MSC-Exos Promote Healing of MHs

Early Phase 1

• Conditions: Macular Holes
• Interventions: Biological: exosomes derived from mesenchymal stem cells (MSC-Exo)

• Registration Number: NCT03437759
• Lead Sponsor: Tianjin Medical University

Brief Summary

Purpose: To assess the safety and efficacy of mesenchymal stem cells (MSCs) and MSC-derived exosomes (MSC-Exos) for promoting healing of large and refractory macular holes (MHs).

Hypothesis: MSC and MSC-Exo therapy may promote functional and anatomic recovery from MH. MSC-Exo therapy may be a useful and safe method for improving visual outcomes of surgery for refractory MHs.

Detailed Description

Based on the purpose and hypothesis,the participants with large and longstanding idiopathic MHs underwent vitrectomy, internal limiting membrane peeling, MSC or MSC-Exo intravitreal injection, and heavy silicon oil, air, 20% SF6, or 14% C3F8 tamponade. MSCs were isolated from human umbilical cord, and MSC-Exos were isolated from supernatants of MSCs via sequential ultracentrifugation. At the time of study enrollment, as well as physical examinations, best-corrected visual acuity (BCVA) and intraocular pressure will be measured and fundoscopy be performed. All diagnoses of MH are going to confirmed via spectral-domain optical coherence tomography (OCT), and the minimum linear diameter (MLD) of each MH will be measured parallel to the retinal pigment epithelium.The participants are going to be followed up for at least 6 months via BCVA measurement, fundoscopy, OCT, and physical examinations.

Study Timeline

• Study Start: 2017-03-01
• Study First Submitted: 2018-01-23
• Study First Submitted QC: 2018-02-16
• Study First Posted: 2018-02-19
• Primary Completion: 2018-05-30
• Status Verified: 2021-04
• Last Update Submitted: 2021-04-01
• Last Update Posted: 2021-04-06
• Study Completion: 2021-12-30

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 44

Inclusion Criteria

1.Clinical diagnosis of idiopathic macular hole whose diameter is greater than 400 microns

Exclusion Criteria

1. Only one functional eye
2. In other clinical trials.
3. Other diseases which can affect visual acuity, such as cataract, diabetic retinopathy, glaucoma, corneal diseases, etc.
4. Eye had undergone vitrectomy or scleral buckling, cataract surgery, Nd:YAG laser less than one month ago.
5. Contralateral eye has poor prognosis than the study eye.
6. Idiopathic or autoimmune uveitis history.
7. Aphakic eye
8. Physical condition is poor that can not keep prone position.
9. Secondary macular lesions
10. The equivalent spherical diopter of the study eye before any refractive correction or cataract surgery, which is greater than 6.0d or above 26mm of the ocular axis of the study eye.
11. Intraocular pressure is higher than 25mmHg
12. Within ocular inflammation, such as eye blepharitis, scleritis, keratitis and conjunctivitis.
13. Systemic condition is poor, such as the poor control of diabetes and hypertension, myocardial infarction, cerebrovascular accident, renal failure and so on,and the researchers assessed those who are unable to complete the trail.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Experimental group	exosomes derived from mesenchymal stem cells (MSC-Exo)	Our intervention is to add treatment of exosomes derived from mesenchymal stem cells (MSC-Exo) after pars plana vitrectomy(PPV) and ILM peeling.

Primary Outcome Measures

Name	Time	Method
Macular holes closure	baseline to 24 weeks post-surgery	Minimum linear diameter (MLD) of the hole measured by OCT

Secondary Outcome Measures

Name	Time	Method
Best corrected visual acuity(BCVA)	baseline to 24 weeks post-surgery	BCVA using a Landolt C acuity chart method

Trial Locations

Locations (1)

Tianjin Medical University Hospital; 🇨🇳 Tianjin, China