Management of Patients With Neovascular Age-related Macular Degeneration Undergoing Cataract Surgery

Wet Macular Degeneration Clinical Trial

Official title:

Management of Patients With Neovascular Age-related Macular Degeneration Undergoing Cataract Surgery: A Pilot Study

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT03944070
• Other study ID #: 2017/001_OPH-ECSAMD
• Status: Recruiting
• Phase: N/A
• Start date: January 1, 2018
• Est. completion date: January 2020

Study information

• Verified date: May 2019
• Source: Ophthalmica Eye Institute
• Contact: Paris G Tranos, PhD
• Phone: 00302310263063
• Email: tranos[@]ophthalmica.gr
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

To-date there have been only very few studies to examine the effect of cataract surgery to patients with wet age-related macular degeneration. The evidence on the effects of cataract surgery in such patients suggests improvement of their visual function and quality of life, but at the same time a subclinical susceptibility to macular edema and exacerbation of the choroidal neovascularization. Therefore it is highly important to identify the optimum treatment regime, pursuing the best anatomical and functional postoperative results.

Description:

To-date there have been only very few studies to examine the effect of cataract surgery to patients with neovascular age-related macular degeneration (AMD), especially in the era of anti-vascular endothelial growth factor (anti-VEGF) therapy. Furthermore the issue of optimum treatment regimen that should be used in the peroperative period has never been addressed. Since the human life expectancy gradually increases, the number of patients who are under anti-VEGF intravitreal injections for wet AMD will be increasing accordingly. Cataract surgery in such patients, despite guarded prognosis has been proved to improve their visual function and quality of life. On the other hand, it has been shown that cataract surgery induces anatomic changes based on optical coherence tomography analysis, suggesting a subclinical susceptibility to postoperative cystoid macular edema or exacerbation of choroidal neovascularization. Therefore it is highly important to identify the optimum treatment regime, pursuing the best anatomical and functional postoperative results.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 16
• Est. completion date: January 2020
• Est. primary completion date: January 2020
• Accepts healthy volunteers: No
• Gender: All
• Age group: 50 Years to 99 Years

Eligibility

Inclusion Criteria:

• Active choroidal neovascularization (at least 1 intravitreal injection in the past 12 months) associated with AMD and involving the foveal center

• BCVA of 1.0 (LogMAR) or better

• Duration of wet AMD less than 3 years

Exclusion Criteria:

• Coexisting ocular pathology potentially affecting visual acuity and/or status of the macula including diabetic retinopathy, advanced glaucoma, retinal vein occlusion, retinal detachment

• Newly diagnosed patients with wet AMD who are on anti-VEGF treatment for less than 6 months

Related Conditions & MeSH terms

• Cataract
• Cataract Extraction
• Macular Degeneration
• Wet Macular Degeneration

Intervention

Drug:
• Ranibizumab
Intravitreal Ranibizumab is approved for the treatment of wet AMD. In this study we will compare an intensive injection protocol versus the standard treat and extend protocol in wet AMD patients undergoing cataract surgery.

Locations

Country	Name	City	State
Greece	Ophthalmica Eye Institute	Thessaloníki	Kalamaria

Sponsors (1)

Lead Sponsor	Collaborator
Ophthalmica Eye Institute

Country where clinical trial is conducted

Greece, 

References & Publications (2)

Kessel L, Erngaard D, Flesner P, Andresen J, Tendal B, Hjortdal J. Cataract surgery and age-related macular degeneration. An evidence-based update. Acta Ophthalmol. 2015 Nov;93(7):593-600. doi: 10.1111/aos.12665. Epub 2015 Jan 20. Review. — View Citation

Saraf SS, Ryu CL, Ober MD. The effects of cataract surgery on patients with wet macular degeneration. Am J Ophthalmol. 2015 Sep;160(3):487-492.e1. doi: 10.1016/j.ajo.2015.06.006. Epub 2015 Jun 19. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Visual acuity change from baseline	Difference in visual acuity change from baseline at the end of the follow-up period.	12 months
Primary	Difference in the number of injections	Difference in the number of injections at the end of the follow-up period.	12 months
Secondary	Status of the macular degeneration based on optical coherence tomography parameter, as compared to baseline	The status of the age-related macular degeneration will be evaluated based on optical coherence tomography parameters at the at final follow-up and compared to the baseline. Our main focus is to identify any subfoveal scarring and/ or subfoveal atrophy that may develop during the follow-up and assess changes from the baseline state of the macula.	12 months