Retinal Vein Occlusion Clinical Trial
Official title:
Dexamethasone Implant With Rescue Ranibizumab for Treating Macular Edema Secondary to Retinal Vein Occlusion
This study seeks to compare dexamethasone implant with rescue intravitreal ranibizumab to monthly intravitreal ranibizumab for the treatment of macular edema secondary to branch or central retinal vein occlusion. This is based on the null hypothesis that dexamethasone implant with rescue ranibizumab has inferior best corrected visual acuity at six months compared to monthly ranibizumab alone.
Dexamethasone intravitreal implant (DEX implant; OZURDEX, Allergan, Inc., Irvine, CA) and
Ranibizumab (Lucentis, Genentech, Inc., South San Francisco, CA) as needed group:
- Patients will receive a dexamethasone intravitreal implant injection at day 0.
Injection procedure will be identical to those previously described.8,19,20 Topical
tetracaine drops will be given, a lid speculum inserted, and then 5% povidone iodine
drops will be given. After subconjunctival injection of 2% lidocaine, the 0.7mg DEX
implant will be inserted through the pars plana using a customized, single use,
22-gauge applicator. Patients will be treated with topical ophthalmic antibiotics four
times daily for three days after the procedure.
- During monthly visits 1,2,3, and 5, patients will receive a ranibizumab intravitreal
injection if the macula SD-OCT during that visit shows mean central foveal thickness ≥
250 μm or the best-corrected visual acuity is 20/40 or worse. The injection procedure
is described in the next section.
- During monthly visit 4, patients will receive a dexamethasone intravitreal implant
injection if the macula SD-OCT during that visit shows mean central foveal thickness ≥
250 μm or the best-corrected visual acuity is 20/40 or worse.
Monthly Ranibizumab (Lucentis, Genentech, Inc., South San Francisco, CA) group:
- Patients will receive a ranibizumab intravitreal injection on day 0. During each other
visit, patients will receive a ranibizumab intravitreal injection. The protocol will
use the term "monthly" to represent a 30 day interval between treatments. The minimal
interval between treatments may be 25 days.
- Injection procedures will be identical to those previously described.8,19,20 Topical
tetracaine drops will be given, a lid speculum inserted, and then 5% povidone iodine
drops will be given. After subconjunctival injection of 2% lidocaine, a 30-gauge needle
will be inserted through the pars plana, and 0.5 mg (0.05mL) of drug injected.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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