063
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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23/10/2017
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Approval date [1]
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10/01/2018
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Ethics approval number [1]
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2017-11-837
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Summary
Brief summary
This is an open label study in patients who have been previously treated with intravitreal anti-VEGF drug for macular oedema secondary to retinal vein occlusion despite regular injections. The study will describe the effectiveness, safety of intravitreal aflibercept and changes in health related quality of life (HRQoL) among these patients.
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Trial website
www.sydneyretina.com.au
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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 Andrew Chang
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Address
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Sydney Retina Clinic and Day Surgery
Level 13, Park House
187 Macquarie Street
Sydney, NSW 2000
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Country
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Australia
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Phone
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+61 2 9221 3755
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Fax
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+61 2 9221 1637
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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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Kimberly Spooner
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Address
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Sydney Retina Clinic and Day Surgery
Level 13, Park House
187 Macquarie Street
Sydney, NSW 2000
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Country
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Australia
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Phone
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+61 2 9221 3755
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Fax
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+61 2 9221 1637
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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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Andrew Chang
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Address
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Sydney Retina Clinic and Day Surgery
Level 13, Park House
187 Macquarie Street
Sydney, NSW 2000
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Country
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Australia
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Phone
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+61 2 9221 3755
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Fax
78404
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+61 2 9221 1637
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Email
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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
Source
Title
Year of Publication
DOI
Embase
Prospective study of aflibercept for the treatment of persistent macular oedema secondary to retinal vein occlusions in eyes not responsive to long-term treatment with bevacizumab or ranibizumab.
2020
https://dx.doi.org/10.1111/ceo.13636
N.B. These documents automatically identified may not have been verified by the study sponsor.
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