Effect of PPV+ILM Peeling +/- Subretinal Injection of Ringer Lactate in Management of Nontractional Refractory DME

NCT ID: NCT06271473

Last Updated: 2024-08-06

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

RECRUITING

Clinical Phase

NA

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-08-30

Study Completion Date

2025-06-30

Brief Summary

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To evaluate the efficacy and safety of combined pars plana vitrectomy and planned foveal detachment through subretinal injection of ringer's solution in patients with non-tractional refractory diabetic macular edema.

Detailed Description

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In non-tractional cases, PPV allows a more efficient clearance of VEGF and other cytokines from the retina and improves retinal oxygenation by promotion of intraocular fluid currents, and relief of any subclinical tractional forces, thereby reducing DME.

To evaluate the efficacy and safety of combined pars plana vitrectomy and planned foveal detachment through subretinal injection of ringer's solution in patients with non-tractional refractory diabetic macular edema.

Conditions

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Efficacy Safety

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

20 eyes of 20 patients will be divided randomly into 2 groups:

* Group (A): 10 eyes subjecting to vitrectomy + ILM peeling only
* Group (B): 10 eyes subjecting to vitrectomy + ILM peeling + planned foveal detachment via subretinal injection of ringer's solution.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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subjecting to vitrectomy + ILM peeling only

Group Type ACTIVE_COMPARATOR

vitrectomy + ILM peeling +/- planned foveal detachment via subretinal injection of ringer's solution.

Intervention Type PROCEDURE

vitrectomy + ILM peeling +/- planned foveal detachment via subretinal injection of ringer's solution.

subjecting to vitrectomy + ILM peeling + planned foveal detachment

Group Type ACTIVE_COMPARATOR

vitrectomy + ILM peeling +/- planned foveal detachment via subretinal injection of ringer's solution.

Intervention Type PROCEDURE

vitrectomy + ILM peeling +/- planned foveal detachment via subretinal injection of ringer's solution.

Interventions

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vitrectomy + ILM peeling +/- planned foveal detachment via subretinal injection of ringer's solution.

vitrectomy + ILM peeling +/- planned foveal detachment via subretinal injection of ringer's solution.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age: above 40 years old.

* Patients with type two diabetes mellitus of more than 5 years duration.
* Patients with Best corrected visual acuity better than 3/60.
* Central macular thickness (CMT) of more than 250 μm despite undergoing six monthly injection of anti-VEGF therapy or corticosteroid or less than 10% reduction in CMT at the last follow up visit.
* No evidence of vitreomacular traction.
* Lens status: Pseudophakia or clear crystalline lens.

Exclusion Criteria

Other causes of macular edema (intraocular inflammation, retinal vein occlusion, Irvin-gass syndrome, pharmacological).

* Ischemic maculopathy by FFA.
* Presence of bad prognostic signs in OCT such as disorganization of inner retinal layers (DRIL) and extensive disruption of IS-OS junction subfoveally.
* Presence of apparent retinal pigment epithelium (RPE) atrophy at or near the macula.
* Presence of proliferative diabetic fibrovascular membranes threatening or at the macula.
* Presence of diabetic optic atrophy or neuropathy.
* Presence of neovascular glaucoma.
* Cataractous lens either preoperatively or as intra or postoperative complication.
* Vitrectomized Eyes.
* A prior intraocular surgery within the past six-months.
* Lost follow up
Minimum Eligible Age

40 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ain Shams University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Abdelrahman G Salman, MD

Role: PRINCIPAL_INVESTIGATOR

professor at Ain Shams university

Locations

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Ain Shams university

Cairo, , Egypt

Site Status ACTIVE_NOT_RECRUITING

Ain Shams university

Cairo, , Egypt

Site Status RECRUITING

Countries

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Egypt

Central Contacts

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Azza MA Said, MD

Role: CONTACT

2001006228992

David G Samuel, Mscc

Role: CONTACT

2001064442469

Facility Contacts

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Azza MA Said, MD

Role: primary

+201006228992

David G Samuel, Msc

Role: backup

+201064442469

Other Identifiers

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AinShamsU3

Identifier Type: -

Identifier Source: org_study_id

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