To assess Ranibizumab versus Intravitreal anti-inflammatory therapy for treatment of repeated swelling related to fluid collection at the center of the retina.
- Conditions
- Health Condition 1: H30-H36- Disorders of choroid and retinaHealth Condition 2: H302- Posterior cyclitis
- Registration Number
- CTRI/2018/09/015638
- Lead Sponsor
- Johns Hopkins University Bloomberg School of Public Health
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ot Yet Recruiting
- Sex
- Not specified
- Target Recruitment
- 0
1. 18 years of age or older;
Eye level inclusion criteria - at least one eye must meet all of the following conditions
2. Inactive or minimally active non-infectious anterior, intermediate, posterior or panuveitis, as defined by SUN132 criteria as <= 0.5+ anterior chamber cells, <= 0.5+ vitreous haze grade and no active retinal/choroidal lesions for a minimum of 4 weeks
3. Macular edema (ME) defined as the presence of macular thickness greater than the normal range for the OCT machine being used (see cut points below), regardless of the presence of cysts, following most recent intravitreal corticosteroid injection (>= 4 weeks following intravitreal triamcinolone injection or >= 12 weeks following intravitreal dexamethasone implant injection);
Greater than 300 μm for Zeiss Cirrus
Greater than 320 μm for Heidelberg Spectralis
Greater than 300 μm for Topcon 3DOCT
4. Baseline fluorescein angiogram that, as assessed by the study ophthalmologist, is gradable for degree of leakage in the central subfield
5. Best corrected visual acuity (BCVA) 5/200 or better
6. Baseline intraocular pressure > 5 mm Hg and <= 21 mm Hg (current use of <=3 intraocular pressure-lowering medications and/or prior glaucoma surgery are acceptable (Note: combination medications, e.g., Combigan, are counted as two IOP-lowering medications)
7. Media clarity and pupillary dilation sufficient to allow OCT testing and assessment of the fundus.
1. History of infectious uveitis in either eye
2. History of infectious scleritis of any type in either eye (Note: History of noninfectious scleritis that has been active in past 12 months is an eye-level exclusion â??see #13 below)
3. History of keratitis (with the exception of keratitis due to dry eye) in either eye
4. History of central serous retinopathy in either eye
5. Active infectious conjunctivitis in either eye;
6. Oral prednisone dose > 10 mg per day (or of an alternative corticosteroid at a dose higher than that equipotent to prednisone 10 mg per day) OR oral prednisone dose <= 10 mg per day at baseline that has not been stable for at least 4 weeks (note: if patient is off of oral prednisone at baseline (M01 study visit) dose stability requirement for past 4 weeks does not apply)
7. Systemic immunosuppressive drug therapy that has not been stable for at least 4 weeks (note: use of systemic methotrexate is acceptable as long as regimen has been stable for at least 4 weeks)
8. Use of oral acetazolamide or other systemic carbonic anhydrase inhibitor at baseline
9. Known allergy or hypersensitivity to any component of the study drugs;
10. For women of childbearing potential: pregnancy, breastfeeding, or a positive pregnancy test
unwilling to practice an adequate birth control method (abstinence, combination barrier and spermicide, or hormonal) for duration of trial
Eye level exclusion criteria - at least one eye that meets all inclusion criteria cannot have any of the following conditions
11. History of infectious endophthalmitis
12. History of severe glaucoma as defined by optic nerve damage (cup/disc ratio of >= 0.9 or
any notching of optic nerve to the rim);
13. History of active noninfectious scleritis in past 12 months (Note: History of noninfectious scleritis is acceptable if the last episode of active scleritis resolved at least 12 months prior to enrollment);
14. Presence of an epiretinal membrane noted clinically or by OCT that per the judgment of study ophthalmologist may be significant enough to limit improvement of ME (i.e., causing substantial wrinkling of the retinal surface)
15. Torn or ruptured posterior lens capsule
16. Presence of silicone oil;
17.Ozurdex administered in past 12 weeks
18. Anti-VEGF agent, intravitreal methotrexate, or intravitreal/periocular corticosteroid administered in past 4 weeks
19. Fluocinolone acetonide implant (Retisert) placed in past 3 years.
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method The primary outcome is the percent change in central subfield thickness from the baseline OCT measurement at the 12-week visit.Timepoint: 12 weeks
- Secondary Outcome Measures
Name Time Method Rate of IOP elevation of 21 mm Hg or â?¥ 10 mm Hg from baseline <br/ ><br>change in macular thickness as measured by OCT. <br/ ><br>Proportion of eyes with macular edema events <br/ ><br>Mean change in BCVA using ETDRS visual acuity charts <br/ ><br>Inflammation as graded using the scales used in the MUST Trial. <br/ ><br>Safety outcomes <br/ ><br>Cost-effectiveness of treatments for uveitic macular edema <br/ ><br>Visual function related quality of life as measured by the NEI Visual Function Questionnaire.Timepoint: 24 weeks