OCT-angiography in Diabetic Patients

Diabetic Macular Edema Clinical Trial

Official title:

OCT-angiography in Diabetic Patients: Qualitative Changes of the Intermediate and Deep Capillary Plexuses After Resolution of Macular Edema by Intravitreal Pharmacotherapy

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT02870803
• Other study ID #: Retina Clinic / OCT
• Status: Recruiting
• Phase: N/A
• First received: August 14, 2016
• Last updated: April 21, 2017
• Start date: July 2016
• Est. completion date: April 2018

Study information

• Verified date: April 2017
• Source: Retina Clinic, Sao Paulo, Brazil
• Contact: Gabriel Andrade, M.D.
• Phone: (11) 3058-2020
• Email: drgabrielandrade[@]gmail.com
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

Around the world there is an increasing incidence of diabetes mellitus, with millions of people affected. In this population, diabetic macular edema (DME) is the most common cause of visual impairment. While the visual impairment caused by EMD is variable, its early treatment can improve visual acuity and quality of life. The objective of this project is to use the new OCT-angiography technology, which evaluates macular capillary network without the need of intravenous injection of contrast, to assess macular microcirculatory network in its response to intravitreal pharmacological treatment of EMD. The resulting qualitative evaluation can be helpful in understanding the pathophysiology of visual loss associated with DME and in determining prognosis.

Description:

Patients who participate in this study will be selected among adults treated at the Retina Clinic and Ocular Oftalmologia clinics and will be aware of all stages of the research, formalizing the approval of their participation by informed consent term. The tests will be performed after pupillary dilation with 2 eye drops of tropicamide 1% (Mydriacyl, Alcon Laboratories), in Cirrus 5000 HD-OCT devices (Carl Zeiss Meditec - Dublin USA). Image acquisition protocols Optic Disc Cube 200x200 and 512x128 Macular Cube will be used, with analysis by RNFL protocols and NGO Analysis Report and Macular Cube Analysis Report, respectively. Subjective analysis of the examinations will be performed by the three authors of this project independently and then compared between them.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 20
• Est. completion date: April 2018
• Est. primary completion date: November 2017
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Previous diagnosis of diabetes mellitus type 1 or 2;

• Age equal or greater than 18 years;

• At least one eye with diabetic macular edema and central thickness greater than or equal to 290 microns (female patients) or 305 microns (males) measured by OCT and subjected to intravitreal pharmacotherapy.

Exclusion Criteria:

• Aphakic patients;

• History of major eye surgeries (vitrectomy, cataract surgery, scleral buckle, other intraocular surgery) in the last 4 months;

• Tractional retinal detachment involving the macula, vitreomacular traction syndrome or other concurrent macular diseases;

• Advanced or uncontrolled glaucoma (according to the investigator's judgment); Evidence of angle neovascularization;

• Presence of an eye condition (besides diabetic retinopathy) which, in the opinion of the investigator, may alter the visual acuity during the study course (e.g. venous or arterial retinal occlusions, uveitis or other ocular inflammatory diseases, neovascular glaucoma, etc.);

• Significative cataract which, in the opinion of the investigator, may be decreasing visual acuity in 3 lines or more;

• History of YAG Laser capsulotomy in the last 2 months;

• Severe renal disease, defined as chronic renal failure requiring dialysis or a kidney transplant;

• Blood pressure higher than 180/110 mmHg, acute myocardial infarction, other acute cardiac events requiring hospitalisation, stroke, transient ischemic attack or treatment for congestive heart failure;

• Systemic treatment with anti-VEGF or pro-VEGF in the last 4 months.

Related Conditions & MeSH terms

• Diabetic Macular Edema
• Macular Edema

Locations

Country	Name	City	State
Brazil	Retina Clinic	São Paulo

Sponsors (1)

Lead Sponsor	Collaborator
Retina Clinic, Sao Paulo, Brazil

Country where clinical trial is conducted

Brazil, 

References & Publications (6)

Kiri A, Dyer DS, Bressler NM, Bressler SB, Schachat AP. Detection of diabetic macular edema: Nidek 3Dx stereophotography compared with fundus biomicroscopy. Am J Ophthalmol. 1996 Nov;122(5):654-62. — View Citation

Klein R, Klein BE, Moss SE. Visual impairment in diabetes. Ophthalmology. 1984 Jan;91(1):1-9. — View Citation

Knudsen ST, Bek T, Poulsen PL, Hove MN, Rehling M, Mogensen CE. Macular edema reflects generalized vascular hyperpermeability in type 2 diabetic patients with retinopathy. Diabetes Care. 2002 Dec;25(12):2328-34. — View Citation

Otani T, Kishi S. Correlation between optical coherence tomography and fluorescein angiography findings in diabetic macular edema. Ophthalmology. 2007 Jan;114(1):104-7. Epub 2006 Oct 27. — View Citation

Ozdek SC, Erdinç MA, Gürelik G, Aydin B, Bahçeci U, Hasanreisoglu B. Optical coherence tomographic assessment of diabetic macular edema: comparison with fluorescein angiographic and clinical findings. Ophthalmologica. 2005 Mar-Apr;219(2):86-92. — View Citation

Puliafito CA, Hee MR, Lin CP, Reichel E, Schuman JS, Duker JS, Izatt JA, Swanson EA, Fujimoto JG. Imaging of macular diseases with optical coherence tomography. Ophthalmology. 1995 Feb;102(2):217-29. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	OCT-angiography qualitative changes	Assess the OCT-angiography qualitative changes observed in intermediate and deep capillary networks in diabetic patients after the resolution of macular edema with intravitreal drug treatment	12 months