MedPath

Treatment of Adenoviral Conjunctivitis With SHP640 Compared to Povidone-iodine (PVP-I) and Placebo

Phase 3
Terminated
Conditions
Adenoviral Conjunctivitis
Interventions
Registration Number
NCT02998541
Lead Sponsor
Shire
Brief Summary

The purpose of this study is to determine if an investigational treatment is effective compared with placebo and PVP-Iodine in the treatment of adults and children with adenoviral conjunctivitis.

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
219
Inclusion Criteria
  • An understanding, ability, and willingness to fully comply with study procedures and restrictions (by the parent(s), guardian, or legally authorized representative, if applicable).

  • Ability to voluntarily provide written, signed, and dated (personally or via a parent(s), guardian, or legally authorized representative(s) informed consent (and assent, if applicable) to participate in the study.

  • Participants of any age at Visit 1 (Note: participants lesser than (<) 3 months of age at Visit 1 must have been full-term, i.e. greater than or equal to (>=) 37 weeks gestational age at birth).

  • Meet at least 1 of the 2 criteria below:

    a) Have a positive AdenoPlus test at Visit 1 in at least 1 eye. b) Have at least 2 of the following 5 criteria, based upon medical history and examination: i.Symptoms within the past 7 days consistent with acute upper respiratory tract infection (eg. sore throat, cough, rhinorrhea, etc).

ii. Contact within the past 7 days with family members or other individuals with recent onset of symptoms consistent with conjunctivitis iii. Acute onset within the past 4 days of one or more of the following ocular symptoms: burning/irritation, foreign body sensation, light sensitivity.

iv. Enlarged periauricular lymph node(s). v. Presence of follicles on tarsal conjunctiva. Note:If the participant only meets Inclusion Criterion (a positive AdenoPlus test in at least 1 eye), then the same eye must meet the mentioned below Inclusion Criterion.

  • Have a clinical diagnosis of suspected adenoviral conjunctivitis in at least 1 eye confirmed by the presence of the following minimal clinical signs and symptoms in that same eye:

    1. Report presence of signs and/or symptoms of adenoviral conjunctivitis for lesser than or equal to (<=) 4 days prior to Visit 1
    2. Bulbar conjunctival injection: a grade of >= 1 (mild) on a 0-4 Bulbar Conjunctival Injection Scale.
    3. Watery conjunctival discharge: a grade of >= 1 (mild) on a 0-3 Watery Conjunctival Discharge Scale
  • Be willing to discontinue contact lens wear for the duration of the study.

  • Have a Best Corrected Visual Acuity (BCVA) of 0.60 logMAR or better in each eye as measured using an Early Treatment Diabetic Retinopathy Study (ETDRS) chart. BCVA will be assessed by an age appropriate method in accordance with the AAP Policy Statement for Visual System Assessment in Infants, Children, and Young Adults by Pediatricians (Donahue and Baker 2016; American Academy of Pediatrics 2016).The policy statement recommends formal vision screening can begin at 3 years of age. VA measurements for children under the age of 3 will be done at the discretion of the investigator.

  • If not done, child should be able to fixate on and follow a moving object, except participants <2 months of age who have not yet developed this ability. Participants <2 months will be enrolled at the discretion of the investigator.

  • Male, or non-pregnant, non-lactating female who agrees to comply with any applicable contraceptive requirements of the protocol or females of non-childbearing potential.

Exclusion Criteria
  • Current or recurrent disease that could affect the action, absorption, or disposition of the investigational product, or clinical or laboratory assessments, per investigator's discretion.
  • Current or relevant history of physical or psychiatric illness, any medical disorder that may make the participants unlikely to fully complete the study, or any condition that presents undue risk from the investigational product or procedures.
  • Have known or suspected intolerance or hypersensitivity to the investigational product, closely related compounds, or any of the stated ingredients.
  • Prior enrollment in a FST-100 or SHP640 clinical study.
  • Participants who are employees, or immediate family members of employees (who are directly related to study conduct), at the investigational site.
  • Have a history of ocular surgical intervention within <= 6 months prior to Visit 1 or planned for the period of the study.
  • Have a pre-planned overnight hospitalization during the period of the study.
  • Have presence of any intraocular, corneal, or conjunctival ocular inflammation (eg, uveitis, iritis, ulcerative keratitis, chronic blepharoconjunctivitis), other than adenoviral conjunctivitis.
  • Have presence of corneal subepithelial infiltrates at Visit 1.
  • Have active or history of ocular herpes.
  • Have at enrollment or within <= 30 days of Visit 1, a clinical presentation more consistent with the diagnosis of non-infectious conjunctivitis (except presumed seasonal/perennial allergic conjunctivitis), or non-adenoviral ocular infection (e.g. bacterial, fungal, acanthamoebal, or other parasitic).

Note:history or concomitant presence of presumed seasonal or perennial allergic conjunctivitis signs/symptoms is not exclusionary.

  • Neonates or infants (i.e. participants less than 12 months of age) who have suspected or confirmed (based on the result of any test conducted prior to screening) conjunctivitis of gonococcal, chlamydial, herpetic or chemical origin.

  • Neonates or infants (i.e. participants less than 12 months of age) whose birth mothers had any sexually transmitted disease within 1 month of delivery or any history of genital herpes.

  • Presence of nasolacrimal duct obstruction at Visit 1 (Day 1).

  • Presence of any significant ophthalmic condition (e.g. Retinopathy of Prematurity, congenital cataract, congenital glaucoma) or other congenital disorder with ophthalmic involvement that could affect study variables.

  • Be a known intraocular pressure (IOP) steroid responder, have a known history or current diagnosis of glaucoma, or be a glaucoma suspect.

  • Have any known clinically significant optic nerve defects.

  • Have a history of recurrent corneal erosion syndrome, either idiopathic or secondary to previous corneal trauma or dry eye syndrome; presence of corneal epithelial defect or any significant corneal opacity at Visit 1.

  • Presence of significant, active condition in the posterior segment which requires invasive treatment (e.g. intravitreal treatment with VEGF inhibitors or corticosteroids) and may progress during the study participation period.

  • Have used any topical ocular or systemic anti-vials or antibiotics within <= 7 days of enrollment.

  • Have used any topical ocular Non-steroidal Anti-inflammataory Drugs (NSAIDs) within <= 1 day of enrollment.

  • Have used any topical ophthalmic steroids in the last <= 14 days.

  • Have used any systemic corticosteroid agents within <= 14 days of Day 1. Stable (initiated >= 30 days prior to enrollment) use of inhaled and nasal corticosteroids is allowed, given no anticipated change in dose for the duration of the study. Topical dermal steroids are allowed except in the peri-ocular area.

  • Have used non-corticosteroid immunosuppressive agents within <= 14 days of Day 1.

  • Have used any topical ophthalmic products, including tear substitutes, and over-the-counter preparations such as lid scrubs, within 2 hours of Visit 1 and be unable to discontinue all topical ophthalmic products for the duration of the study. Use of hot or cold compresses is also not permitted during the study.

  • Have any significant ocular disease (eg, Sjogren's syndrome) or any uncontrolled systemic disease or debilitating disease (eg, cardiovascular disease, hypertension, sexually transmitted diseases/infections, diabetes or cystic fibrosis), that may affect the study parameters, per the investigator's discretion.

  • Any known history of immunodeficiency disorder or known active conditions predisposing to immunodeficiency, such as human immunodeficiency virus, hepatitis B or C, evidence of active hepatitis A (antihepatitis A virus immunoglobulin M), or organ or bone marrow transplantation.

  • Within 30 days prior to the first dose of investigational product:

    1. Have used an investigational product or device, or
    2. Have been enrolled in a clinical study (including vaccine studies) that, in the investigator's opinion, may impact this Shire-sponsored study

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboParticipants will receive one drop of placebo ophthalmic solution in each eye QID for 7 days.
SHP640SHP640Participants will receive one drop of SHP640 (0.1 percent \[%\] dexamethasone and 0.6% PVP-I) ophthalmic suspension in each eye 4 times daily (QID) for 7 days.
PVP-I 0.6%PVP-I 0.6%Participants will receive one drop of 0.6% PVP-I ophthalmic solution in each eye QID for 7 days.
Primary Outcome Measures
NameTimeMethod
Number of Participants With Clinical Resolution Among Who Received SHP640 or Placebo on Day 6Day 6

Clinical resolution of adenoviral conjunctivitis was defined as the absence (score=0) of bulbar conjunctival injection and watery conjunctival discharge in the study eye. The study eye was defined based on participant's bulbar conjunctival redness and watery conjunctival discharge scores at baseline as well as his/her cell culture-immunofluorescence assay (CC-IFA) results at baseline. Bulbar conjunctival injection was assessed based on a 0 (Normal conjunctival vascular pattern)-4 (Markedly prominent, intense diffuse hyperemia) scale which used pictures from the validated bulbar redness (VBR) scale. Watery conjunctival discharge was assessed based on a 0-3 scale (0 - None and 3 - Severe: Abundant quantity of watery discharge observed in the lower conjunctival fornix and in the lower lid margin). Higher score represent worse symptoms for both scores. Data analysis was performed in SHP640 and placebo reporting groups only but not in PVP-I 0.6%.

Secondary Outcome Measures
NameTimeMethod
Number of Participants With Modified Clinical Resolution on Day 3, 6, 8 and 12/Early Termination (ET)Day 3, 6, 8 and 12/ET

Modified clinical resolution was defined as a global clinical score of 0 or 1. Global clinical score was the sum of bulbar conjunctival injection and watery conjunctival discharge. The study eyewas defined based on participants bulbar conjunctival redness and watery conjunctival discharge scores at baseline as well as his/her CC-IFA results at baseline.

Number of Participants With Status of Cross-over Infection on Day 3, 6, 8 and 12/Early Termination (ET)Day 3, 6, 8 and 12/ET

Number of participants with status of cross-over infection to a participant's fellow eye. Participants with only 1 infected eye at baseline were reported.

Number of Participants With Clinical Resolution Among Who Received SHP640 or Povidone-Iodine (PVP-I) on Day 6Day 6

Clinical resolution of adenoviral conjunctivitis was defined as the absence (score=0) of bulbar conjunctival injection and watery conjunctival discharge in the study eye. The study eye was defined based on participant's bulbar conjunctival redness and watery conjunctival discharge scores at baseline as well as his/her CC-IFA results at baseline. Bulbar conjunctival injection was assessed based on a 0 (Normal conjunctival vascular pattern)-4 (Markedly prominent, intense diffuse hyperemia) scale which used pictures from the validated bulbar redness (VBR) scale. Watery conjunctival discharge was assessed based on a 0-3 scale (0 - None and 3 - Severe: Abundant quantity of watery discharge observed in the lower conjunctival fornix and in the lower lid margin). Higher score represent worse symptoms for both scores. Data analysis was performed in SHP640 and PVP-I 0.6% reporting groups only but not in placebo.

Number of Participants With Adenoviral Eradication Among Who Received Povidone-Iodine (PVP-I) or Placebo on Day 3Day 3

Adenoviral eradication for the study eye was defined as negative Cell Culture- Immunofluorescence Assay (CC-IFA) in that eye. CC-IFA for each eye was conducted using conjunctival swab samples collected at each visit to determine the presence of adenovirus. The study eye was defined based on participants bulbar conjunctival redness and watery conjunctival discharge scores at baseline as well as his/her CC-IFA results at baseline. Data analysis was performed in PVP-I 0.6% and placebo reporting groups only but not in SHP640.

Number of Participants With at Least 2 Point Reduction From Baseline in the Global Clinical Score at Day 3, 6, 8 and 12/Early Termination (ET)Day 3, 6, 8 and 12/ET

Global clinical score was the sum of bulbar conjunctival injection and watery conjunctival discharge. The study eye was defined based on participants bulbar conjunctival redness and watery conjunctival discharge scores at baseline as well as his/her CC-IFA results at baseline.

Number of Participants With Adenoviral Eradication Among Who Received SHP640 or Placebo on Day 6Day 6

Adenoviral eradication for the study eye was defined as negative CC-IFA in that eye. CC-IFA for each eye was conducted using conjunctival swab samples collected at each visit to determine the presence of adenovirus. The study eye was defined based on participant's bulbar conjunctival redness and watery conjunctival discharge scores at baseline as well as his/her CC-IFA results at baseline. Data analysis was performed in SHP640 and placebo reporting groups only but not in PVP-I 0.6%.

Number of Participants With Clinical Resolution on on Day 3, 8 and 12/Early Termination (ET)Day 3, 8 and 12/ET

Clinical resolution of adenoviral conjunctivitis was defined as the absence (score=0) of bulbar conjunctival injection and watery conjunctival discharge in the study eye. The study eye was defined based on participant's bulbar conjunctival redness and watery conjunctival discharge scores at baseline as well as his/her CC-IFA results at baseline. Bulbar conjunctival injection was assessed based on a 0 (Normal conjunctival vascular pattern)-4 (Markedly prominent, intense diffuse hyperemia) scale which used pictures from the validated bulbar redness (VBR) scale. Watery conjunctival discharge was assessed based on a 0-3 scale (0 - None and 3 - Severe: Abundant quantity of watery discharge observed in the lower conjunctival fornix and in the lower lid margin). Higher score represent worse symptoms for both scores.

Number of Participants With Clinical Resolution Among Who Received Povidone-Iodine (PVP-I) or Placebo on Day 6Day 6

Clinical resolution of adenoviral conjunctivitis was defined as the absence (score=0) of bulbar conjunctival injection and watery conjunctival discharge in the study eye. The study eye was defined based on participant's bulbar conjunctival redness and watery conjunctival discharge scores at baseline as well as his/her CC-IFA results at baseline. Bulbar conjunctival injection was assessed based on a 0 (Normal conjunctival vascular pattern)-4 (Markedly prominent, intense diffuse hyperemia) scale which used pictures from the validated bulbar redness (VBR) scale. Watery conjunctival discharge was assessed based on a 0-3 scale (0 - None and 3 - Severe: Abundant quantity of watery discharge observed in the lower conjunctival fornix and in the lower lid margin). Higher score represent worse symptoms for both scores. Data analysis was performed in PVP-I 0.6% and placebo reporting groups only but not in SHP640.

Number of Participants With Adenoviral Eradication Among Who Received SHP640 or Povidone-Iodine (PVP-I) on Day 6Day 6

Adenoviral eradication for the study eye was defined as negative CC-IFA in that eye. CC-IFA for each eye was conducted using conjunctival swab samples collected at each visit to determine the presence of adenovirus. The study eye was defined based on participants bulbar conjunctival redness and watery conjunctival discharge scores at baseline as well as his/her CC-IFA results at baseline. Data analysis was performed in SHP640 and PVP-I 0.6% reporting groups only but not in placebo.

Percent Change From Baseline in Adenovirus Viral Titer as Assessed by Quantitative Polymerase Chain Reaction (qPCR) at Day 6 and 8Day 6 and 8

qPCR test was performed on all CC-IFA positive samples at all visits to determine viral count in the study eye. The study eye was defined based on participants bulbar conjunctival redness and watery conjunctival discharge scores at baseline as well as his/her CC-IFA results at baseline. Percent (%) change from baseline in adenovirus viral titer as assessed by qPCR was reported.

Number of Participants With Adenoviral Eradication on Day 8 and 12/Early Termination (ET)Day 8 and 12/ET

Adenoviral eradication for the study eye was defined as negative CC-IFA in that eye. CC-IFA for each eye was conducted using conjunctival swab samples collected at each visit to determine the presence of adenovirus. The study eye was defined based on participants bulbar conjunctival redness and watery conjunctival discharge scores at baseline as well as his/her CC-IFA results at baseline.

Change From Baseline in Individual Clinical Signs Score at Day 3, 6, 8 and 12/Early Termination (ET)Day 3, 6, 8 and 12/ET

The Individual clinical signs score (bulbar conjunctival injection and watery conjunctival discharge) in the study were reported. The study eye was defined based on participants bulbar conjunctival redness and watery conjunctival discharge scores at baseline as well as his/her CCIFA results at baseline.

Number of Participants With Expanded Clinical Resolution on Day 3, 6, 8 and 12/Early Termination (ET)Day 3, 6, 8 and 12/ET

Expanded clinical resolution was defined as a global clinical score of 0, 1, or 2 with neither injection nor discharge having a score of 2. Global clinical score was the sum of bulbar conjunctival injection and watery conjunctival discharge. The study eye was defined based on participants bulbar conjunctival redness and watery conjunctival discharge scores at baseline as well as his/her CC-IFA results at baseline.

Time to Clinical Resolution on Day 3, 6, 8 and 12/Early Termination (ET)Day 3, 6, 8 and 12/ET

Time to clinical resolution were reported based on the assessments in the study eye.

Number of Participants With Treatment-Emergent Adverse Events (TEAEs) and Serious Adverse Event (SAEs) of SHP640From start of the study up to Day 14

An Adverse Event (AE) was any untoward medical occurrence in a clinical investigation participant administered a pharmaceutical product and that does not necessarily have a causal relationship with this treatment. A SAE was any untoward medical occurrence (whether considered to be related to investigational product or not) that at any dose: results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital abnormality/birth defect, is an important medical event. Any AE that occured after the first dose of IP instillation was considered a TEAE.

Trial Locations

Locations (129)

Mercy Research

🇺🇸

Springfield, Missouri, United States

Instituto Oftalmológico Fernández-Vega

🇪🇸

Oviedo, Asturias, Spain

Lakeside Vision Center

🇺🇸

Irvine, California, United States

Lone Star Eye Care, P.A.

🇺🇸

Sugar Land, Texas, United States

Macy Eye Center

🇺🇸

Los Angeles, California, United States

Massachusetts Eye and Ear Infirmary

🇺🇸

Boston, Massachusetts, United States

UPMC Eye Center

🇺🇸

Pittsburgh, Pennsylvania, United States

Arizona Eye Center

🇺🇸

Chandler, Arizona, United States

M&M Eye Institute

🇺🇸

Prescott, Arizona, United States

Northern New Jersey Eye Institute

🇺🇸

South Orange, New Jersey, United States

Bhagwan Mahaveer Jain Hospital

🇮🇳

Bangalore, Karnataka, India

Rabin Medical Center-Beilinson Campus

🇮🇱

Petah Tikva, Israel

Macula D&T S.R.L.

🇵🇪

Lima, Peru

S. P. Medical College & Associated Group of Hospitals

🇮🇳

Bikaner, Rajasthan, India

Sapthagiri Hospital

🇮🇳

Bangalore, Karnataka, India

Clinica Oftalmologia Gil Piña

🇪🇸

Huelva, Spain

Midwestern University Eye Institute

🇺🇸

Glendale, Arizona, United States

Milton M. Hom, OD, FAAO

🇺🇸

Azusa, California, United States

Walman Eye Center

🇺🇸

Sun City, Arizona, United States

Inland Eye Specialists

🇺🇸

Hemet, California, United States

Mark B. Kislinger, MD, PhD, Inc.

🇺🇸

Glendora, California, United States

Oxford Optical

🇺🇸

Los Angeles, California, United States

Loma Linda University

🇺🇸

Loma Linda, California, United States

Shultz Chang Vision

🇺🇸

Northridge, California, United States

Stanford Byers Eye Institute

🇺🇸

Palo Alto, California, United States

Arch Health Partners

🇺🇸

Poway, California, United States

North Bay Eye Associates, Inc.

🇺🇸

Petaluma, California, United States

Martel Eye Medical Group

🇺🇸

Rancho Cordova, California, United States

The Eye Associates

🇺🇸

Bradenton, Florida, United States

Shasta Eye Medical Group, Inc.

🇺🇸

Redding, California, United States

South Florida Vision Associates, LLC

🇺🇸

Fort Lauderdale, Florida, United States

East Florida Eye Institute

🇺🇸

Stuart, Florida, United States

Andrew Gardner Logan, MD / dba Logan Ophthalmic Research, LLC

🇺🇸

Tamarac, Florida, United States

Eye Care Centers Management, Inc.

🇺🇸

Morrow, Georgia, United States

Illinois Eye Center

🇺🇸

Peoria, Illinois, United States

Jackson Eye

🇺🇸

Lake Villa, Illinois, United States

MediSphere Medical Research Center, an AMR affiliate

🇺🇸

Evansville, Indiana, United States

Kannarr Eye Care

🇺🇸

Pittsburg, Kansas, United States

Koffler Vision Group

🇺🇸

Lexington, Kentucky, United States

Kentucky Eye Institute

🇺🇸

Lexington, Kentucky, United States

Baker, Carl W

🇺🇸

Paducah, Kentucky, United States

Eye Center Northeast

🇺🇸

Bangor, Maine, United States

Lakeview Vision - Gretna

🇺🇸

Gretna, Louisiana, United States

Haik Humble Eye Center

🇺🇸

West Monroe, Louisiana, United States

Clinical Eye Research of Boston

🇺🇸

Winchester, Massachusetts, United States

Shire Call Center

🇺🇸

Lexington, Massachusetts, United States

Lifelong Vision Foundation

🇺🇸

Chesterfield, Missouri, United States

Hassman Research Institute

🇺🇸

Berlin, New Jersey, United States

Matossian Eye Associates

🇺🇸

Doylestown, Pennsylvania, United States

Wyomissing Optometric Center

🇺🇸

Wyomissing, Pennsylvania, United States

Black Hills Regional Eye Institute

🇺🇸

Rapid City, South Dakota, United States

The Eye Center at Southern College of Optometry

🇺🇸

Memphis, Tennessee, United States

Total Eye Care, PA

🇺🇸

Memphis, Tennessee, United States

Eye Specialty Group

🇺🇸

Memphis, Tennessee, United States

Houston Eye Associates

🇺🇸

League City, Texas, United States

Lake Travis Eye & Laser Center

🇺🇸

Lakeway, Texas, United States

DCT-Shah Research, LLC dba Discovery Clinical Trials

🇺🇸

Mission, Texas, United States

Ericksen Research & Development, LLC

🇺🇸

Clinton, Utah, United States

Emerson Clinical Research Institute, LLC

🇺🇸

Falls Church, Virginia, United States

University of Wisconsin

🇺🇸

Madison, Wisconsin, United States

Kepler Universitätsklinikum

🇦🇹

Linz, Austria

University of the Sunshine Coast Clinical Trials Centre

🇦🇺

Sippy Downs, Queensland, Australia

AKH - Medizinische Universitaet Wien

🇦🇹

Vienna, Austria

University of Waterloo School of Optometry and Vision Science

🇨🇦

Waterloo, Ontario, Canada

Vienna Institute for Research in Ocular Surgery

🇦🇹

Vienna, Austria

The Ottawa Hospital - General Campus, University of Ottawa Eye Institute

🇨🇦

Ottawa, Ontario, Canada

CHU Limoges - Hopital Dupuytren

🇫🇷

Limoges, Haute Vienne, France

McGill University Health Centre/Glen Site / Royal Victoria Hospital

🇨🇦

Montreal, Quebec, Canada

Eye Clinic Dr Kirsta Turman

🇪🇪

Tallinn, Estonia

East Tallinn Central Hospital

🇪🇪

Tallinn, Estonia

Tartu University Hospital

🇪🇪

Tartu, Estonia

Hopital Necker - Enfants Malades

🇫🇷

Paris, France

Klinisches Studienzentrum der Augenklinik

🇩🇪

Mainz, Germany

Szegedi Tudomanyegyetem Szent-Gyorgyi Albert Klinikai Kozpont

🇭🇺

Szeged, Csongrad, Hungary

Augenärzte am Franziskus Hospital

🇩🇪

Muenster, Germany

Bugat Pal Korhaz

🇭🇺

Gyongyos, Heves, Hungary

Csolnoky Ferenc Korhaz

🇭🇺

Veszprem, Hungary

Debreceni Egyetem

🇭🇺

Debrecen, Hungary

Somogy Megyei Kaposi Mor Oktato Korhaz

🇭🇺

Kaposvár, Hungary

L. V. Prasad Eye Institute

🇮🇳

Hyderabad, Andhra Pradesh, India

Sankara Eye Hospital

🇮🇳

Bangalore, Karnataka, India

M. S. Ramaiah Medical College and Hospital

🇮🇳

Bangalore, Karnataka, India

K.L.E. Society's Dr. Prabhakar Kore Hospital and Medical Research Centre

🇮🇳

Belgaum, Karnataka, India

Soroka University Medical Center

🇮🇱

Beer Sheva, Israel

Dr. D. Y. Patil Medical College

🇮🇳

Navi Mumbai, Maharashtra, India

NKP Salve Institute of Medical Sciences

🇮🇳

Nagpur, Maharashtra, India

HaEmek Medical Center

🇮🇱

Afula, Israel

ICARE Eye Hospital and Post Graduate Institute

🇮🇳

Noida, Uttar Pradesh, India

PBMA'S H. V. Desai Eye Hospital

🇮🇳

Pune, Maharashtra, India

Regional Institute of Ophthalmology

🇮🇳

Kolkata, West Bengal, India

Rambam MC

🇮🇱

Haifa, Israel

Kaplan Medical Center

🇮🇱

Rehovot, Israel

Tel Aviv Sourasky Medical Center

🇮🇱

Tel Aviv, Israel

Instituto Regional de Oftalmología

🇵🇪

La Libertad, Peru

A.O.U. Policlinico San'Orsola-Malpighi

🇮🇹

Bologna, Italy

Oftalmosalud SRL.

🇵🇪

Lima, Peru

Centrum Medyczne UNO-MED

🇵🇱

Krakow, Poland

Centrum Diagnostyki i Mikrochirurgii Oka LENS

🇵🇱

Olsztyn, Poland

Centrum Medyczne Uno-Med (Private Practice)

🇵🇱

Tarnów, Poland

Szpital Specjalistyczny nr 1

🇵🇱

Bytom, Poland

Newtown Clinical Research

🇿🇦

Johannesburg, Gauteng, South Africa

Retina Sp. z o.o.

🇵🇱

Warszawa, Poland

Into Research

🇿🇦

Pretoria, Gauteng, South Africa

Pretoria Eye Institute Research Foundation

🇿🇦

Pretoria, Gauteng, South Africa

Nelson R Mandela School of Medicine Ophthalmology Department

🇿🇦

Durban, KwaZulu-Natal, South Africa

Complejo Asistencial Universitario de Burgos

🇪🇸

Burgos, Spain

Hospital Universitari de Girona Dr Josep Trueta

🇪🇸

Girona, Spain

Hospital Universitario Puerta de Hierro Majadahonda

🇪🇸

Majadahonda, Spain

Clinica Rementeria

🇪🇸

Madrid, Spain

Cartuja Vision

🇪🇸

Sevilla, Spain

Hospital Clinico Universitario Lozano Blesa

🇪🇸

Zaragoza, Spain

FISABIO-Oftalmología Médica

🇪🇸

Valencia, Spain

Manchester Royal Eye Hospital

🇬🇧

Manchester, Greater Manchester, United Kingdom

Hospital Universitario Miguel Servet

🇪🇸

Zaragoza, Spain

Shaare Zedek Medical Center

🇮🇱

Jerusalem, Israel

Minnesota Eye Consultants, P.A.

🇺🇸

Bloomington, Minnesota, United States

Eye Physicians of Long Beach

🇺🇸

Long Beach, California, United States

Oculus Research

🇺🇸

Raleigh, North Carolina, United States

Toyos Clinic

🇺🇸

Nashville, Tennessee, United States

R and R Eye Research, LLC.

🇺🇸

San Antonio, Texas, United States

Bascom Palmer Eye Institute

🇺🇸

Miami, Florida, United States

Lorites Medical Group

🇺🇸

Miami, Florida, United States

Pediatric & Adult Research Center, LLC

🇺🇸

Orlando, Florida, United States

Senior Health Services

🇺🇸

Louisville, Kentucky, United States

The Regents of the University of Michigan

🇺🇸

Ann Arbor, Michigan, United States

Moyes Eye Center

🇺🇸

Kansas City, Missouri, United States

Nevada Eye Care Professionals

🇺🇸

Las Vegas, Nevada, United States

James Branch, M.D.

🇺🇸

Winston-Salem, North Carolina, United States

Nashville Vision Associates

🇺🇸

Nashville, Tennessee, United States

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