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KeratoconusNCT03071302

Evaluation of Tomographic and Genetic Aspects of Keratoconus Patients Compared to Sounds Corneas

A study testing EVALUATION OF VSX1, SOD1, and TIMP3 genes in people with Keratoconus and Keratoconus, Unspecified, Bilateral, run by Sao Jose do Rio Preto Medical School at 1 site in Brazil.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Evaluation of tomographic (Pentacam) parameters and genetic parameters of Visual System Homeobox 1 (VSX1), Superoxide Dismutase (SOD1), Tissue Inhibitors of Metalloproteinases (TIMP3) genes of keratoconus patients diagnosed by clinical exam and topographic pattern. Read more about this study

Who is it for?
Ages 10 to 60 yearsHealthy volunteers can take part
What is being tested?
EVALUATION OF VSX1, SOD1, and TIMP3 genes
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
210 participants
Where
1 siteBrazil
Study dates
1 Aug 2015to 31 Dec 2016
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 10 to 60 years
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult

Who may be able to join

  • Patients diagnosed with keratoconus in clinical examination, topography and tomography
  • Patients with clinical examination, topography, and tomography aspect of sound cornea in one eye, and the fellow eye diagnosed with keratoconus by clinical examination, topography, and tomography.
  • Patients diagnosed with keratoconus by clinical examination, topography, and tomography in both eyes (OU).
  • Patients with some degree of ametropia that underwent to PRK and LASIK

Who cannot join

  • History of eye trauma, glaucoma, dysfunctional tear syndrome, rosacea, neurotrophic keratopathy, systemic or topical use of immunosuppressive drugs, previous ocular surgeries.

Trial locations and contacts

1 site in 1 country.

Brazil1 site
  • Visum Eye Center / Immunogenetic laboratory of FAMERP

    São José do Rio Preto, São Paulo, 15015-020

Other trials in Brazil

About this study

Evaluation of tomographic (Pentacam) parameters and genetic parameters of Visual System Homeobox 1 (VSX1), Superoxide Dismutase (SOD1), Tissue Inhibitors of Metalloproteinases (TIMP3) genes of keratoconus patients diagnosed by clinical exam and topographic pattern. Basically we are screening patients that don't have keratoconus that those have keratoconus. The pentacam index of corneal curvature, thinnest point, corneal high order aberrations, posterior and anterior elevation, corneal densitometry, corneal volume were investigated. To analyze the genes, we took corneal epithelium samples of patients submitted to cross linking compared to (PRK) Photo Refractive Keratectomy ones. Also will be evaluated the genes of peripheral blood.

Read the detailed description

Keratoconus is a common disease that affects the cornea in both genders in all ethnic groups and that can manifest unilaterally or bilaterally in patients. Keratoconus due to a degenerative disease, its progression can be fast in various situations, affecting 1 in every 2,000 people, what results in severe structural changes of the cornea, which reduces its thickness and modify its normal curvature to a more conical shape. Keratoconus arises in adolescence and lasts for thirty to forty years of age, where it stabilizes and it is considered a major cause of corneal transplantation. Factors such as atopy, overuse of contact lenses and the act of rubbing the eyes are also related to the disease. The clinical picture consists of a lot of varied symptoms and it depends on the stage of disease progression. Currently it is known that genetic and environmental factors are involved in the desease emergence. Recently several genetic studies have aimed to identify mutations in genes which are directly linked to Keratoconus, such as VSX1, SOD1 and TIMP3 genes. However, despite the efforts directed towards the understanding of the genetic aspects of this disease, involving many genes, there are still many questions about the role of these genes in Keratoconus etiology. Thus, the present study aims to identify the presence of mutations in VSX1, SOD1 and TIMP3 genes, which are considered important candidates for the origin and development of this eye anomaly, through the analysis of their nucleotide sequences in corneal tissue and peripheral blood in Keratoconus patients, in their unilateral and bilateral forms. The results will allow to compare the presented mutations in different analysed tissues for unilateral and bilateral forms of Keratoconus and also compare them with the same tissues in healthy patients, in an attempt to establish what the likely inherited and/or acquired genetic mutations are causing this condition. Thus providing genetic data, still unpublished in Brazilian populations, which may offer subsidies for the characterization of the mutation dynamics and their patterns, on the origin and development of Keratoconus. Also will be evaluated the tomographic index as corneal curvature, thinnest point, corneal high order aberrations, posterior and anterior elevation, corneal densitometry, corneal volume. The idea is focused on that suspicious cornea that has the fellow eye with unequivocal keratoconus.

Being tested
EVALUATION OF VSX1, SOD1, and TIMP3 genes
Keywords
Keratoconus,Corneal Dystrophies, corneal Tomography, topography
Medical subject headings
Keratoconus, Corneal Dystrophies, Hereditary

What participants receive

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

  • EVALUATION OF VSX1, SOD1, and TIMP3 genesOther

    Also called pentacam and gene evaluation

    Evaluation of VISX1, SOD1, TIMP3 genes in corneal epithelium, and in peripheral blood. Evaluation of pentacam parameters

Study groups in NCT03071302
Study groupRoleWhat they receive
keratoconusActive comparatorEvaluation of Visual System Homeobox 1 (VSX1), Superoxide Dismutase (SOD1), Tissue Inhibitors of Metalloproteinases (TIMP3) genes. Keratoconus with fellow eye without topographic and tomographic keratoconous pattern.Evaluation of tomographic datas. Sometimes we picked up the sample of corneal epithelium, and peripheral blood sample from corneal cross linking surgeries, in that case of keratoconus progression. Group A Keratoconus/ like sound cornea. Group C Keratoconus / Keratoconus Group C Keratoconus / Keratoconus
Receives: Other: EVALUATION OF VSX1, SOD1, and TIMP3 genes
sound corneaPlacebo comparatorEvaluation of VSX1, SOD1, and TIMP3 genes. To analyze tomographic aspects, we evaluated the patients that underwent to LASIK (Lasei in situ Keratomileusis) with 2 year with follow up without any sign of ectasia To analyze the genes we picked up the sample of corneal epithelium, and peripheral blood sample from PRK (PhotoRefractive Keratectomy) surgeries. These patients showed topographic and tomographic normal pattern. Group B Sound Cornea / Sound Cornea
Receives: Other: EVALUATION OF VSX1, SOD1, and TIMP3 genes

What is being measured

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

  1. Evaluate the tomographic parameters of keratoconus, subclinical keratoconus in relation to sound corneas and identify the mutations present in the genes VSX1, SOD1 and TIMP3 in individuals affected by keratoconus.

    The aim of this study was to evaluate Evaluate the tomographic parameters of keratoconus, subclinical keratoconus in relation to sound corneas and identify the mutations present in the genes VSX1, SOD1 and TIMP3 in individuals affected by keratoconus in several forms of manifestation.

    Measured: 18 months

Secondary outcomes (2)
  1. Tomographic parameters

    Evaluating whether cross-referencing of known indexes may improve sensitivity and specificity in the detection of subclinical keratoconus;

    • Evaluate if there is a correlation between the different tomographic indices; To evaluate the cornea densitometry in patients with keratoconus and its absence.

    Measured: 18 months

  2. Genetic evaluation, VISX1, SOD1, TIMP3

    Avalue if after removal of the epithelium there is a very large change in the curvature, elevations and topometry of the cornea;

    • Identify the presence of mutations in the VSX1, SOD1 and TIMP3 genes, from nucleotide sequence analysis in tissues of the affected cornea, normal cornea and peripheral blood, in patients with this pathology in their several forms.
    • Compare the mutations present in the different tissues analyzed, for the unilateral and bilateral forms of keratoconus and also to compare them with the same tissues in healthy patients;
    • Establish which are the probable inherited and / or acquired genetic mutations that cause this pathology, from the analysis of the same in the peripheral blood of the affected individuals.

    Measured: 18 months

Timeline

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

  1. First posted6 Mar 2017
  2. Study start1 Aug 2015
  3. Primary completion31 Dec 2016
  4. Study completion31 Dec 2016

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
Screening
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
210 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03071302
Sponsor's protocol ID
CAAE 44071315.7.0000.5415
Other IDs
2015/17226-7, 2015
Status last verified
Feb 2017
First submitted
28 Feb 2017
Last updated
6 Mar 2017
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Bisceglia L, De Bonis P, Pizzicoli C, Fischetti L, Laborante A, Di Perna M, Giuliani F, Delle Noci N, Buzzonetti L, Zelante L. Linkage analysis in keratoconus: replication of locus 5q21.2 and identification of other suggestive Loci. Invest Ophthalmol Vis Sci. 2009 Mar;50(3):1081-6. doi: 10.1167/iovs.08-2382. Epub 2008 Oct 31.

    PubMed 18978346
  • Karolak JA, Gajecka M. Genomic strategies to understand causes of keratoconus. Mol Genet Genomics. 2017 Apr;292(2):251-269. doi: 10.1007/s00438-016-1283-z. Epub 2016 Dec 28.

    PubMed 28032277
  • Li X, Yang H, Rabinowitz YS. Longitudinal study of keratoconus progression. Exp Eye Res. 2007 Oct;85(4):502-7. doi: 10.1016/j.exer.2007.06.016. Epub 2007 Jul 6.

    PubMed 17681291
  • Abu-Amero KK, Kalantan H, Al-Muammar AM. Analysis of the VSX1 gene in keratoconus patients from Saudi Arabia. Mol Vis. 2011 Mar 8;17:667-72.

    PubMed 21403853
  • Alio JL, Shabayek MH. Corneal higher order aberrations: a method to grade keratoconus. J Refract Surg. 2006 Jun;22(6):539-45. doi: 10.3928/1081-597X-20060601-05.

    PubMed 16805116
  • Ambrosio R Jr, Alonso RS, Luz A, Coca Velarde LG. Corneal-thickness spatial profile and corneal-volume distribution: tomographic indices to detect keratoconus. J Cataract Refract Surg. 2006 Nov;32(11):1851-9. doi: 10.1016/j.jcrs.2006.06.025.

    PubMed 17081868
  • Ambrosio R Jr, Caiado AL, Guerra FP, Louzada R, Sinha RA, Luz A, Dupps WJ, Belin MW. Novel pachymetric parameters based on corneal tomography for diagnosing keratoconus. J Refract Surg. 2011 Oct;27(10):753-8. doi: 10.3928/1081597X-20110721-01. Epub 2011 Jul 29.

    PubMed 21800785
  • Arnal E, Peris-Martinez C, Menezo JL, Johnsen-Soriano S, Romero FJ. Oxidative stress in keratoconus? Invest Ophthalmol Vis Sci. 2011 Nov 4;52(12):8592-7. doi: 10.1167/iovs.11-7732.

    PubMed 21969298
  • Bae GH, Kim JR, Kim CH, Lim DH, Chung ES, Chung TY. Corneal topographic and tomographic analysis of fellow eyes in unilateral keratoconus patients using Pentacam. Am J Ophthalmol. 2014 Jan;157(1):103-109.e1. doi: 10.1016/j.ajo.2013.08.014. Epub 2013 Oct 25.

    PubMed 24452012
  • Beckh U, Schonherr U, Naumann GO. [Autosomal dominant keratoconus as the chief ocular symptom in Lobstein osteogenesis imperfecta tarda]. Klin Monbl Augenheilkd. 1995 Apr;206(4):268-72. doi: 10.1055/s-2008-1035438. German.

    PubMed 7791289
  • Behndig A, Karlsson K, Johansson BO, Brannstrom T, Marklund SL. Superoxide dismutase isoenzymes in the normal and diseased human cornea. Invest Ophthalmol Vis Sci. 2001 Sep;42(10):2293-6.

    PubMed 11527942
  • Bardak H, Gunay M, Yildiz E, Bardak Y, Gunay B, Ozbas H, Bagci O. Novel visual system homeobox 1 gene mutations in Turkish patients with keratoconus. Genet Mol Res. 2016 Nov 3;15(4). doi: 10.4238/gmr15049024.

    PubMed 27819732
  • Bykhovskaya Y, Margines B, Rabinowitz YS. Genetics in Keratoconus: where are we? Eye Vis (Lond). 2016 Jun 27;3:16. doi: 10.1186/s40662-016-0047-5. eCollection 2016.

    PubMed 27350955
  • Chen D, Lam AK. Intrasession and intersession repeatability of the Pentacam system on posterior corneal assessment in the normal human eye. J Cataract Refract Surg. 2007 Mar;33(3):448-54. doi: 10.1016/j.jcrs.2006.11.008.

    PubMed 17321396
  • Chow RL, Volgyi B, Szilard RK, Ng D, McKerlie C, Bloomfield SA, Birch DG, McInnes RR. Control of late off-center cone bipolar cell differentiation and visual signaling by the homeobox gene Vsx1. Proc Natl Acad Sci U S A. 2004 Feb 10;101(6):1754-9. doi: 10.1073/pnas.0306520101. Epub 2004 Jan 26.

    PubMed 14745032

Questions about this trial

What is this clinical trial studying?

A study testing EVALUATION OF VSX1, SOD1, and TIMP3 genes in people with Keratoconus and Keratoconus, Unspecified, Bilateral, run by Sao Jose do Rio Preto Medical School at 1 site in Brazil.

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 4 inclusion and 1 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: finished, as of the sponsor's last update on 6 Mar 2017. 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 Brazil. 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. Some participants in this study may receive a placebo. 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 is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Evaluate the tomographic parameters of keratoconus, subclinical keratoconus in relation to sound corneas and identify the mutations present in the genes VSX1, SOD1 and TIMP3 in individuals affected by keratoconus. (time frame: 18 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03071302, which also lists 97 linked publications.

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 6 Mar 2017.

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