Intravitreal Aflibercept Injection for Radiation Retinopathy
Information source: Washington University School of Medicine
ClinicalTrials.gov processed this data on August 23, 2015 Link to the current ClinicalTrials.gov record.
Condition(s) targeted: Radiation Retinopathy; Macular Edema
Intervention: Aflibercept every 2 months (Drug); Aflibercept monthly (Drug)
Phase: Phase 1
Status: Active, not recruiting
Sponsored by: Washington University School of Medicine Official(s) and/or principal investigator(s): Prabakar K Rao, MD, Principal Investigator, Affiliation: Washington University School of Medicine
Summary
The purpose of this study is to assess the safety of intravitreal aflibercept injection - in
the treatment of macular edema associated with retinopathy secondary to previous radiation
therapy.
Clinical Details
Official title: Treatment of Radiation Retinopathy With Intravitreal Aflibercept Injection 2.0mg
Study design: Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
Primary outcome: Incidence of adverse eventsSeverity of adverse events
Secondary outcome: Mean change in best corrected visual acuity from baselineMean change in central foveal thickness by optical coherence tomography (OCT) from baseline Mean visual acuity Mean central foveal thickness Proportion of patients gaining 3 lines of vision Mean change in lesion characteristics (lesion size, leakage) Proportion of patients with no fluid on OCT Mean change in macular volume
Detailed description:
Radiation retinopathy can cause decreased vision in patients who have received either
external beam radiation or local plaque therapy to the eye. An early manifestation of
radiation retinopathy is macular edema, which represents fluid within the retina that
affects central vision. There is currently no approved treatment for this disease, although
there have been anecdotal reports of benefit with laser photocoagulation, intravitreal
anti-VEGF agents, or intravitreal steroid use. This is a phase 1 study to evaluate
aflibercept for the treatment of macular edema associated with retinopathy secondary to
previous radiation treatment.
Eligibility
Minimum age: 18 Years.
Maximum age: N/A.
Gender(s): Both.
Criteria:
Inclusion Criteria:
- Retinopathy associated with previous I-125 brachytherapy for uveal melanoma (85 Gy
over 96 hours) at least 6 months prior to enrollment
- Ability to provide written informed consent and comply with study assessments for the
full duration of the study
- Age > 18 years
- Center involved macular edema > 300µm in thickness on SD-OCT
- Best corrected visual acuity of 20/40- 20/400
- Birth control therapy for females of child-bearing age
Exclusion Criteria:
- Pre-existing retinopathy due to other disorders
- Vision decrease is considered to be due to ischemic radiation retinopathy without
macular edema or optic neuropathy
- Presence of metastasis
- Pregnancy (positive pregnancy test) or lactation
- Premenopausal women not using adequate contraception. The following are considered
effective means of contraception: surgical sterilization or use of oral
contraceptives, barrier contraception with either a condom or diaphragm in
conjunction with spermicidal gel, an IUD, or contraceptive hormone implant or patch.
- Prior enrollment in any study with intravitreal aflibercept injection
- Any other condition that the investigator believes would pose a significant hazard to
the subject if the investigational therapy were initiated
- Uncontrolled glaucoma in the study eye (defined as IOP ≥ 30 mmHg despite treatment
with anti-glaucoma medication)
- History of cerebral vascular accident, myocardial infarction, transient ischemic
attacks within 4 months of study enrollment.
- Active infectious conjunctivitis, keratitis, scleritis, or endophthalmitis in either
eye
- Any concurrent intraocular condition in the study eye (e. g., cataract or diabetic
retinopathy) that, in the opinion of the investigator, could either require medical
or surgical intervention during the study period to prevent or treat visual loss that
might result from that condition, or if allowed to progress untreated, could likely
contribute to loss of at least 2 Snellen equivalent lines of BCVA over the 6-month
study period
- Presence of significant subfoveal fibrosis or atrophy
- Intraocular surgery (including cataract surgery) in the study eye within 2 months of
enrollment
- Active intraocular inflammation (grade trace or above) in the study eye
- History of allergy to fluorescein, ICG or iodine, not amenable to treatment
- Prior/Concomitant Treatment:
- Panretinal photocoagulation treatment
- Previous intraocular steroids or PDT within 3 months
- Previous participation in any studies of investigational drugs within 30 days
preceding Day 0 (excluding vitamins and minerals)
- Previous treatment with intravitreally (in either eye) or intravenously administered
Avastin (bevacizumab) within 60 days or concomitant use in either eye outside the
scope of this study
- Previous use of Eylea, Macugen or Lucentis in study eye within 60 days or concomitant
use in either eye outside the scope of this study
- Prior submacular or vitreous surgery
Locations and Contacts
Washington University School of Medicine, St. Louis, Missouri 63110, United States
Retina Consultants of Houston, Houston, Texas 77030, United States
Additional Information
Related publications: Horgan N, Shields CL, Mashayekhi A, Teixeira LF, Materin MA, Shields JA. Early macular morphological changes following plaque radiotherapy for uveal melanoma. Retina. 2008 Feb;28(2):263-73. doi: 10.1097/IAE.0b013e31814b1b75. Finger PT, Chin K. Anti-vascular endothelial growth factor bevacizumab (avastin) for radiation retinopathy. Arch Ophthalmol. 2007 Jun;125(6):751-6. Wen JC, McCannel TA. Treatment of radiation retinopathy following plaque brachytherapy for choroidal melanoma. Curr Opin Ophthalmol. 2009 May;20(3):200-4. doi: 10.1097/ICU.0b013e328329b62d. Review.
Starting date: November 2012
Last updated: June 1, 2015
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