Title

Efficacy of an Intravitreal DEX Implant in Retinal Vein Occlusion Following Treatment With Anti-VEGF Injections.
Efficacy of an Intravitreal Dexamethasone Implant on Macular Function in Retinal Vein Occlusion Following Treatment With Intravitreal Anti-VEGF Injections.
  • Phase

    Phase 3
  • Study Type

    Interventional
  • Study Participants

    10
To test the efficacy of a 0.7 mg intravitreal dexamethasone implant (Ozurdex®) on macular function and recalcitrant macular edema associated with retinal vein occlusion following treatment with 2 or more prior intravitreal anti-VEGF drug injections.
The efficacy of the DEX implant on macular edema for RVO is well established in multiple clinical trials. However, the duration and frequency of re-treatment have not been extensively explored. In addition, no prior studies have tested the efficacy of the DEX implant on retinal and macular function using diagnostic testing measurements such as multi-focal ERG, microperimetry and RAM testing. Since VA and OCT outcomes do not always correlate, these other assessments (mf-ERG, microperimetry, RAM testing) may be useful as early predictors of when or if patients should be retreated. This study will assess 2 groups (0.7mg PRN and 0.7mg Q16 weeks) and assess high resolution OCT, RAM testing, microperimetry, and Multi-focal ERG outcomes. For the PRN group retreated based on any fluid on OCT, we will investigate if microperimetry or multifocal ERG changes would have been an earlier predictor of fluid returning.
Study Started
Oct 31
2011
Primary Completion
Jul 31
2012
Study Completion
Feb 28
2013
Results Posted
May 31
2017
Last Update
May 31
2017

Drug Ozurdex

0.7 mg intravitreal DEX implant on first visit, then PRN if evidence of macular edema on OCT studies

  • Other names: Dexamethasone implant, DEX implant

Drug Ozurdex

0.7 mg intravitreal DEX implant on first visit then every 16 weeks

  • Other names: dexamethasone implant, DEX implant

Ozurdex PRN Active Comparator

0.7 mg intravitreal DEX implant at Visit 1 then PRN for duration of trial (48 weeks) if evidence of fluid on OCT

Ozurdex Q16 weeks Active Comparator

0.7 mg intravitreal DEX implant at Visit 1 then Q16 weeks

Criteria

Inclusion Criteria:

Presence of central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO)
Prior treatment with >= 2 intravitreal anti-VEGF injections but no treatment in last 45 days.
Age 18 years or older
ETDRS Visual acuity between 3 and 72 letters and approximate Snellen equivalent of 20/25 to 20/800
Central foveal thickness >275 microns or presence of cystic edema on OCT studies.
For sexually active women of childbearing potential, agreement to the use of an appropriate form of contraception (or abstinence) for the duration of the study.
Ability to provide written informed consent • Capable of complying with study protocol

Exclusion Criteria:

History of steroid-related glaucoma (steroid response) requiring more than one topical glaucoma medication.
Intraocular injection of steroid medication within prior 4 months
Evidence of significant retinal ischemia on fluorescein angiography in the opinion of the treating physician.
Previous laser photocoagulation within 4 months of study
Concurrent ocular disease (e.g proliferative diabetic retinopathy, geographic atrophy) that would limit visual acuity in the opinion of the treating physician
Patients who are pregnant.
Unwilling or unable to follow or comply with all study related procedures.

Summary

Ozurdex PRN

Ozurdex Q16 Weeks

All Events

Event Type Organ System Event Term Ozurdex PRN Ozurdex Q16 Weeks

Macular Function Using Microperimetry

To determine if there is change in mean macular sensitivity using microperimetry at 48 weeks compared to baseline for both the PRN and Q16weeks treatment groups

Ozurdex PRN

Baseline

2.7
dB (Mean)
Standard Error: 0.8

Final Visit

4.2
dB (Mean)
Standard Error: 1.7

Ozurdex Q16 Weeks

Baseline

12.7
dB (Mean)
Standard Error: 2.6

Final Visit

10.7
dB (Mean)
Standard Error: 1.9

Macular Function Using Multi-focal ERG

To determine if there is a change in central amplitude responses using multifocal ERG at 48 weeks compared to baseline values for both the PRN and Q16weeks treatment groups

Ozurdex PRN

Baseline

3.61
nV/deg2 (Mean)
Standard Error: 0.39

Final Visit

18.2
nV/deg2 (Mean)
Standard Error: 4.03

Ozurdex Q16 Weeks

Baseline

6.62
nV/deg2 (Mean)
Standard Error: 0.83

Final Visit

30.18
nV/deg2 (Mean)
Standard Error: 9.60

To Determine if There is a Change in Visual Acuity (Number of ETDRS Letters) at 48 Weeks Compared to Baseline Values for Both the PRN and Q16weeks Treatment Groups

Ozurdex PRN

Baseline

46.4
ETDRS letters (Mean)
Standard Error: 7.1

Final Visit

27.8
ETDRS letters (Mean)
Standard Error: 8.4

Ozurdex Q16 Weeks

Baseline

55.6
ETDRS letters (Mean)
Standard Error: 7.5

Final Visit

53.2
ETDRS letters (Mean)
Standard Error: 8.5

To Determine if There is a Change in Central Foveal Thickness (Microns on High Resolution OCT) at 48 Weeks Compared to Baseline Values for Both the PRN and Q16weeks Treatment Groups

Ozurdex PRN

Baseline

501.7
microns (Mean)
Standard Error: 59.7

Final Visit

361.4
microns (Mean)
Standard Error: 47.3

Ozurdex Q16 Weeks

Baseline

353.5
microns (Mean)
Standard Error: 27.0

Final Visit

326.7
microns (Mean)
Standard Error: 21.2

Total

10
Participants

Age, Continuous

66.2
years (Mean)
Standard Deviation: 4.7

Age, Categorical

Region of Enrollment

Sex: Female, Male

Overall Study

Active Comparator: Ozurdex PRN

Active Comparator: Ozurdex q16 Weeks

Drop/Withdrawal Reasons

Active Comparator: Ozurdex PRN

Active Comparator: Ozurdex q16 Weeks