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The purpose of this study is to determine the long-term effects of transcorneal electrostimulation (TcES) in patients with retinitis pigmentosa (RP). In a prior study (NCT00804102) the results of short-term stimulation showed a positive effect on the visual field and other parameters. In this study, the patients will be stimulated with either 0%, 150% or 200% of the individually determined phosphene threshold.
The study was performed at the Centre for Ophthalmology, University of Tübingen, Germany. The protocol was approved by the local ethics committee. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. Informed consent was obtained from all patients for being included in the study. The study was conducted according to the standards of GCP, the European Union Directive for Medical Devices, and the German Medical Product Law.
Patients were seen at 14 visits over a period of 78 weeks: one baseline visit (screening), followed by 12 visits (in week 1-4 weekly, then in weeks 10, 16, 22, 28, 34, 40, 46 and 52; dates varied a maximum of ± 1 week) including application of TcES for 52 weeks and one follow-up visit (in week 78, dates varied a maximum of ± 1 week).
After inclusion patients were randomly assigned to TcES with 0 mA (sham), 150% or 200% of their individual electrical phosphene threshold (EPT) current at 20 Hz.
Patients and technicians who performed kinetic perimetry, as well as full-field electrophysiology (ERG), multifocal ERG (mfERG) and dark adaptation, were blinded to the treatment group for the entire study period. The physicians who performed all other examinations and TcES were not blinded to study treatment because they were responsible for setting the stimulation parameters.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Sham | Sham Comparator | OkuStim is used to determine the phosphene threshold, device is turned on but no stimulation is performed. |
|
| 150% | Experimental | OkuStim is used to determine the phosphene threshold, and then to administer transcorneal electrostimulation with a stimulation strength corresponding to 150% of the patient's phosphene threshold. |
|
| 200% | Experimental | OkuStim is used to determine the phosphene threshold, and then to administer transcorneal electrostimulation with a stimulation strength corresponding to 200% of the patient's phosphene threshold. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Transcorneal electrostimulation | Device |
|
|
| Measure | Description | Time Frame |
|---|---|---|
| Visual Field, III4e | Change in the area measured by kinetic visual field measurement | one year |
| Visual Field, V4e | Change in the area measured by kinetic visual field measurement | one year |
| Measure | Description | Time Frame |
|---|---|---|
| ERG B-wave | one year | |
| ERG A-wave | one year | |
| BCVA |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Florian Gekeler, Prof. Dr. | Eberhard-Karls-Universität Tübingen | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department für Augenheilkunde, Eberhard-Karls-Universität | Tübingen | 72076 | Germany |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23049087 | Background | Naycheva L, Schatz A, Rock T, Willmann G, Messias A, Bartz-Schmidt KU, Zrenner E, Gekeler F. Phosphene thresholds elicited by transcorneal electrical stimulation in healthy subjects and patients with retinal diseases. Invest Ophthalmol Vis Sci. 2012 Nov 1;53(12):7440-8. doi: 10.1167/iovs.12-9612. | |
| 22350549 | Background |
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Patients were recruited from the hospital's hereditary retinal degeneration clinic (Centre for Ophthalmology, University of Tuebingen, Tuebingen, Germany).
Of 88 enrolled participants, 63 met the inclusion criteria and were randomized to treatment.
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| ID | Title | Description |
|---|---|---|
| FG000 | Sham | OkuStim was used to determine the phosphene threshold, device was turned on but no stimulation was performed. |
| FG001 | 150% | OkuStim was used to determine the phosphene threshold, and then to administer transcorneal electrostimulation with a stimulation strength corresponding to 150% of the patient's phosphene threshold. |
| FG002 | 200% | OkuStim was used to determine the phosphene threshold, and then to administer transcorneal electrostimulation with a stimulation strength corresponding to 200% of the patient's phosphene threshold. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Sham | Device was turned on but no stimulation was performed. |
| BG001 | 150% | Transcorneal electrostimulation with 150% of phosphene threshold. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Visual Field, III4e | Change in the area measured by kinetic visual field measurement | Posted | Mean | 95% Confidence Interval | deg2 | one year |
|
52 weeks treatment, follow-up visit after 72 weeks. AEs were recorded until the follow-up visit at 72 weeks.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Sham | Device was turned on but no stimulation was performed. | 0 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Non-Ocular Adverse Events Total | General disorders | Systematic Assessment | All AEs that were non-ocular |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. R. Schippert | Okuvision GmbH | +49 7121 15935 | 50 | ruth.schippert@okuvision.de |
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| ID | Term |
|---|---|
| D012174 | Retinitis Pigmentosa |
| ID | Term |
|---|---|
| D015785 | Eye Diseases, Hereditary |
| D005128 | Eye Diseases |
| D058499 | Retinal Dystrophies |
| D012162 | Retinal Degeneration |
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Best corrected visual acuity
| one year |
| VFQ-25 | Visual Function Questionnaire (VFQ-25) | one year |
| Dark Adaptation | Adaptation time, changes in pupil diameter, threshold to fullfield blue and red light is measured with a fullfield stimulus threshold test (FST) on the ESPION ERG machine (Diagnosys). | one year |
| Gekeler F; Arbeitsgruppe Elektrostimulation des Department fur Augenheilkunde am Universitats-Klinikum Tubingen. [Transcorneal electrostimulation]. Ophthalmologe. 2012 Feb;109(2):129-35. doi: 10.1007/s00347-011-2450-6. German. |
| 21467183 | Background | Schatz A, Rock T, Naycheva L, Willmann G, Wilhelm B, Peters T, Bartz-Schmidt KU, Zrenner E, Messias A, Gekeler F. Transcorneal electrical stimulation for patients with retinitis pigmentosa: a prospective, randomized, sham-controlled exploratory study. Invest Ophthalmol Vis Sci. 2011 Jun 23;52(7):4485-96. doi: 10.1167/iovs.10-6932. |
| 22807300 | Background | Schatz A, Arango-Gonzalez B, Fischer D, Enderle H, Bolz S, Rock T, Naycheva L, Grimm C, Messias A, Zrenner E, Bartz-Schmidt KU, Willmann G, Gekeler F. Transcorneal electrical stimulation shows neuroprotective effects in retinas of light-exposed rats. Invest Ophthalmol Vis Sci. 2012 Aug 15;53(9):5552-61. doi: 10.1167/iovs.12-10037. |
| 23329121 | Background | Rock T, Schatz A, Naycheva L, Gosheva M, Pach J, Wilhelm B, Peters T, Bartz-Schmidt KU, Zrenner E, Willmann G, Gekeler F. [Effects of transcorneal electrical stimulation in patients with Stargardt's disease]. Ophthalmologe. 2013 Jan;110(1):68-73. doi: 10.1007/s00347-012-2749-y. German. |
| 28114587 | Result | Schatz A, Pach J, Gosheva M, Naycheva L, Willmann G, Wilhelm B, Peters T, Bartz-Schmidt KU, Zrenner E, Messias A, Gekeler F. Transcorneal Electrical Stimulation for Patients With Retinitis Pigmentosa: A Prospective, Randomized, Sham-Controlled Follow-up Study Over 1 Year. Invest Ophthalmol Vis Sci. 2017 Jan 1;58(1):257-269. doi: 10.1167/iovs.16-19906. |
| BG002 | 200% | Transcorneal electrostimulation with 200% of phosphene threshold. |
| BG003 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
|
|
| Primary | Visual Field, V4e | Change in the area measured by kinetic visual field measurement | Posted | Mean | 95% Confidence Interval | deg2 | one year |
|
|
|
| Secondary | ERG B-wave | Not Posted | one year | Participants |
| Secondary | ERG A-wave | Not Posted | one year | Participants |
| Secondary | BCVA | Best corrected visual acuity | Not Posted | one year | Participants |
| Secondary | VFQ-25 | Visual Function Questionnaire (VFQ-25) | Not Posted | one year | Participants |
| Secondary | Dark Adaptation | Adaptation time, changes in pupil diameter, threshold to fullfield blue and red light is measured with a fullfield stimulus threshold test (FST) on the ESPION ERG machine (Diagnosys). | Not Posted | one year | Participants |
| 22 |
| 0 |
| 22 |
| 13 |
| 22 |
| EG001 | 150% | Transcorneal electrostimulation with 150% of phosphene threshold. | 0 | 21 | 0 | 21 | 18 | 21 |
| EG002 | 200% | Transcorneal electrostimulation with 200% of phosphene threshold. | 0 | 20 | 0 | 20 | 20 | 20 |
|
| Macular edema | Eye disorders | Systematic Assessment |
|
| Dry Eye Symptom | Eye disorders | Systematic Assessment |
|
| Ocular discomfort | Eye disorders | Systematic Assessment |
|
| Ocular pain | Eye disorders | Systematic Assessment |
|
| Subjective visual decrease | Eye disorders | Systematic Assessment |
|
| Skin irritation due to electrode | Eye disorders | Systematic Assessment |
|
| Ocular infection | Eye disorders | Systematic Assessment |
|
| Corneal erosion | Eye disorders | Systematic Assessment |
|
| General and ocular infection | Eye disorders | Systematic Assessment |
|
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| D012164 |
| Retinal Diseases |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| 1 year |
|