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Diabetic Macular Edema (DME) Treatment With Ranibizumab and Dexamethasone or Ranibizumab Only.

Registration Number
NCT04601675
Lead Sponsor
He Eye Hospital
Brief Summary

The aim of this study is to evaluate the visual outcome and prognostic factors after intraocular injections of Ranibizumab or combination of Ranibizumab And Dexamethasone under pro re nata treatment regimen for Diabetic Macular Edema patients.

Detailed Description

The aim of this study is to evaluate the clinical outcome after intraocular injections of Ranibizumab or combination of Ranibizumab and Dexamethasone under pro re nata treatment regimen for the patients with Diabetic Macular Edema patients. Mean change of logarithm of the minimal angle of resolution (logMAR) visual acuity (VA), central foveal thickness (CFT), contrast sensitivity (CS) as well as predictive factors including best-corrected visual acuity (BCVA), vision related questionnaires and various other ocular parameters will be assessed.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
100
Inclusion Criteria

Patients with diabetic retinopathy and centre involving DMO, as determined by using spectral domain optical coherence tomography (SD-OCT), in one or both eyes with:

  1. Central retinal subfield thickness of > 300 but < 400 microns as determined by SD-OCT due to diabetic macular oedema OR
  2. Central retinal subfield thickness of < 300 microns provided that intraretinal and/or subretinal fluid is present in the central subfield (central 1 mm) related to diabetic macular oedema AND
  3. Visual acuity of > 24 Early Treatment Diabetic Retinopathy Study (ETDRS) letters (Snellen equivalent > 20/320)
  4. Amenable to laser treatment, as judged by the treating ophthalmologist
  5. Over 18 years of age
Exclusion Criteria

Eyes of patients will not be included in the study if:

  1. The macular oedema is due to causes other than diabetic macular oedema such as epiretinal membrane, vitreomacular traction, vein occlusion, or others
  2. The eye is ineligible for macular laser treatment, as judged by the treating ophthalmologist
  3. The eye has DMO and central subfield retinal thickness (CST) of > 400 microns.
  4. The eye has activeA proliferative diabetic retinopathy (PDR) requiring treatment.
  5. The eye has received intravitreal Anti- Vascular Endothelical Growth Factor (Anti-VEGF) therapy within the previous two months.
  6. The eye has received macular laser treatment within the previous 12 months.
  7. The eye has received intravitreal injection of steroids.
  8. The eye has received cataract surgery within the previous six weeks
  9. The eye has received panretinal photocoagulation within the previous 3 months
  10. Patients on pioglitazone and the drug cannot be stopped 3 months prior to entering into the trial and for the duration of the study
  11. The patient has chronic renal failure requiring dialysis or kidney transplant
  12. The patient has any other condition that in the opinion of the investigator would preclude participation in the study (such as unstable medical status or severe disease that would make it difficult for the patient to be able to complete the study)
  13. The patient has very poor glycemic control and started intensive therapy within the previous 3 months
  14. The patient will use an investigational drug during the study

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Diabetic ME: Ranibizumab and intravitreal DexamethasoneRanibizumab Ophthalmic and Intravitreal DexamethasoneParticipants with diabetic macular edema will receive a combination of Ranibizumab and intravitreal Dexamethasone
Diabetic ME: RanibizumabRanibizumab Ophthalmic onlyParticipants with diabetic macular edema (ME) will receive Ranibizumab only.
Primary Outcome Measures
NameTimeMethod
Mean change in binocular BCVABaseline, 1 week, 1month, 2 months, 3 months, and 6 months.

Binocular BCVA is assessed by using ETDRS visual acuity charts at 4 meters at baseline (pre-treatment) and 1 week, 1month, 2 months, 3 months, and 6 months after treatment.

Mean change in monocular BCVA in the treatment eyeBaseline, 1 week, 1month, 2 months, 3 months, and 6 months.

Monocular BCVA in the treatment eye is assessed by using ETDRS visual acuity charts at 4 meters at baseline (pre-treatment) and 1 week, 1month, 2 months, 3 months, and 6 months after treatment.

Secondary Outcome Measures
NameTimeMethod
Mean change in EQ-5D 5LBaseline, 1 week, 1 month, 2 months, 3 months, and 6 months.

Scores from EQ-5D 5L questionnaire will be assessed and compared at baseline, 1 week, 1 month, 2 months, 3 months, and 6 months.

Mean change in VisQoL scoresBaseline, 1 week, 1 month, 2 months, 3 months, and 6 months.

Scores from VisQoL questionnaire will be assessed and compared at baseline, 1 week, 1 month, 2 months, 3 months, and 6 months.

Mean change in wavefront aberrationsBaseline, 1 week, 1 month, 2 months, 3 months, and 6 months.

Mean deviation (MD) of wavefront aberrations is assessed by Nidek OPD Scan III test at baseline, 1 week, 1month, 2 months, 3 months, and 6 months.

Change in Humphrey 10-2 visual field in the treatment eyeBaseline, 1 week, 1 month, 2 months, 3 months, and 6 months.

Mean deviation (MD) of the Humphrey 10-2 visual field is assessed by a Humphrey 10-2 visual field test at baseline, 1 week, 1month, 2 months, 3 months, and 6 months.

People meeting driving standardsBaseline, 1 week, 1 month, 2 months, 3 months, and 6 months.

Percentage (%) of people meeting driving standards is assessed by an Esterman binocular visual field test at baseline and and 6 months.

Mean change in central subfield retinal thicknessBaseline, 1 week, 1month, 2 months, 3 months, and 6 months.

Mean change in central subfield retinal thickness in the study eye, as determined by spectral domain optical coherence tomography (OCT), from baseline to 6 months.

Mean change in NEI VFQ25Baseline, 1 week, 1 month, 2 months, 3 months, and 6 months.

Scores from NEI VFQ25 questionnaire will be assessed and compared at baseline, 1 week, 1 month, 2 months, 3 months, and 6 months.

Mean change in ocular surface and tear-filmBaseline, 1 week, 1 month, 2 months, 3 months, and 6 months.

Mean deviation (MD) of ocular surface and tear-film parameters is assessed by Oculus Keratographer test at baseline, 1 week, 1month, 2 months, 3 months, and 6 months.

Mean change in vessel densityBaseline, 1 week, 1 month, 2 months, 3 months, and 6 months.

Mean deviation (MD) of vessel density is assessed by Spectralis OCT2, Heidelberg-Engineering test at baseline, 1 week, 1month, 2 months, 3 months, and 6 months.

Side effects1 week, 1 month, 2 months, 3 months, and 6 months.

Side effects are measured by a review of the participant's medical and ophthalmic history.

Use of additional treatments (including laser)1 week, 1 month, 2 months, 3 months, and 6 months.

Use of additional treatments (including laser) is assessed by the treating ophthalmologist

Trial Locations

Locations (1)

He Eye Specialist Hospital

🇨🇳

Shenyang, Liaoning, China

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