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Diabetic Macular OedemaMEMNCT02309476

Sub-threshold Photocoagulation of Diabetic Macular Oedema

A study testing PASCAL Laser, Green Laser 0.75, PASCAL Laser, Green Laser 1 and PASCAL Laser, 70% Yellow Laser 0.75 in people with Diabetic Macular Oedema, run by Manchester University NHS Foundation Trust at 1 site in United Kingdom.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

Topcon's Endpoint Management (EM) is a new software from the Pascal® laser which allows us to decrease the intensity of the burns (invisible burns) showing some landmarks with normal intensity so the investigators can see the area which has been treated. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Diabetic Macular Oedema
What is being tested?
PASCAL Laser, Green Laser 0.75, PASCAL Laser, Green Laser 1 and PASCAL Laser, 70% Yellow Laser 0.75
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
0 participants
Where
1 siteUnited Kingdom
Study dates
Oct 2012to Dec 2015
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patient-eligibility
  • Older than 18 years of age
  • Male or female patients with diabetes mellitus type I or type 2 who meet the WHO or ADA criteria for diabetes
  • Able to give informed consent
  • Study Eye eligibility
  • ETDRS visual acuity equivalent to 35 letters or better (Snellen equivalent 20/200 or better)
Show all 10Show fewer
  • The patient must have non-proliferative diabetic retinopathy (NPDR) with diffuse macular oedema
  • Mean average central retinal thickness at least 300 microns as measured by Deep Range Imaging Optical Coherence Tomography (DRI -OCT) scans
  • Adequate pupil dilatation and clear media to perform wide-field colour, red-free imaging and fundus fluorescein angiography (WF-FFA), wide-field fundus autofluorescence imaging (WF-AF) and DRI-OCT
  • Ability to perform accurate Humphmrey visual field test

Who cannot join

  • Patient-eligibility
  • History of chronic renal failure or renal transplant for diabetic nephropathy
  • Recent (last 6 months) or on-going poor glycaemic control. H1Ac greater than 10.0mg/dL
  • Creatinine greater than 1.2 mg/dL
  • HDL equal to or greater than 40 mg/dL
  • Uncontrolled hypertension. Blood pressure greater or equal to 180/110 mmHg
Show all 20Show fewer
  • Patient is unavailable for follow-up visits
  • Pregnant women or breast-feeding females
  • Study Eye eligibility
  • Lens opacity that could influence vision and results
  • Proliferative Diabetic Retinopathy.
  • Any surgical or non-retinal laser treatment to the study eye within 2 months
  • Narrow drainage angles with raised intraocular pressure and angle closure glaucoma.
  • Planned YAG peripheral iridotomy
  • Previous retinal laser photocoagulation, intraocular drug therapy, or macular laser treatment to treatment eye in last year
  • Vitreomacular traction determined clinically and / or OCT, which in the opinion of the investigator, contributes to macular edema (associated or cause a detachment of the fovea) and prevents the improvement with treatment.
  • Atrophy / scar / fibrosis involving the center of the macula, including evidence of atrophy treated with laser within 200 microns of the FAZ.
  • Any previous ocular condition that may be associated with a risk of macular edema
  • Important known allergies to sodium fluorescein dye used in angiography.
  • 12. Active lid or adnexal infection 13. Planned intra-ocular surgery within one year

Trial locations and contacts

1 site in 1 country.

United Kingdom1 site
  • Central Manchester Foundation Trust

    Manchester, England, M13 9WL

Other trials in United Kingdom

About this study

Official title: Manchester Pascal Endpoint Management Laser Treatment of Diffuse Diabetic Macular Oedema (DMO): A Safety and Efficacy Study

Topcon's Endpoint Management (EM) is a new software from the Pascal® laser which allows us to decrease the intensity of the burns (invisible burns) showing some landmarks with normal intensity so the investigators can see the area which has been treated. The Pascal® system with EM utilizes 577nm laser wavelength compared to the 532nm laser wavelength which was utilized in previous Pascal® laser studies.

This study aims to demonstrate that 577nm Pascal® with EM has the same efficacy and effectiveness as 532nm Pascal® in the treatment of diabetic macular oedema.

Read the detailed description

Diabetic macular oedema (DMO) remains the most common cause of visual loss in diabetic patients and affects around 29% of diabetic patients with 20 or more years of disease. The Early Treatment Diabetic Retinopathy Study (ETDRS) demonstrated a significant benefit of laser photocoagulation for the treatment of clinically significant macular oedema, reducing the incidence of vision loss by approximately 50% at 3 years' follow-up.

The original ETDRS photocoagulation technique was adopted throughout the world and gradually modified through the years. Despite the great improvements, loss of central vision, paracentral scotoma and decreased color vision are some adverse events that can still occur, mostly caused by the progressive enlargement of the laser scars consequent to the visible burn of conventional laser photocoagulation.

New strategies have been developed for laser treatments that minimize the chorioretinal damage while maintaining at least similar treatment efficacy.

And numerous clinical studies have been conducted with subvisible laser treatments. However, the lack of a visible endpoint makes it difficult for the treating physician to know which retinal areas have been treated in order to avoid retreatment and also to be confident that the desired target tissue had been treated.

Topcon's Endpoint Management (EM) is a new software from the Pascal® laser which allows us to decrease the intensity of the burns (invisible burns) showing some landmarks with normal intensity so the investigators can see the area which has been treated.

The Pascal® system with EM utilizes 577nm laser wavelength compared to the 532nm laser wavelength which was utilized in previous Pascal® laser studies.

This study aims to demonstrate that 577nm Pascal® with EM has the same efficacy and effectiveness as 532nm Pascal®.

Being tested
PASCAL Laser, Green Laser 0.75, PASCAL Laser, Green Laser 1, PASCAL Laser, 70% Yellow Laser 0.75, PASCAL Laser, 70% Yellow Laser 1, PASCAL Laser, 40% Yellow Laser 0.75
Keywords
diffuse diabetic macular oedema, Pascal, Laser, DMO

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PASCAL Laser, Green Laser 0.75Device

    Barely Visible Pascal laser grid using 532nm "green" wavelength, 0.75 burn-widths-apart. Intervention: macular laser grid Number of burns: Full grid 112 burns Spot size: 100micron Duration: 10 ms Exposure: barely visible burn Average power: 100 to 1000 mW Spot spacing: 0.75 burn-widths-apart Distribution: Grid

  • PASCAL Laser, Green Laser 1Device

    Barely Visible Pascal laser grid using 532nm "green" wavelength, 1 burn-widths-apart. Intervention: macular laser grid Number of burns: Full grid 112 burns Spot size: 100micron Duration: 10 ms Exposure: barely visible burn Average power: 100 to 1000 mW Spot spacing: 0.75 burn-widths-apart Distribution: Grid

  • PASCAL Laser, 70% Yellow Laser 0.75Device

    Pascal EM at 70% 577nm "yellow" laser grid, 0.75 burn-widths-apart Intervention: macular laser grid Number of burns: Full grid 112 burns Spot size: 100micron Duration: 10 ms Exposure: A barely visible burn will be aimed at for the "Landmark" burn and EndPoint Management will be set at 70% to achieve non-visible burns Average power: 100 to 1000 mW Spot spacing: 0.75 burn-widths-apart Distribution: Grid

  • PASCAL Laser, 70% Yellow Laser 1Device

    Pascal EM at 70% 577nm "yellow" laser grid, 0.75 burn-widths-apart Intervention: macular laser grid Number of burns: Full grid 112 burns Spot size: 100micron Duration: 10 ms Exposure: A barely visible burn will be aimed at for the "Landmark" burn and EndPoint Management will be set at 70% to achieve non-visible burns Average power: 100 to 1000 mW Spot spacing: 1 burn-widths-apart Distribution: Grid

  • PASCAL Laser, 40% Yellow Laser 0.75Device

    Pascal EM at 40% 577nm "yellow" laser grid, 0.75 burn-widths-apart Intervention: macular laser grid Number of burns: Full grid 112 burns Spot size: 100micron Duration: 10 ms Exposure: A barely visible burn will be aimed at for the "Landmark" burn and EndPoint Management will be set at 740% to achieve non-visible burns Average power: 100 to 1000 mW Spot spacing: 0.75 burn-widths-apart Distribution: Grid

  • PASCAL Laser, 40% Yellow Laser 1Device

    Pascal EM at 40% 577nm "yellow" laser grid, 0.75 burn-widths-apart Intervention: macular laser grid Number of burns: Full grid 112 burns Spot size: 100micron Duration: 10 ms Exposure: A barely visible burn will be aimed at for the "Landmark" burn and EndPoint Management will be set at 740% to achieve non-visible burns Average power: 100 to 1000 mW Spot spacing: 0.75 burn-widths-apart Distribution: Grid

Study groups in NCT02309476
Study groupRoleWhat they receive
PASCAL Laser, Green Laser 0.75ExperimentalBarely Visible Pascal laser grid using 532nm "green" wavelength, 0.75 burn-widths-apart. Intervention: macular laser grid Number of burns: Full grid 112 burns Spot size: 100micron Duration: 10 ms Exposure: barely visible burn Average power: 100 to 1000 mW Spot spacing: 0.75 burn-widths-apart Distribution: Grid
Receives: Device: PASCAL Laser, Green Laser 0.75
PASCAL Laser, Green Laser 1 burnExperimentalBarely Visible Pascal laser grid using 532nm "green" wavelength, 1 burn-widths-apart Intervention: macular laser grid Number of burns: Full grid 112 burns Spot size: 100micron Duration: 10 ms Exposure: barely visible burn Average power: 100 to 1000 mW Spot spacing: 1 burn-widths-apart Distribution: Grid
Receives: Device: PASCAL Laser, Green Laser 1
PASCAL Laser, 70% Yellow Laser 0.75ExperimentalPascal EM at 70% 577nm "yellow" laser grid, 0.75 burn-widths-apart Intervention: macular laser grid Number of burns: Full grid 112 burns Spot size: 100micron Duration: 10 ms Exposure: A barely visible burn will be aimed at for the "Landmark" burn and EndPoint Management will be set at 70% to achieve non-visible burns Average power: 100 to 1000 mW Spot spacing: 0.75 burn-widths-apart Distribution: Grid
Receives: Device: PASCAL Laser, 70% Yellow Laser 0.75
PASCAL Laser, 70% Yellow Laser 1ExperimentalPascal EM at 70% 577nm "yellow", 1 burn-widths-apart Intervention: macular laser grid Number of burns: Full grid 112 burns Spot size: 100micron Duration: 10 ms Exposure: A barely visible burn will be aimed at for the "Landmark" burn and EndPoint Management will be set at 70% to achieve non-visible burns Average power: 100 to 1000 mW Spot spacing: 1 burn-widths-apart Distribution: Grid
Receives: Device: PASCAL Laser, 70% Yellow Laser 1
PASCAL Laser, 40% Yellow Laser 0.75ExperimentalPascal EM at 40% 577nm "yellow", 0.75 burn-widths-apart Intervention: macular laser grid Number of burns: Full grid 112 burns Spot size: 100micron Duration: 10 ms Exposure: A barely visible burn will be aimed at for the "Landmark" burn and EndPoint Management will be set at 40% to achieve non-visible burns Average power: 100 to 1000 mW Spot spacing: 0.75 burn-widths-apart Distribution: Grid
Receives: Device: PASCAL Laser, 40% Yellow Laser 0.75
PASCAL Laser, 40% Yellow Laser 1ExperimentalPascal EM at 40% 577nm "yellow" laser grid, 1 burn-widths-apart Intervention: macular laser grid Number of burns: Full grid 112 burns Spot size: 100micron Duration: 10 ms Exposure: A barely visible burn will be aimed at for the "Landmark" burn and EndPoint Management will be set at 40% to achieve non-visible burns Average power: 100 to 1000 mW Spot spacing: 1 burn-widths-apart Distribution: Grid
Receives: Device: PASCAL Laser, 40% Yellow Laser 1

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. reduction of diabetic macular edema (central retinal thickness) within the 6 arms of the study

    To compare Green Pascal® laser and Yellow Pascal® laser using EM among 6 groups of participants using Pascal® laser with an application of full grid 112 burns in a single session

    Measured: 12 months

Secondary outcomes (2)
  1. Improvement in visual acuity (> 10 letters or two lines in the ETDRS chart)

    Measured: 12 months

  2. increase in retinal sensitivity within the 6 arms of the study

    increase in retinal sensitivity will be assessed with fundus-related perimetry (microperimetry)

    Measured: 12 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Dec 2014 (estimated)
  2. Study startOct 2012
  3. Primary completionDec 2014
  4. Study completionDec 2015 (estimated)

Why it stopped: The PI decided to close the study early as patients with diffused macular oedema without any previous treatment are uncommon.

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02309476
Sponsor's protocol ID
R03018
Acronym
MEM
Status last verified
Mar 2020
First submitted
29 Sep 2014
Last updated
17 Mar 2020
Results posted
No
Data monitoring committee
No

Questions about this trial

What is this clinical trial studying?

A study testing PASCAL Laser, Green Laser 0.75, PASCAL Laser, Green Laser 1 and PASCAL Laser, 70% Yellow Laser 0.75 in people with Diabetic Macular Oedema, run by Manchester University NHS Foundation Trust at 1 site in United Kingdom.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 20 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: withdrawn, as of the sponsor's last update on 17 Mar 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was withdrawn before enrolling participants, so there are no results.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

reduction of diabetic macular edema (central retinal thickness) within the 6 arms of the study (time frame: 12 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Mar 2020.

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