Retinal Detachment Clinical Trial
Official title:
Rasagiline (Azilect) - Neuroprotection for Macula-off Retinal Detachment
This randomised, double-blind, placebo-controlled clinical trial investigates the neuroprotective effect of rasagiline in patients suffering from a retinal detachment affecting central vision. Based on results from a study in mice suffering from retinal degeneration, the investigators hypothesize that rasagiline delays neurodegeneration in the retina and improves visual acuity outcomes after retinal detachment surgery. Rasagiline is a second-generation propargylamine with neuroprotective properties modulating the caspase-dependent pathway of programmed cell death.
Background
In previous experimental studies neuroprotection by rasagiline has been shown in rds-mice, a
model for slow retinal degeneration. It is known from these experiments that rasagiline
specifically delays apoptosis, but also modifies inflammation and autophagy. The
bioavailability of the drug in the central nervous system is high, and based on the
literature is sufficient in the retina.
In retinal detachments the outer layers of the neurosensory retina are deprived of nutrients
and degeneration of the photoreceptors occurs fast. This is particularly relevant in the
macular area of the retina where the density of photoreceptors is high, such that visual
acuity recovery can be significantly limited by photoreceptor loss.
Objective
To assess the neuroprotective effect of oral rasagiline (1mg daily for 7 days) administered
perioperatively in patients undergoing surgical retinal detachment repair for central vision
involving retinal detachments.
Methods
In this clinical trial, patients suffering from retinal detachments affecting the fovea get
randomly assigned to perioperative oral treatment with either rasagiline (1mg) or placebo
once daily for 7 days. Pharmacologic treatment is initiated at the time of hospital
admission, usually the day before surgery. The main outcome of the study is visual acuity six
months after surgical retinal detachment repair. Structural differences of the neurosensory
retina between groups will be analysed by optical coherence tomography, a non-invasive
imaging method for retinal pathology.
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