Evaluation of Pain and Inflammation After Injection of Lucentis vs Eylea for Treatment of Wet Macular Degeneration

Phase 1

Completed

Brief Summary: This study is designed to compare the post injection inflammation and pain seen after intravitreal injections of Ranibizumab vs Aflibercept.

Detailed Description: This is an open-label, Phase I-II study of post injection pain and inflammation after intravitreally administered Ranibizumab and Aflibercept in 100 subjects with Neovascular Age-Related Macular Degeneration. We will enroll both treatment experienced ( patients who were treated with Lucentis or Eylea, but not Avastin in the past) and treatment naive patients ( new onset Neovascular AMD with no history of intravitreal injections).

The treatment experienced patients will be treated with the intravitreal medication other than what they were receiving in the past, for example, patients treated with Lucentis will switch to Eylea for study purposes and vice versa.

Consented, enrolled subjects will receive open-label intravitreal injection of either 0.5mg Ranibizumab or 2mg Aflibercept. A standard intravitreal injection protocol will be followed. Patients will be reevaluated between 24-48 hours and 5-7 days post injections. A non-injecting physician will evaluate the patients for anterior chamber inflammation; this physician will be blinded about the specific treatment. Anterior chamber inflammation is described as any cell or flare in the anterior chamber. These will be evaluated using Standardization of Uveitis Nomenclature (SUN) working group classifications.

Pain score will be evaluated using a Numerical Rating Scale. Each patient will have a standard script verbally read to them at their visit, and asked to rate their pain based on this scale.

Recruitment & Eligibility

Inclusion Criteria

Able to provide informed consent and comply with study assessments for the full duration of the study
Age >/= 65 years
New onset Neovascular Age-Related Macular Degeneration or (See No.4)
Previously treated Neovascular Age-Related Macular Degeneration with Lucentis or Eylea intravitreal injections
Visual Acuity of 20/400 or better
No history of Post injection pain or inflammation with prior treatments -

Exclusion Criteria

History of Endophthalmitis in either eye
Uncontrolled or symptomatic Dry Eye Syndrome
History of Anterior or Posterior Uveitis
History of Post injection pain or inflammation with prior treatments
Recent thromboembolic event(<3 months)
Pregnancy(positive pregnancy test) or Lactation/Premenopausal women not using adequate contraception -

Arm && Interventions

Group	Intervention	Description
Aflibercept 2.0mg Intravitreal injection	Aflibercept 2.0mg	Intravitreal Aflibercept 2.0mg once
Ranibizumab 0.5mg Intravitreal injection	Ranibizumab 0.5mg	Intravitreal injection of Ranibizumab 0.5mg once

Primary Outcome Measures

Name	Time	Method
Evidence of Anterior Chamber Inflammation	24 to 48 hours (visit #1) and 5 to 7 days (visit #2)	Evidence of anterior chamber inflammation at visit #1 and #2 using Standardization of Uveitis Nomenclature (SUN)

Secondary Outcome Measures

Name	Time	Method
Patients With Post Injection Pain Score of One or Higher on Pain Scale	24 to 48 hours (visit #1) and 5 to 7 days (visit #2)	Pain score rated on an 11 point numerical rating from 0-10 ( 0 = no pain, and 10 = worst possible pain) administered to each patient verbally at visit #1 and visit #2. The data below shows number of patients with pain score 1 or greater in each group.