Protective Effect of Phenytoin on Glaucoma

NCT ID: NCT00739154

Last Updated: 2008-08-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

200 participants

Study Classification

OBSERVATIONAL

Study Start Date

2008-11-30

Study Completion Date

2010-12-31

Brief Summary

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since glaucoma is considered an optic neuropathy, new treatments for glaucoma are being continuously investigated, including neuroprotection.

Previous studies implied that phenytoin, a potent anti-convulsive drug, has a neuroprotective role, and Na+ channels blockage was suggested as a possible mechanism.

This study predicts that glaucoma patients taking Phenytoin will have a less advanced glaucoma as compared to patients not taking the drug. Glaucoma severity will be determined by visual acuity, visual fields, optic disc cupping and nerve fiber layer thickness

Detailed Description

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The study will examine adult patients who suffer from glaucoma and epileptic disorders on the same time. the study group will include glaucoma patients, being treated with oral Phenytoin for their epileptic disorder. The study group will be compared to 2 control groups:

* Glaucoma patients with epileptic disorder,receiving different medication than Phenytoin
* Glaucoma patients with no epileptic disorder.

4 parameters will be evaluated for all groups:
1. Best corrected visual acuity
2. Optic disc cupping
3. visual fields and general perimetric indices
4. peripapillary retinal nerve fiber layer.

Every participant in the study,after giving his informed consent, will be evaluated by a senior ophthalmologist in a single office appointment. The appointment will include a visual acuity, complete ophthalmic examination,Humphrey perimetric visual field testing and peripapillary RNFL thickness measurement by OCT.

no drug or other treatment will be given to the participants

after data collection, average +/-Standard deviation for the 4 parameters will be compared between the 3 groups. Student T-test and one- way ANOVA will be used for statistical analysis.

Conditions

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Primary Open Angle Glaucoma Secondary Open Angle Glaucoma Narrow-Angle Glaucomas Normal Tension Glaucoma

Keywords

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glaucoma Phenytoin retinal nerve fiber layer corrected pattern standard deviation visual acuity optic disc cupping

Study Design

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Observational Model Type

COHORT

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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1

glaucoma patients who also suffer from epileptic disorder and receiving chronic oral Phenytoin treatment

No interventions assigned to this group

2

glaucoma patients who also suffer from epileptic disorder receiving anti-convulsant treatment other then Phenytoin

No interventions assigned to this group

3

glaucoma patients with no epileptic disorder and not receiving anti-convulsant treatment

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Clinical diagnosis of glaucoma
* chronic treatment with phenytoin for any indication

Exclusion Criteria

* pregnancy
* visual acuity less then 6/60
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Rabin Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Rabin medical center

Principal Investigators

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Omer Y Bialer, MD

Role: STUDY_DIRECTOR

Rabin medical center, Petah Tikva, Israel

Dan Gaa'ton, MD

Role: STUDY_DIRECTOR

Rabin medical center, Petah-Tikva, Israel

Locations

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Beilinson hospital, Rabin medical center

Petah Tikva, , Israel

Site Status

Countries

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Israel

Central Contacts

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Omer Y Bialer, MD

Role: CONTACT

Phone: 972-39376100

Email: [email protected]

Dov Weinberger, MD

Role: CONTACT

Phone: 972-39376101

Email: [email protected]

References

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Chidlow G, Wood JP, Casson RJ. Pharmacological neuroprotection for glaucoma. Drugs. 2007;67(5):725-59. doi: 10.2165/00003495-200767050-00006.

Reference Type BACKGROUND
PMID: 17385943 (View on PubMed)

Ben Simon GJ, Bakalash S, Aloni E, Rosner M. A rat model for acute rise in intraocular pressure: immune modulation as a therapeutic strategy. Am J Ophthalmol. 2006 Jun;141(6):1105-11. doi: 10.1016/j.ajo.2006.01.073.

Reference Type BACKGROUND
PMID: 16765680 (View on PubMed)

Willmore LJ. Antiepileptic drugs and neuroprotection: current status and future roles. Epilepsy Behav. 2005 Dec;7 Suppl 3:S25-8. doi: 10.1016/j.yebeh.2005.08.006. Epub 2005 Oct 18.

Reference Type BACKGROUND
PMID: 16239127 (View on PubMed)

Huang D, Swanson EA, Lin CP, Schuman JS, Stinson WG, Chang W, Hee MR, Flotte T, Gregory K, Puliafito CA, et al. Optical coherence tomography. Science. 1991 Nov 22;254(5035):1178-81. doi: 10.1126/science.1957169.

Reference Type BACKGROUND
PMID: 1957169 (View on PubMed)

Mills RP, Budenz DL, Lee PP, Noecker RJ, Walt JG, Siegartel LR, Evans SJ, Doyle JJ. Categorizing the stage of glaucoma from pre-diagnosis to end-stage disease. Am J Ophthalmol. 2006 Jan;141(1):24-30. doi: 10.1016/j.ajo.2005.07.044.

Reference Type BACKGROUND
PMID: 16386972 (View on PubMed)

Klein BE, Klein R, Sponsel WE, Franke T, Cantor LB, Martone J, Menage MJ. Prevalence of glaucoma. The Beaver Dam Eye Study. Ophthalmology. 1992 Oct;99(10):1499-504. doi: 10.1016/s0161-6420(92)31774-9.

Reference Type RESULT
PMID: 1454314 (View on PubMed)

Ates O, Cayli SR, Gurses I, Turkoz Y, Tarim O, Cakir CO, Kocak A. Comparative neuroprotective effect of sodium channel blockers after experimental spinal cord injury. J Clin Neurosci. 2007 Jul;14(7):658-65. doi: 10.1016/j.jocn.2006.03.023.

Reference Type RESULT
PMID: 17532502 (View on PubMed)

Podos SM, Becker B, Beaty C, Cooper DG. Diphenylhydantoin and cortisol metabolism in glaucoma. Am J Ophthalmol. 1972 Sep;74(3):498-500. doi: 10.1016/0002-9394(72)90915-4. No abstract available.

Reference Type RESULT
PMID: 5053695 (View on PubMed)

Naskar R, Quinto K, Romann I, Schuettauf F, Zurakowski D. Phenytoin blocks retinal ganglion cell death after partial optic nerve crush. Exp Eye Res. 2002 Jun;74(6):747-52. doi: 10.1006/exer.2002.1173.

Reference Type RESULT
PMID: 12126947 (View on PubMed)

Lo AC, Black JA, Waxman SG. Neuroprotection of axons with phenytoin in experimental allergic encephalomyelitis. Neuroreport. 2002 Oct 28;13(15):1909-12. doi: 10.1097/00001756-200210280-00015.

Reference Type RESULT
PMID: 12395089 (View on PubMed)

Hains BC, Waxman SG. Neuroprotection by sodium channel blockade with phenytoin in an experimental model of glaucoma. Invest Ophthalmol Vis Sci. 2005 Nov;46(11):4164-9. doi: 10.1167/iovs.05-0618.

Reference Type RESULT
PMID: 16249495 (View on PubMed)

Savini G, Bellusci C, Carbonelli M, Zanini M, Carelli V, Sadun AA, Barboni P. Detection and quantification of retinal nerve fiber layer thickness in optic disc edema using stratus OCT. Arch Ophthalmol. 2006 Aug;124(8):1111-7. doi: 10.1001/archopht.124.8.1111.

Reference Type RESULT
PMID: 16908813 (View on PubMed)

Carpineto P, Ciancaglini M, Zuppardi E, Falconio G, Doronzo E, Mastropasqua L. Reliability of nerve fiber layer thickness measurements using optical coherence tomography in normal and glaucomatous eyes. Ophthalmology. 2003 Jan;110(1):190-5. doi: 10.1016/s0161-6420(02)01296-4.

Reference Type RESULT
PMID: 12511365 (View on PubMed)

Williams ZY, Schuman JS, Gamell L, Nemi A, Hertzmark E, Fujimoto JG, Mattox C, Simpson J, Wollstein G. Optical coherence tomography measurement of nerve fiber layer thickness and the likelihood of a visual field defect. Am J Ophthalmol. 2002 Oct;134(4):538-46. doi: 10.1016/s0002-9394(02)01683-5.

Reference Type RESULT
PMID: 12383810 (View on PubMed)

Budenz DL, Chang RT, Huang X, Knighton RW, Tielsch JM. Reproducibility of retinal nerve fiber thickness measurements using the stratus OCT in normal and glaucomatous eyes. Invest Ophthalmol Vis Sci. 2005 Jul;46(7):2440-3. doi: 10.1167/iovs.04-1174.

Reference Type RESULT
PMID: 15980233 (View on PubMed)

Leung CK, Chan WM, Chong KK, Yung WH, Tang KT, Woo J, Chan WM, Tse KK. Comparative study of retinal nerve fiber layer measurement by StratusOCT and GDx VCC, I: correlation analysis in glaucoma. Invest Ophthalmol Vis Sci. 2005 Sep;46(9):3214-20. doi: 10.1167/iovs.05-0294.

Reference Type RESULT
PMID: 16123421 (View on PubMed)

Other Identifiers

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non

Identifier Type: -

Identifier Source: secondary_id

005062

Identifier Type: -

Identifier Source: org_study_id