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Short-term Additive Effect of Topical Ketorolac on the Management of Diabetic Macular Edema With Intravitreal Bevacizumab

Phase 2
Completed
Conditions
DME
Interventions
Drug: prescription topical ketorolac in group 1
Drug: prescription artificial tear in group 2
Drug: prescription topical ketorolac in group 2
Drug: prescription artificial tear in group1
Registration Number
NCT04119921
Lead Sponsor
Shahid Beheshti University of Medical Sciences
Brief Summary

Purpose: To evaluate the short-term effect of adding topical ketorolac to the management of diabetic macular edema (DME) with intravitreal bevacizumab (IVB).

Setting: Ophthalmology department of Imam Hossein and Torfe Medical Centers. Ophthalmic Epidemiology Research Center of Shahid Beheshti University of Medical Sciences Methods: In a randomized double-masked placebo-controlled crossover clinical trial, all eyes with DME with best-corrected visual acuity (BCVA) between 20/40 and 20/400 were included. They should have had at least one intravitreal anti-VEGF injection in the past 2 months. They were randomized into two groups. Both groups received two IVB injections with 6-week interval. One group received topical ketorolac every 6 hour in the first interval and then artificial tear every 6 hour as a placebo in the second interval. The other group received the opposite medications. Best-corrected visual acuity (BCVA) and central macular thickness (CMT) evaluations were repeated at the termination of each treatment period i.e. at 6 and 12 weeks. The main outcome measure was BCVA changes in logMAR and the second outcome was CMT changes. The interim analysis of this study is presented in this report.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
26
Inclusion Criteria
  • BCVA≤20/40 and BCVA 20/400 and better
  • History of at least 1 intra-viteral bevacizumab (IVB) in the last 2 months
  • Requires 2 IVB in the next 12 weeks
  • Macular thickness >300 μm
  • NO Other eye diseases
  • Media clarity , pupillary dilation, and subject cooperation sufficient for adequate fundus photographs
Exclusion Criteria
  • hgb A1c> 8
  • high risk PDR
  • Macular edema due to a cause other than diabetic retinopathy
  • Any other ocular condition that visual acuity would not improve from resolution of edema (eg.foveal atrophy)
  • Prior treatment with intravitreal or peribulbar corticosteroid injection during last 3months
  • History of macular photocoagulation during the last 6 months
  • intraocular surgery(except cataract surgery)
  • Cataract extractionin less than 6 months ago
  • Uveitis ,NVG ,exudative AMD, HR PDR.
  • Uncontrolled glaucoma
  • Vitreomacular traction or epiretinal membrane

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
usage of topical ketorolac in group1prescription topical ketorolac in group 1usage of topical ketorolac every 6 hour in the first interval and then artificial tear every 6 hour as a placebo in the second interval.
usage of artificial tear in group 2prescription artificial tear in group 2usage of artificial tear every 6 hour in the first interval and then topical ketorolac every 6 hour as a placebo in the second interval.
usage of topical ketorolac in group2prescription topical ketorolac in group 2usage of artificial tear every 6 hour in the first interval and then topical ketorolac every 6 hour as a placebo in the second interval
usage of artificial tear in group 1prescription artificial tear in group1usage of topical ketorolac every 6 hour in the first interval and then artificial tear every 6 hour as a placebo in the second interval
Primary Outcome Measures
NameTimeMethod
visual acuity6 weeks

Snellen E-chart

Secondary Outcome Measures
NameTimeMethod
Centeral macular thickness6 weeks

Ophtical Cohearence Tomography

Trial Locations

Locations (1)

Ophthalmic Research Center

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Tehran, Iran, Islamic Republic of

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