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The study was withdrawn due to insufficient participant enrollment.
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This study will investigate the efficacy and safety of OZURDEX® (dexamethasone intravitreal implants; DEX, Allergan, Inc. Irvine, CA) as monotherapy for the treatment of non-infectious intermediate-, posterior- or panuveitis. This is a prospective randomized controlled clinical trial taking place at the University of Ottawa Eye Institute, Ottawa, Ontario, Canada, and other possible centers in Canada. Consecutive consenting subjects who meet inclusion/exclusion criteria will be selected to participate in this study. The subjects must have either non-infectious intermediate, posterior, or panuveitis. The subjects will be randomly chosen to be part of one of two groups; one group will receive DEX as monotherapy and the other group will receive oral prednisone. Approximately 84 eyes (42 per arm) will take part in study. The primary outcome will measure the proportion of eyes with a vitreous haze score of 0 six months post initial treatment. Secondary measures will include best corrected visual acuity (BCVA), central retinal thickness (CRT) measured by spectral-domain optical coherence tomography (SD-OCT), time to vitreous haze resolution and time to failure defined at number of months with DEX implant until an adjunct therapy is indicated. Baseline measurements will be recorded within 1 month prior to treatment in both groups, with follow up measurements collected at 0, 1, 2, 4, 6 and 12 months post-operatively.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intravitreal Dexamethasone Implant Group | Experimental | Subjects randomized to the experimental group will receive a 0.7mg intravitreal dexamethasone (DEX) implant which will be injected in the vitreous cavity as one of the treatments of interest in this study. |
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| Prednisone Taper Group | Active Comparator | Subjects randomized to the comparator group will receive oral prednisone. The initial dose is expected to range between 40 to 60mg of oral prednisone per day, with gradual tapering to the lowest dose that controls inflammation and eventually transitioning to a maintenance dose. Maintenance dose will be gradually lowered as per standard of care if remission is achieved for 6 to 12 months. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ozurdex 0.7mg Ophthalmic Implant | Drug | A 0.7mg intravitreal dexamethasone implant will be used for the treatment of posterior, intermediate and panuveitis for minimum of 6 months. |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of patients with Vitreous Haze score of 0 at 6 months | This score (using NEI/SUN criteria) is used to grade intraocular inflammation based on vitreous cells and protein exudation. A lower score is indicative of less inflammation which is the goal when using either Ozurdex implant or a oral prednisone. | Measurements obtained at 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Best Corrected Visual Acuity at various time points | This score will be used to determine the functional outcome (visual acuity) with the treatments. | Measurements obtained at: 1 month, 2 months, 4 months, 6 months, 12 months |
| Proportion of patients with vitreous haze improvement by 1, and 2 units from baseline to various time points |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ottawa Hospital Research Institute - Vision Research Centre | Ottawa | Ontario | K1H8L6 | Canada |
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| ID | Term |
|---|---|
| D015866 | Uveitis, Posterior |
| D015867 | Uveitis, Intermediate |
| D015864 | Panuveitis |
| ID | Term |
|---|---|
| D014605 | Uveitis |
| D014603 | Uveal Diseases |
| D005128 | Eye Diseases |
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| ID | Term |
|---|---|
| D002123 | Calcium Dobesilate |
| D014785 | Vision, Ocular |
| D011241 | Prednisone |
| ID | Term |
|---|---|
| D001557 | Benzenesulfonates |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
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| Prednisone | Drug | The comparator will be a prednisone taper which is currently the standard care for the uveitis types of focus. |
|
This score will be used to look at the degree of changes in the inflammation. |
| Measurements obtained at: 1 month, 2 months, 4 months, 6 months, 12 months |
| Time to vitreous haze score of 0 from baseline to various time points | This will be used to assess if there are differences in time to achieving lowest possible inflammation amongst groups. | Measurements obtained at: 1 month, 2 months, 4 months, 6 months, 12 months |
| Anterior chamber cells/flare from baseline to various time points | Using SUN grading criteria, the proportion of patients with cells grade 0, 0.5+, 1+, 2+, 3+, 4+ and flare grade of 0, 1+, 2+, 3+, 4+ will be determined at Month 6. | Measurements obtained at: 1 month, 2 months, 4 months, 6 months, 12 months |
| Change in central average thickness (µm) from baseline to various time points | This score will be used to assess anatomical changes (e.g. cystoid macular edema) with treatment | Measurements obtained at: 1 month, 2 months, 4 months, 6 months, 12 months |
| Change in central average volume (in mm3) from baseline to various time points | This score will be used to assess anatomical changes (e.g. cystoid macular edema) with treatment | Measurements obtained at: 1 month, 2 months, 4 months, 6 months, 12 months |
| Change in National Eye Institute Visual Function Questionnaire 25 Score | This will be used to determine impact of disease on the subject's quality of life. The worst possible score is 0 while best is 100. The higher the score, the higher the subjective visual function. | Baseline and 12mo |
| Incidence of complications | Measure complication of treatment including but not limited to cataracts formation, ocular hypertension, vitreous hemorrhage, and endophthalmitis. | Anywhere between baseline to 12 months |
| Percentage of patients with Vitreous Haze score of 0 at various time points | This score (using NEI/SUN criteria) is used to grade intraocular inflammation based on vitreous cells and protein exudation. A lower score is indicative of less inflammation which is the goal when using either Ozurdex implant or a oral prednisone. | Measurements obtained at: 1 month, 2 months, 4 months, 6 months (primary outcome), 12 months |
| D006838 |
| Hydrocarbons |
| D009930 | Organic Chemicals |
| D001190 | Arylsulfonates |
| D017739 | Arylsulfonic Acids |
| D013451 | Sulfonic Acids |
| D013456 | Sulfur Acids |
| D013457 | Sulfur Compounds |
| D055537 | Light Signal Transduction |
| D015398 | Signal Transduction |
| D001669 | Biochemical Phenomena |
| D055598 | Chemical Phenomena |
| D002468 | Cell Physiological Phenomena |
| D012677 | Sensation |
| D009424 | Nervous System Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
| D009799 | Ocular Physiological Phenomena |
| D011244 | Pregnadienediols |
| D011245 | Pregnadienes |
| D011278 | Pregnanes |
| D013256 | Steroids |
| D000072473 | Fused-Ring Compounds |
| D011083 | Polycyclic Compounds |