Comparison of PDT Combination With Ranibizumab vs. Ranibizumab Monotherapy in Persistent PCV With Initial Loading Dose
- Conditions
- Age-related Macular Degeneration
- Interventions
- Registration Number
- NCT02864472
- Lead Sponsor
- Seoul National University Hospital
- Brief Summary
The aim of this study is to compare the efficacy of early intervention of PDT combination compared with consecutive monthly treatment of intravitreal ranibizumab injections in PCV patients showing insufficient response with initial loading dose.
- Detailed Description
PCV is generally recognized as a subtype of wet AMD characterized by the presence of aneurysmal orange-red polypoidal lesions with or without branching vascular network (BVN) in the choroidal vasculature as observed on indocyanine angiography (ICGA), representing 13% to 54.7% of newly diagnosed patients with neovascular AMD. Fifty percent of PCV had persistent leakage or recurrent bleeding with poor visual outcome, if left untreated.
And in the EVEREST study has shown that synergistic effects of anti-VEGF and vPDT combination: vPDT strongly regress polyp and anti-VEGF control to up-regulation of VEGF induced by vPDT compared to ranibizumab monotherapy in newly diagnosed PCV patients. Additionally, combination offers an opportunity for individualized treatment with potentially fewer treatments and less costs.
Therefore, the aim of this study is to compare the efficacy of early intervention of PDT combination compared with consecutive monthly treatment of intravitreal ranibizumab injections in PCV patients showing insufficient response with initial loading dose.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 40
- Age equal to or older than 50 years
- Insufficient responder to ranibizumab Tx
- ICGA-confirmed PCV
- BCVA letter score of 73 to 24 using Early Treatment of Diabetic Retinopathy Study charts
- Ability to provide written informed consent and comply with study assessments for the full duration of the study
- Prior treatment with other anti-VEGF treatments in the study eye.
- Prior treatment with other anti-VEGF treatments within 3 months prior to Visit 1 in the non-study eye.
- Prior treatment with verteporfin within 6 months prior to Visit 1 in the study eye.
- Prior treatment with verteporfin within 7 days prior to Visit 1 in the non-study eye.
- Previous subfoveal focal laser photocoagulation involving the foveal center in the study eye
- Previous submacular surgery in the study eye
- A history of angioid streaks, presumed ocular histoplasmosis syndrome, or pathologic myopia
- Experienced RPE tear, retinal detachment, macular hole, or uncontrolled glaucoma
- Previous participation in a clinical trial involving anti-angiogenic drugs
- Intraocular surgery: 2 months before Visit 1 in the study eye.
- Previous participation in any studies of investigational drugs
- Administration of periocular, intravitreal, or systemic corticosteroid in the previous 3 months.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description combination Tx PDT combination Tx(vPDT +ranibizumab) (M0) + ranibizumab PRN (M3-6) combination Tx ranibizumab PRN combination Tx(vPDT +ranibizumab) (M0) + ranibizumab PRN (M3-6) mono Tx ranibizumab PRN Ranibizumab (at 4 weeks interval) \*3 (M0-2) + ranibizumab PRN (M3-6) mono Tx Ranibizumab Ranibizumab (at 4 weeks interval) \*3 (M0-2) + ranibizumab PRN (M3-6)
- Primary Outcome Measures
Name Time Method Change in central retinal thickness after 6month Change in central retinal thickness measured by OCT
- Secondary Outcome Measures
Name Time Method Change of ETDRS BCVA after 6month Change of ETDRS BCVA from baseline to 26 weeks and time course of it