Retinopathy of PrematurityPhase 4NCT04623684
Efficacy and Safety of Mydriatic Microdrops Compared With Standard Drops for Retinopathy of Prematurity (ROP) Screening: a Pilot Randomized Clinical Trial
A Phase 4 study testing Microdrop administration [phenylephrine 1.67% + tropicamide 0.33% (drop volume: 6-7 μL)] and Standard drop administration [phenylephrine 1.67% + tropicamide 0.33% (drop volume: 28-34 μL)] in people with Retinopathy of Prematurity, run by Aristotle University Of Thessaloniki at 1 site in Greece.
Trial summary
The purpose is to assess whether the use of microdrop instillation of phenylephrine 1.67% and tropicamide 0.33% maintains mydriatic efficacy while presents an improved safety profile compared with standard drops of phenylephrine 1.67% and tropicamide 0.33%, which is routine care for pupil dilation during retinopathy… Read more about this study
- Who is it for?
- Ages 30 to 37 weeks
- Conditions the study is for
- Retinopathy of Prematurity
- What is being tested?
- Microdrop administration [phenylephrine 1.67% + tropicamide 0.33% (drop volume: 6-7 μL)] and Standard drop administration [phenylephrine 1.67% + tropicamide 0.33% (drop volume: 28-34 μL)]
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 25 participants
- Where
- 1 siteGreece
- Study dates
- 24 Mar 2020to 29 Sep 2020
- Phase
- Phase 4
- 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 30 to 37 weeks
- All sexes
- No healthy volunteers
- Child
Who may be able to join
- Preterm infants undergoing screening for ROP, i.e.
- with gestational age (GA) < 32 weeks and/or birth weight (BW) < 1501 grams
- infants of greater GA and BW with increased comorbidity, e.g. sepsis, prolonged need for oxygen supplementation etc.
Who cannot join
- Unstable clinical condition
- Suspicion of cardiovascular disease
- Severe congenital anomalies
- Clinical syndromes
- Traumatic apoptosis of the corneal epithelium
- Corneal ulcer
- Anatomical variations of the anterior segment
Trial locations and contacts
1 site in 1 country.
About this study
The purpose is to assess whether the use of microdrop instillation of phenylephrine 1.67% and tropicamide 0.33% maintains mydriatic efficacy while presents an improved safety profile compared with standard drops of phenylephrine 1.67% and tropicamide 0.33%, which is routine care for pupil dilation during retinopathy of prematurity (ROP) screening in our neonatal intensive care unit.
Read the detailed description
A pilot prospective randomized crossover clinical trial is conducted for assessing the mydriatic efficacy and safety of microdrops (6-7 μL) compared with standard drops (28-34 μL) for retinopathy of prematurity screening. A random number table was used to allocate participants into either a) receiving standard drop on their first and microdrop on their second screening examination a week later, or b) receiving microdrop first and standard drop a week later. The mydriatic agent contains phenylephrine 1.67% and tropicamide 0.33%, which derives from compounding the commercial phenylephrine 5% with the commercial tropicamide 0.5% in volume ratio 1:2.
- Conditions
- Retinopathy of Prematurity
- Being tested
- Microdrop administration [phenylephrine 1.67% + tropicamide 0.33% (drop volume: 6-7 μL)], Standard drop administration [phenylephrine 1.67% + tropicamide 0.33% (drop volume: 28-34 μL)]
- Keywords
- microdrops, mydriasis, dilating drops, retinopathy of prematurity, ROP, screening
- Medical subject headings
- Retinopathy of Prematurity, Mydriasis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Microdrop administration [phenylephrine 1.67% + tropicamide 0.33% (drop volume: 6-7 μL)]Drug
1 drop (6-7 μL) for 3 doses, 5 minutes' intervals
Standard drop administration [phenylephrine 1.67% + tropicamide 0.33% (drop volume: 28-34 μL)]Drug
1 drop (28-34 μL) for 3 doses, 5 minutes' intervals
| Study group | Role | What they receive |
|---|---|---|
| Study Group | Experimental | Mydriasis with microdrops Receives: Drug: Microdrop administration [phenylephrine 1.67% + tropicamide 0.33% (drop volume: 6-7 μL)] |
| Control Group | Active comparator | Mydriasis with standard drops Receives: Drug: Standard drop administration [phenylephrine 1.67% + tropicamide 0.33% (drop volume: 28-34 μL)] |
What is being measured
The primary outcome is the main question the study is designed to answer.
Mydriatic efficacy: mm of pupil diameter (left and right eye)
Measured: 45 minutes after the first drop instillation
Mydriatic efficacy: mm of pupil diameter (left and right eye)
Measured: 90 minutes after the first drop instillation
Secondary outcomes (14)
Mydriatic efficacy: mm of pupil diameter (left and right eye)
Measured: 120 minutes after the first drop instillation
Systemic side effects: measurements of Heart Rate (bpm)
Measured: 45 minutes after the first drop instillation
Systemic side effects: measurements of Heart Rate (bpm)
Measured: 90 minutes after the first drop instillation
Systemic side effects: measurements of Heart Rate (bpm)
Measured: 120 minutes after the first drop instillation
Systemic side effects: measurements of oxygen saturation (SpO2) (%)
Measured: 45 minutes after the first drop instillation
Systemic side effects: measurements of oxygen saturation (SpO2) (%)
Measured: 90 minutes after the first drop instillation
Systemic side effects: measurements of oxygen saturation (SpO2) (%)
Measured: 120 minutes after the first drop instillation
Systemic side effects: measurements of Blood Pressure (Systolic, Diastolic and Mean Blood Pressure) (mmHg)
Measured: 45 minutes after the first drop instillation
Systemic side effects: measurements of Blood Pressure (Systolic, Diastolic and Mean Blood Pressure) (mmHg)
Measured: 90 minutes after the first drop instillation
Systemic side effects: measurements of Blood Pressure (Systolic, Diastolic and Mean Blood Pressure) (mmHg)
Measured: 120 minutes after the first drop instillation
Systemic side effects: measurements of Blood Pressure (Systolic, Diastolic and Mean Blood Pressure) (mmHg)
Measured: Hourly for the first 24 hours after mydriasis
Local side effects: periorbital pallor, eyelid swelling, flushing
Measured: 45 minutes after the first drop instillation
Adverse events including apnea, increased gastric residuals, inhibited duodenal motor activity, delayed gastric emptying, feeding intolerance, abdominal distension, vomiting, paralytic ileus, acute gastric dilatation and necrotizing enterocolitis (NEC)
Measured: During the 24 hours after mydriasis for ROP screening
Number of participants with non-adequate mydriasis to fully visualize peripheral fundus according to the examiner
Measured: Upon eye examination (45 to 90 minutes after the first drop)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Nov 2020
- Study start24 Mar 2020
- Primary completion22 Sep 2020
- Study completion29 Sep 2020
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (4)Papers the sponsor has linked to this study.
- Other trials for Retinopathy of PrematurityStudies of the same condition, open and under way.
- More trials run by Aristotle University Of ThessalonikiThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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 4
- Primary purpose
- Screening
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 25 participants (actual)
Sponsor and investigators
- Lead sponsor
- Aristotle University Of Thessaloniki
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Asimina Mataftsi, Aristotle University Of Thessaloniki
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04623684
- Sponsor's protocol ID
- 170/10-03-2020
- Status last verified
- Mar 2022
- First submitted
- 31 Oct 2020
- Last updated
- 4 Apr 2022
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Lynch MG, Brown RH, Goode SM, Schoenwald RD, Chien DS. Reduction of phenylephrine drop size in infants achieves equal dilation with decreased systemic absorption. Arch Ophthalmol. 1987 Oct;105(10):1364-5. doi: 10.1001/archopht.1987.01060100066027.
PubMed 3662909Elibol O, Alcelik T, Yuksel N, Caglar Y. The influence of drop size of cyclopentolate, phenylephrine and tropicamide on pupil dilatation and systemic side effects in infants. Acta Ophthalmol Scand. 1997 Apr;75(2):178-80. doi: 10.1111/j.1600-0420.1997.tb00119.x.
PubMed 9197568Seliniotaki AK, Prousali E, Lithoxopoulou M, Kokkali S, Ziakas N, Soubasi V, Mataftsi A. Alternative mydriasis techniques for retinopathy of prematurity screening. Int Ophthalmol. 2020 Dec;40(12):3613-3619. doi: 10.1007/s10792-020-01542-x. Epub 2020 Aug 9.
PubMed 32772218Seliniotaki AK, Lithoxopoulou M, Talimtzi P, Georgiou E, Diamanti E, Ziakas N, Haidich AB, Mataftsi A. Efficacy and safety of mydriatic microdrops for retinopathy of prematurity screening: an external pilot crossover randomized controlled trial. J Perinatol. 2022 Mar;42(3):371-377. doi: 10.1038/s41372-021-01229-w. Epub 2021 Oct 15.
PubMed 34654903
Study at a glance
From the registry record, last updated by the sponsor on 4 Apr 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Efficacy and Safety of Mydriatic Microdrops Compared With Standard Drops for Retinopathy of Prematurity (ROP) Screening: a Pilot Randomized Clinical Trial
- ClinicalTrials.gov ID
- NCT04623684
- Acronym / sponsor ID
- 170/10-03-2020
- Conditions
- Retinopathy of Prematurity
- Keywords
- microdrops, mydriasis, dilating drops, retinopathy of prematurity, ROP, screening
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 25 participants (actual)
- Lead sponsor
- Aristotle University Of ThessalonikiUniversity, hospital or other
- Study start
- 24 Mar 2020 (actual)
- Primary completion
- 22 Sep 2020 (actual)
- Study completion
- 29 Sep 2020 (actual)
- First posted
- 10 Nov 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose is to assess whether the use of microdrop instillation of phenylephrine 1.67% and tropicamide 0.33% maintains mydriatic efficacy while presents an improved safety profile compared with standard drops of phenylephrine 1.67% and tropicamide 0.33%, which is routine care for pupil dilation during retinopathy of prematurity (ROP) screening in our neonatal intensive care unit.
Detailed description
A pilot prospective randomized crossover clinical trial is conducted for assessing the mydriatic efficacy and safety of microdrops (6-7 μL) compared with standard drops (28-34 μL) for retinopathy of prematurity screening. A random number table was used to allocate participants into either a) receiving standard drop on their first and microdrop on their second screening examination a week later, or b) receiving microdrop first and standard drop a week later. The mydriatic agent contains phenylephrine 1.67% and tropicamide 0.33%, which derives from compounding the commercial phenylephrine 5% with the commercial tropicamide 0.5% in volume ratio 1:2.
Study design
- Primary purpose
- Screening
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Study Group | Experimental | Drug: Microdrop administration [phenylephrine 1.67% + tropicamide 0.33% (drop volume: 6-7 μL)]Mydriasis with microdrops |
| Control Group | Active comparator | Drug: Standard drop administration [phenylephrine 1.67% + tropicamide 0.33% (drop volume: 28-34 μL)]Mydriasis with standard drops |
Who may qualify
- Ages
- 30 to 37 weeks
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
Key inclusion criteria (3 listed)
- Preterm infants undergoing screening for ROP, i.e.
- with gestational age (GA) < 32 weeks and/or birth weight (BW) < 1501 grams
- infants of greater GA and BW with increased comorbidity, e.g. sepsis, prolonged need for oxygen supplementation etc.
Key exclusion criteria (7 listed)
- Unstable clinical condition
- Suspicion of cardiovascular disease
- Severe congenital anomalies
- Clinical syndromes
- Traumatic apoptosis of the corneal epithelium
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Microdrop administration [phenylephrine 1.67% + tropicamide 0.33% (drop volume: 6-7 μL)]1 drop (6-7 μL) for 3 doses, 5 minutes' intervals | Drug | Study Group |
| Standard drop administration [phenylephrine 1.67% + tropicamide 0.33% (drop volume: 28-34 μL)]1 drop (28-34 μL) for 3 doses, 5 minutes' intervals | Drug | Control Group |
Primary outcome
Mydriatic efficacy: mm of pupil diameter (left and right eye)
Time frame: 45 minutes after the first drop instillation
Mydriatic efficacy: mm of pupil diameter (left and right eye)
Time frame: 90 minutes after the first drop instillation
14 secondary outcomes
Mydriatic efficacy: mm of pupil diameter (left and right eye)
Time frame: 120 minutes after the first drop instillation
Systemic side effects: measurements of Heart Rate (bpm)
Time frame: 45 minutes after the first drop instillation
Systemic side effects: measurements of Heart Rate (bpm)
Time frame: 90 minutes after the first drop instillation
Systemic side effects: measurements of Heart Rate (bpm)
Time frame: 120 minutes after the first drop instillation
Systemic side effects: measurements of oxygen saturation (SpO2) (%)
Time frame: 45 minutes after the first drop instillation
Systemic side effects: measurements of oxygen saturation (SpO2) (%)
Time frame: 90 minutes after the first drop instillation
Systemic side effects: measurements of oxygen saturation (SpO2) (%)
Time frame: 120 minutes after the first drop instillation
Systemic side effects: measurements of Blood Pressure (Systolic, Diastolic and Mean Blood Pressure) (mmHg)
Time frame: 45 minutes after the first drop instillation
Systemic side effects: measurements of Blood Pressure (Systolic, Diastolic and Mean Blood Pressure) (mmHg)
Time frame: 90 minutes after the first drop instillation
Systemic side effects: measurements of Blood Pressure (Systolic, Diastolic and Mean Blood Pressure) (mmHg)
Time frame: 120 minutes after the first drop instillation
Systemic side effects: measurements of Blood Pressure (Systolic, Diastolic and Mean Blood Pressure) (mmHg)
Time frame: Hourly for the first 24 hours after mydriasis
Local side effects: periorbital pallor, eyelid swelling, flushing
Time frame: 45 minutes after the first drop instillation
Adverse events including apnea, increased gastric residuals, inhibited duodenal motor activity, delayed gastric emptying, feeding intolerance, abdominal distension, vomiting, paralytic ileus, acute gastric dilatation and necrotizing enterocolitis (NEC)
Time frame: During the 24 hours after mydriasis for ROP screening
Number of participants with non-adequate mydriasis to fully visualize peripheral fundus according to the examiner
Time frame: Upon eye examination (45 to 90 minutes after the first drop)
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Apr 2022.
- Background: PubMed 3662909Lynch MG, Brown RH, Goode SM, Schoenwald RD, Chien DS. Reduction of phenylephrine drop size in infants achieves equal dilation with decreased systemic absorption. Arch Ophthalmol. 1987 Oct;105(10):1364-5. doi: 10.1001/archopht.1987.01060100066027.
- Background: PubMed 9197568Elibol O, Alcelik T, Yuksel N, Caglar Y. The influence of drop size of cyclopentolate, phenylephrine and tropicamide on pupil dilatation and systemic side effects in infants. Acta Ophthalmol Scand. 1997 Apr;75(2):178-80. doi: 10.1111/j.1600-0420.1997.tb00119.x.
- Background: PubMed 32772218Seliniotaki AK, Prousali E, Lithoxopoulou M, Kokkali S, Ziakas N, Soubasi V, Mataftsi A. Alternative mydriasis techniques for retinopathy of prematurity screening. Int Ophthalmol. 2020 Dec;40(12):3613-3619. doi: 10.1007/s10792-020-01542-x. Epub 2020 Aug 9.
- Results publication: PubMed 34654903Seliniotaki AK, Lithoxopoulou M, Talimtzi P, Georgiou E, Diamanti E, Ziakas N, Haidich AB, Mataftsi A. Efficacy and safety of mydriatic microdrops for retinopathy of prematurity screening: an external pilot crossover randomized controlled trial. J Perinatol. 2022 Mar;42(3):371-377. doi: 10.1038/s41372-021-01229-w. Epub 2021 Oct 15.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Microdrop administration [phenylephrine 1.67% + tropicamide 0.33% (drop volume: 6-7 μL)] and Standard drop administration [phenylephrine 1.67% + tropicamide 0.33% (drop volume: 28-34 μL)] in people with Retinopathy of Prematurity, run by Aristotle University Of Thessaloniki at 1 site in Greece.
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 3 inclusion and 7 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 4 Apr 2022. 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 Greece. 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.
What does this phase mean?
Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
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?
Mydriatic efficacy: mm of pupil diameter (left and right eye) (time frame: 45 minutes after the first drop instillation). The study lists 2 primary outcomes in all. 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 NCT04623684, which also lists 4 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 4 Apr 2022.