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Epiretinal MembraneNCT04791631

'Distortion as a Predictor of ERM Surgery Outcome'

An observational study of Epiretinal Membrane and Distortion, run by NHS Greater Glasgow and Clyde at 1 site in United Kingdom.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Epiretinal membranes (ERM) consist of an abnormal growth of tissue across the retina and are present about 6% of people aged 50 and over. They can cause symptoms of distortion (straight lines appearing bent) or blurred vision. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Epiretinal Membrane, Distortion, Quality of Life
What is being tested?
Epiretinal membrane surgery
Type of treatment
Surgery or procedure
How many people
60 participants
Where
1 siteUnited Kingdom
Study dates
1 Apr 2021to 1 Apr 2023
Phase
Observational
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

Study population: Patients with epiretinal membranes attending the vitreoretinal clinic at the Tennent Institute of Ophthalmology in Glasgow, UK, and meeting the inclusion criteria.

Who may be able to join

  • Idiopathic epiretinal membrane
  • Patients undergoing vitrectomy and gas surgery, under local or general anaesthetic
  • Able to give informed consent
  • 18 years old and over

Who cannot join

  • Epiretinal membrane secondary to retinal detachment, uveitis or retinal vascular disease
  • Previous vitreoretinal surgery
  • Pre-existing ophthalmic condition which limits the patient's visual acuity (Documented BCVA 6/36 or worse)
  • Pre-existing ophthalmic conditions which cause metamorphopsia (exudative ARMD, central serous retinopathy)
  • VA < 6/60

Trial locations and contacts

1 site in 1 country.

United Kingdom1 site
  • NHS Greater Glasgow and Clyde Clinical Research and Development Central Office

    Paisley, PA2 7DE

    Emma McDonough, Emma.McDonough@ggc.scot.nhs.uk

    Lona Jawaheer, MBChB, lonajawaheer@nhs.net

Other trials in United Kingdom

About this study

Official title: Does Pre-operative D-chart Score Predict Improvement in VFQ-25 Score Following Surgery for Epiretinal Membrane?

Epiretinal membranes (ERM) consist of an abnormal growth of tissue across the retina and are present about 6% of people aged 50 and over. They can cause symptoms of distortion (straight lines appearing bent) or blurred vision. Management options include observation if asymptomatic, or surgery to peel the membrane if symptomatic. Limited data exists regarding how to identify patients who are most likely to benefit from surgery.

We propose to measure the effects on distortion (using D chart), visual acuity and vision-related quality of life (using a validated vision-related quality of life questionnaire) of ERM surgery. This will allow us to investigate whether pre-operative D chart score can predict subsequent improvement in quality of life following surgery. We hope the results will help patients and VR surgeons decide whether or not to proceed with ERM surgery.

The study will be a prospective case series consisting of patients with symptomatic epiretinal membranes who choose to have epiretinal membrane surgery. The study participants will get standard care with the additional administration of a quality of life questionnaire and measurement of distortion (using a D-chart) at 3 different time points (pre-op, and post-op at 26 and 52 weeks). Recruitment will be in Glasgow, with a possibility of other sites being added on at a later stage.

Read the detailed description

Epiretinal membranes consist of a proliferation of fibrocellular tissue along the inner aspect of the retina. Over time, this membrane can result in anterior-posterior traction and cause disruption of the retinal architecture, which can lead to symptoms of blurred vision, or distorted vision (with straight lines appearing bent or wavy).

Patients with ERM now constitute one of the most common referrals to the vitreoretinal service. Management of epiretinal membrane includes observation or surgery for severely symptomatic membranes. The surgery consists of vitrectomy and epiretinal +/- inner limiting membrane peel. Currently there is limited evidence to help identify which patients with an epiretinal membrane are the most likely to benefit from this operation, which makes it more difficult for patients to be able to weigh up the benefits and risks of proceeding with this elective procedure.

Our study will measure the effects on distortion (using D chart), visual acuity and quality of life of ERM surgery. Hence it will allow us to investigate whether the pre-op D chart score can predict subsequent improvement in quality of life following surgery. This will provide vitreoretinal surgeons and patients with an evidence base regarding the success of this elective procedure and offer realistic expectations regarding surgical outcomes. Ultimately, we hope that the results of this study will facilitate the decision of whether or not to proceed with ERM surgery.

We plan to recruit patients with an epiretinal membrane who choose to undergo surgery at the time of their clinic appointment within the vitreoretinal service. In addition to standard care, the study participants will undergo measurements of distortion (using a D-chart, duration 5-10 minutes) and fill in a quality of life questionnaire. These measurements will be taken before the operation and at six and twelve months following the operation.

The aims of the study are:

  • To investigate the sustained effect of epiretinal membrane surgery on distortion (using D-chart), visual acuity and vision-related quality of life (using NEI VFQ-25 questionnaire)
  • To determine the relationship between pre-operative distortion score and post-operative vision-related quality of life score following ERM surgery

Our study will have a larger number of participants with a longer period of follow up (52 weeks) than comparable studies. It will be the first epiretinal membrane study that measures distortion using the D-chart, which we believe to be superior to existing tests (such as the M-chart) which have been used in similar studies.

Being tested
Epiretinal membrane surgery
Medical subject headings
Epiretinal Membrane

What participants receive

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

  • Epiretinal membrane surgeryProcedure or surgery

    Surgery for epiretinal membrane i.e. standard 3-port pars plana vitrectomy and epiretinal membrane and internal limiting membrane peel. Phakic patients will undergo cataract surgery.

What is being measured

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

  1. VFQ-25 score at final visit (52 weeks after ERM surgery)

    Measure of vision-related quality of life using NEI VFQ-25 quality of life questionnaire, 1 year after surgery for epiretinal membrane

    Measured: 1 year

Secondary outcomes (4)
  1. Distortion score pre-operatively and at 26 and 52 weeks after ERM surgery

    Distortion score calculated using D-chart

    Measured: 1 year

  2. Best-corrected visual acuity pre-operatively and at 26 and 52 weeks after ERM surgery

    Visual acuity measured in ETDRS

    Measured: 1 year

  3. Vision-related quality of life pre-operatively and at 26 and 52 weeks after ERM surgery

    Vision-related quality of life assessed using NEI VFQ-25 quality of life questionnaire

    Measured: 1 year

  4. Central retinal thickness pre-operatively and at 26 and 52 weeks after ERM surgery

    Central retinal thickness obtained from OCT scans done in clinic

    Measured: 1 year

Timeline

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

  1. First posted10 Mar 2021
  2. Study start1 Apr 2021 (estimated)
  3. Primary completion1 Apr 2023 (estimated)
  4. Study completion1 Apr 2023 (estimated)

Resources

More details

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

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
60 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04791631
Sponsor's protocol ID
GN18OP439
Status last verified
Mar 2021
First submitted
9 Feb 2021
Last updated
10 Mar 2021
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Dawson SR, Shunmugam M, Williamson TH. Visual acuity outcomes following surgery for idiopathic epiretinal membrane: an analysis of data from 2001 to 2011. Eye (Lond). 2014 Feb;28(2):219-24. doi: 10.1038/eye.2013.253. Epub 2013 Dec 6.

    PubMed 24310238
  • Wong JG, Sachdev N, Beaumont PE, Chang AA. Visual outcomes following vitrectomy and peeling of epiretinal membrane. Clin Exp Ophthalmol. 2005 Aug;33(4):373-8. doi: 10.1111/j.1442-9071.2005.01025.x.

    PubMed 16033349
  • Pournaras CJ, Emarah A, Petropoulos IK. Idiopathic macular epiretinal membrane surgery and ILM peeling: anatomical and functional outcomes. Semin Ophthalmol. 2011 Mar;26(2):42-6. doi: 10.3109/08820538.2010.544237.

    PubMed 21469962
  • Rahman R, Stephenson J. Early surgery for epiretinal membrane preserves more vision for patients. Eye (Lond). 2014 Apr;28(4):410-4. doi: 10.1038/eye.2013.305. Epub 2014 Jan 10.

    PubMed 24406414
  • Ghazi-Nouri SM, Tranos PG, Rubin GS, Adams ZC, Charteris DG. Visual function and quality of life following vitrectomy and epiretinal membrane peel surgery. Br J Ophthalmol. 2006 May;90(5):559-62. doi: 10.1136/bjo.2005.085142. Epub 2006 Jan 18.

    PubMed 16421185
  • Ichikawa Y, Imamura Y, Ishida M. Associations of aniseikonia with metamorphopsia and retinal displacements after epiretinal membrane surgery. Eye (Lond). 2018 Feb;32(2):400-405. doi: 10.1038/eye.2017.201. Epub 2017 Sep 22.

    PubMed 28937146
  • Kinoshita T, Imaizumi H, Miyamoto H, Okushiba U, Hayashi Y, Katome T, Mitamura Y. Changes in metamorphopsia in daily life after successful epiretinal membrane surgery and correlation with M-CHARTS score. Clin Ophthalmol. 2015 Feb 4;9:225-33. doi: 10.2147/OPTH.S76847. eCollection 2015.

    PubMed 25678770
  • Okamoto F, Okamoto Y, Hiraoka T, Oshika T. Effect of vitrectomy for epiretinal membrane on visual function and vision-related quality of life. Am J Ophthalmol. 2009 May;147(5):869-74, 874.e1. doi: 10.1016/j.ajo.2008.11.018. Epub 2009 Feb 6.

    PubMed 19200531
  • McGowan G, Yorston D, Strang NC, Manahilov V. D-CHART: A Novel Method of Measuring Metamorphopsia in Epiretinal Membrane and Macular Hole. Retina. 2016 Apr;36(4):703-8. doi: 10.1097/IAE.0000000000000778.

    PubMed 26441261
  • Klein R, Moss SE, Klein BE, Gutierrez P, Mangione CM. The NEI-VFQ-25 in people with long-term type 1 diabetes mellitus: the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Arch Ophthalmol. 2001 May;119(5):733-40. doi: 10.1001/archopht.119.5.733.

    PubMed 11346401
  • Nichols KK, Mitchell GL, Zadnik K. Performance and repeatability of the NEI-VFQ-25 in patients with dry eye. Cornea. 2002 Aug;21(6):578-83. doi: 10.1097/00003226-200208000-00009.

    PubMed 12131034
  • Orr P, Rentz AM, Margolis MK, Revicki DA, Dolan CM, Colman S, Fine JT, Bressler NM. Validation of the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) in age-related macular degeneration. Invest Ophthalmol Vis Sci. 2011 May 18;52(6):3354-9. doi: 10.1167/iovs.10-5645.

    PubMed 21282568
  • Owen CG, Rudnicka AR, Smeeth L, Evans JR, Wormald RP, Fletcher AE. Is the NEI-VFQ-25 a useful tool in identifying visual impairment in an elderly population? BMC Ophthalmol. 2006 Jun 9;6:24. doi: 10.1186/1471-2415-6-24.

    PubMed 16764714

Questions about this trial

What is this clinical trial studying?

An observational study of Epiretinal Membrane and Distortion, run by NHS Greater Glasgow and Clyde 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 4 inclusion and 5 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: status not confirmed, as of the sponsor's last update on 10 Mar 2021. 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?

Results are not available in the source record.

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

Contact Emma McDonough (+44141 314 4000, Emma.McDonough@ggc.scot.nhs.uk), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

VFQ-25 score at final visit (52 weeks after ERM surgery) (time frame: 1 year). 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 NCT04791631, which also lists 13 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 10 Mar 2021.

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