Evaluation of the "Treat-and-extend" Scheme in Patients With Retinal Vein Occlusion (RVO) With and Without LASER Treatment of Ischaemic Retinal Areas

NCT ID: NCT02522897

Last Updated: 2015-08-13

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: PHASE4
• Total Enrollment: 60 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2015-08-31
• Study Completion Date: 2018-01-31

Brief Summary

The purpose of this study is to determine if additional panretinal photocoagulation of ischemic areas following retinal vein occlusion (RVO) may reduce the rate of recurrence and allow longer treatment intervals in anti-Vascular Endothelial Growth Factor (VEGF) treatment following the "trea-and-extend" scheme.

Detailed Description

Patients with macular edema following RVO receive an anti-VEGF treatment by injection of Ranibizumab for 12 months in the "treat-and-extend" scheme. Following this scheme, all patients receive a series of three injections at the interval of 4 weeks. Thereafter, the retreatment interval is determined by results of certain examinations.

The next control including a reinjection is scheduled with an extension of one week until the patient presents signs of recurrence. Assuming that by the time of recurrence the interval is too long, the next control (following a retreatment) is then scheduled one week sooner than the last control. Following this treatment schedule, the individualized retreatment interval is thereafter kept steady.

Half the patients receive an additional panretinal photocoagulation on visit 3 and / or 4. Aim of this study is to investigate if this additional panretinal photocoagulation may result in a longer individualized retreatment interval corresponding to a reduced rate of recurrence of macular edema.

Conditions

Central Retinal Vein Occlusion With Macular Edema

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Ranibizumab

Patients receive intravitreal injections of 0,5 mg Ranibizumab (Lucentis®) / injection following the "treat-and-extend" scheme for 12 months.

Group Type: ACTIVE_COMPARATOR

Ranibizumab

Intervention Type: DRUG

Ranibizumab + Laser

Apart from receiving intravitreal injections of 0,5 mg Ranibizumab (Lucentis®) / injection following the "treat-and-extend" scheme for 12 months, patients receive a panretinal photocoagulation on visit 3 and / or 4.

Group Type: EXPERIMENTAL

Ranibizumab

Intervention Type: DRUG

Laser

Intervention Type: DEVICE

Interventions

Ranibizumab

Intervention Type: DRUG

Laser

Intervention Type: DEVICE

Other Intervention Names

Lucentis; Visulas 532s Laser

Eligibility Criteria

Inclusion Criteria

• retinal vein occlusion with OCT-diagnosed macular edema with a documented duration of 3 months or less
• age over 18
• documented maximal visual acuity of 0,5 ETDRS
• voluntary participation in this study as proven by written informed consent
• ability to follow study instructions and likely to attend and complete all required visits
• pre-menopausal female patients with childbearing potential must use an approved contraceptive method (Pearl index <1)
• pre-menopausal female patients with childbearing potential: a negative serum pregnancy test must be obtained prior to treatment start
• ischemic area of more than 5 pupillary distance (PD) in angiography

• diabetic retinopathy
• previous anti-VEGF (Lucentis ®, Avastin®, Eylea®) or LASER therapy due to RVO
• previous intravitreal steroid therapy
• status post excision of the vitreous body
• status post intraocular surgery within 3 months before enrolment
• established or suspected ocular or periocular infection
• evidence of giant cell arteriitis
• retinal hemorrhages that seem to prevent a Laser-treatment of ischemic areals within the following 12 weeks
• unregulated hypertension above 200/120 mmHg
• cerebral vascular occurence or myocardium infarct within 12 months before enrolment
• relevant systemic diseases that might be associated with elevated VEGF serum concentration
• active malignancies (status post successful treatment of malignancies is no exclusion criterion)

Exclusion Criteria

• subject without legal capacity who is unable to understand the nature, scope, significance and consequences of this clinical trial
• patients with known allergy to Ranibizumab or ingredients of the injection solution
• treatment in another clinical trial with therapeutic intervention or use of any other investigational medicinal product (IMP) during the trial or within the 30 days before enrolment
• known or persistent abuse of medication, drugs or alcohol
• women who are pregnant or breast-feeding

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

University Hospital, Bonn

OTHER

Sponsor Role: collaborator

PD. Dr. med. Armin Wolf

OTHER

Sponsor Role: lead

Responsible Party

PD. Dr. med. Armin Wolf

PD Dr. med. Armin Wolf

Responsibility Role: SPONSOR_INVESTIGATOR

Principal Investigators

Armin Wolf, PD Dr.

Role: PRINCIPAL_INVESTIGATOR

Eye Clinic of the Ludwig Maximilians University of Munich

Central Contacts

Verena Dykstra, Dr.

Role: CONTACT

verena.dykstra@ukb.uni-bonn.de

+49 228 287 16360

Almut Steinhagen, Dr.

Role: CONTACT

almut.steinhagen@ukb.uni-bonn.de

+49 228 287 16029

Other Identifiers

EXT-201302-Pearl

Identifier Type: -

Identifier Source: org_study_id