Retinopathy, DiabeticClarusDRNCT05746975
Diabetic Retinopathy Classification: ETDRS 7-fields vs Widefield Imaging (ClarusDR)
An observational study of Retinopathy, Diabetic, run by Association for Innovation and Biomedical Research on Light and Image at 1 site in Portugal.
Trial summary
The goal of this observational study is to analyse and compare Diabetic Retinopathy severity level using 30º ETDRS 7-fields and Wide-field Imaging techniques using Clarus 500 (Carl Zeiss Meditech Inc., Dublin, USA) and Optos (Optos, Dunfermline, UK) in diabetic patients with mild to moderate diabetic retinopathy. Read more about this study
- Who is it for?
- Ages 35 to 80 years
- Conditions the study is for
- Retinopathy, Diabetic
- How many people
- 81 participants
- Where
- 1 sitePortugal
- Study dates
- 3 Apr 2023to 4 Nov 2024
- 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 35 to 80 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Diabetic type 2 patients with mild to moderate/severe NPDR
Who may be able to join
- DM type 2 according to 1985 World Health Organization (WHO) criteria
- Age between 35 and 80 years
- BCVA ≥ 75 letters (20 /32)
- Refraction with a spherical equivalent less than 5 Diopters
- NPDR levels 35 and 43-47 (based on the ETDRS criteria - 7 fields CFP)
Who cannot join
- Cataract or other eye disease that may interfere with fundus examinations
- Glaucoma
- Other retinal vascular disease than DR
- Refractive errors > to + or - 5 Diopters
- Pupil diameter of less than 5 mm
- Poor quality images due to artifacts, movements, or media opacities
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Diabetic Retinopathy Classification: ETDRS 7-fields vs Widefield Imaging (Clarus 500 and Optos California)
The goal of this observational study is to analyse and compare Diabetic Retinopathy severity level using 30º ETDRS 7-fields and Wide-field Imaging techniques using Clarus 500 (Carl Zeiss Meditech Inc., Dublin, USA) and Optos (Optos, Dunfermline, UK) in diabetic patients with mild to moderate diabetic retinopathy. The main questions it aims to answer are:
- To compare the Clarus 500TM wide-field imaging technique with the ETDRS 7-fields method in the assessment of DR severity level using the ETDRS DRSS.2. To compare the two wide-field imaging techniques (Clarus 500TM vs OptosTM) in the assessment of DR severity level using the ETDRS DRSS.3. To evaluate the peripheral area imaged by the wide-field Clarus 500TM and OptosTM to characterize DR lesions distribution (predominantly observed within or outside the ETDRS 7-fields) and severity (according to the ETDRS standard photos).4. To determine the relevance and frequency of DR PPL, located outside the ETDRS 7-fields area, and to explore PPL occurrence in different DR severity levels.
Participants will undergo a non-invasive ophthalmological examination, which includes BCVA, 7-fields CFP and UWF FP to assess ETDRS DRSS level.
Read the detailed description
Diabetic Retinopathy (DR) remains a significant cause of blindness in working-age populations across the world. The gold-standard method for assessing its severity is the modified Airlie House classification developed for the Early Treatment Diabetic Retinopathy Study (ETDRS), still used by clinical trials for developing of DR therapeutic and management guidelines.
ETDRS Diabetic Retinopathy Severity Score (DRSS) is based on the identification of DR lesions on colour fundus photography's (CFP) obtained in different locations of the retina. The photography acquisition protocol consists in acquiring seven stereoscopic pairs of overlapping 30° fields images of the ocular fundus to map out the macula and mid-peripheral retina. Photographers and fundus camera systems usually need training and certification by external reading centres to guarantee proper images quality and fields definition in a process that can be challenging with a considerable learning curve. Patient collaboration to follow a fixation point in different locations and withstand intense flashes of light, a good dilation of eye pupil and the difficulty to obtain well focused images in peripherical gaze positions are some of the main difficulties for obtaining gradable images using this 7-fields acquisition protocol.
On the other side, the grading process of ETDRS 7-fields images can be extremely labour-intensive and strongly dependent on the quality of the images, presence of artifacts and the definition of the peripherical fields, requiring well-trained people to identify and recognise features that can be very subtle or easily get unnoticed.
Moreover, the retinal area documented with the ETDRS 7-fields protocol represents approximately only 35% of the retina surface. Substantial diabetic retinal pathology can exist in the retinal periphery located outside this area which is being emphasized by advanced retinal imaging technology. Predominantly Peripheral Lesions (PPL) like the presence of venous beading, new-vessels, haemorrhages and microaneurysms in the extreme periphery have been correlated with peripheral non-perfusion, neurodegenerative changes and consequent increase of DR progression.
Recent instrumentation like OptosTM (Optos, Dunfermline, UK) or Clarus 500TM (Carl Zeiss Meditech Inc., Dublin, USA) allow wide-field acquisitions that document up to 90% of the retina surface in just one or two images decreasing patients tiredness and discomfort and overcoming most of the quality and fields definition issues described above.
OptosTM equipment can acquire almost 200º of the retina in just one picture without the need for pupil dilation and using ultra-widefield scanning laser ophthalmoscopy (SLO) technology. Its final image is based on the superimposition of two images acquired with 2 different laser wavelengths: a green and a red wavelength, giving a semirealistic colour image that despite its high contrast and sharpness, gives the retina a greenish and unreal aspect. Also, its 200º field amplitude is usually disturbed by artifacts caused by the presence of eyelashes or eyelids, that mainly obscure the peripherical area of the retina.
On the other hand, Clarus 500 TM equipment uses an imaging technique called Broad Line Fundus Imaging that is a hybrid of confocal SLO (cSLO) and traditional fundus photography. This technology provides higher resolution images with more accurate coloration of the fundus. A single image capture with this system obtains 133-degrees of view but with the acquisition of just two pictures (a temporal and nasal image of the retina), a 200-degree of view can be achieved.
Several studies have suggested moderate to substantial agreement between Optos ultra-wide field (UWF) and ETDRS 7-fields imaging and have shown that DR occurs in areas peripheral to the ETDRS fields in up to 40% of eyes, which may imply a more severe level of DR in 9% to 15% of eyes. However, there is only limited data regarding the validity of DR assessment using Clarus 500TM imagine technique obtained in cross-sectional studies with few patients.
On this basis, the aim of this work is to identify and compare the ETDRS severity level of diabetic patients using 3 different images modalities: the 30º ETDRS 7-fields colour fundus photography's protocol, the 2 wide-field images technique with Clarus 500 TM and the 1 wide-field image of OptosTM, in a prospective, longitudinal, and randomized study. The ETDRS 7-fields area will be superimposed on both wide-field equipment's images so equivalent retinal areas will be analysed. Our goal is to demonstrate that ETDRS severity level can be accurately evaluated using only two Clarus 500TM high quality images with wider amplitude, decreasing the effort and collaboration skills that are required in older techniques, while improving the quality and identification capability of key disease features with less artifacts than other wide-field systems. Additionally, peripheral retina outside the ETDRS 7-fields area will also be analysed to assess the presence of PPL and evaluate its relevance and association with disease severity level and progression.
Finally, the investigators expect to evaluate patients' opinion about their experience in each imaging modality, evaluating their discomfort and satisfaction degree while submitted to each procedure.
- Conditions
- Retinopathy, Diabetic
- Medical subject headings
- Diabetic Retinopathy
What is being measured
The primary outcome is the main question the study is designed to answer.
ETDRS severity level according to the Early Treatment Diabetic Retinopathy Study - Diabetic Retinopathy Severity Scale (ETDRS-DRSS).
Compare DR severity level between the ETDRS 7-fields imaging and the wide-field imaging techniques: Clarus 500TM and OptosTM. The ETDRS - DRSS goes from level 10 - no presence of DR to level 75 - Severe proliferative DR
Measured: 12 months
One or more than 2-steps change on ETDRS - DRSS severity level
Compare ETDRS -DRSS between the two imaging techniques and evaluate the presence of 1 step or more than 2 steps difference between ETDRS 7-fields imaging and the wide-field imaging techniques: Clarus 500TM and OptosTM
Measured: 12 months
Peripheral DR lesions characterization
Investigate the peripheral area and analyze the presence, distribution, and severity of peripheral DR lesions, in wide-field images: Clarus 500TM and OptosTM.
Presence and distribution of lesions in the periphery will be evaluated as 1) Not observed; 2) predominantly observed outside ETDRS fields; 3) Uniformly distributed within and outside ETDRS fields. 4) Ungradable.
Severity of the peripheral lesions will be evaluated using the same ETDRS-DRSS scale described above and will vary between level 35 and level 65.
Also, it will then be compared with the ETDRS 7-field area and graded as less, equivalent or greater than the observed inside ETDRS 7-fields area.
Measured: 12 months
Secondary outcomes (3)
Evaluation of Images quality in each imaging modality.
Images from each modality (7-fields, Clarus 500 and Optos TM) will be analysed according to 1) presence of artifacts like eyelashes, halos, eyelids, cataract opacities, etc; 2) Presence of unfocused areas 3) % of area occupied by those artifacts.
Measured: 12 months
Evaluation of Patients satisfaction about each imagining modality.
To evaluate patient's experience and degree of satisfaction in each imaging modality, a questionnaire will be developed with qualitative and quantitative questions covering all aspects of the experience.
Measured: 12 months
Correlate and analysed DR findings in each imaging technique with disease severity
To characterize the study population, demographic, and systemic characteristics, as well as visual function (BCVA), will be collected and analysed to correlate DR findings in each imaging technique with disease severity
Measured: 12 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted28 Feb 2023
- Study start3 Apr 2023
- Primary completion4 Nov 2024
- Study completion4 Nov 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (17)Papers the sponsor has linked to this study.
- Other trials for Retinopathy, DiabeticStudies of the same condition, open and under way.
- 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
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 81 participants (actual)
Sponsor and investigators
- Lead sponsor
- Association for Innovation and Biomedical Research on Light and Image
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Ana R Santos, PhD, Principal investigator, Association for Innovation and Biomedical Research on Light and Image
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05746975
- Sponsor's protocol ID
- 4C-2023-12
- Acronym
- ClarusDR
- Status last verified
- Nov 2024
- First submitted
- 6 Feb 2023
- Last updated
- 27 Nov 2024
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
Shimizu K, Kobayashi Y, Muraoka K. Midperipheral fundus involvement in diabetic retinopathy. Ophthalmology. 1981 Jul;88(7):601-12. doi: 10.1016/s0161-6420(81)34983-5.
PubMed 6167923Wessel MM, Aaker GD, Parlitsis G, Cho M, D'Amico DJ, Kiss S. Ultra-wide-field angiography improves the detection and classification of diabetic retinopathy. Retina. 2012 Apr;32(4):785-91. doi: 10.1097/IAE.0b013e3182278b64.
PubMed 22080911Silva PS, Cavallerano JD, Haddad NM, Kwak H, Dyer KH, Omar AF, Shikari H, Aiello LM, Sun JK, Aiello LP. Peripheral Lesions Identified on Ultrawide Field Imaging Predict Increased Risk of Diabetic Retinopathy Progression over 4 Years. Ophthalmology. 2015 May;122(5):949-56. doi: 10.1016/j.ophtha.2015.01.008. Epub 2015 Feb 19.
PubMed 25704318Silva PS, Cavallerano JD, Sun JK, Soliman AZ, Aiello LM, Aiello LP. Peripheral lesions identified by mydriatic ultrawide field imaging: distribution and potential impact on diabetic retinopathy severity. Ophthalmology. 2013 Dec;120(12):2587-2595. doi: 10.1016/j.ophtha.2013.05.004. Epub 2013 Jun 15.
PubMed 23778092Chen A, Dang S, Chung MM, Ramchandran RS, Bessette AP, DiLoreto DA, Kleinman DM, Sridhar J, Wykoff CC, Kuriyan AE. Quantitative Comparison of Fundus Images by 2 Ultra-Widefield Fundus Cameras. Ophthalmol Retina. 2021 May;5(5):450-457. doi: 10.1016/j.oret.2020.08.017. Epub 2020 Aug 29.
PubMed 32866664Rasmussen ML, Broe R, Frydkjaer-Olsen U, Olsen BS, Mortensen HB, Peto T, Grauslund J. Comparison between Early Treatment Diabetic Retinopathy Study 7-field retinal photos and non-mydriatic, mydriatic and mydriatic steered widefield scanning laser ophthalmoscopy for assessment of diabetic retinopathy. J Diabetes Complications. 2015 Jan-Feb;29(1):99-104. doi: 10.1016/j.jdiacomp.2014.08.009. Epub 2014 Aug 28.
PubMed 25240716Silva PS, Cavallerano JD, Sun JK, Noble J, Aiello LM, Aiello LP. Nonmydriatic ultrawide field retinal imaging compared with dilated standard 7-field 35-mm photography and retinal specialist examination for evaluation of diabetic retinopathy. Am J Ophthalmol. 2012 Sep;154(3):549-559.e2. doi: 10.1016/j.ajo.2012.03.019. Epub 2012 May 23.
PubMed 22626617Wessel MM, Nair N, Aaker GD, Ehrlich JR, D'Amico DJ, Kiss S. Peripheral retinal ischaemia, as evaluated by ultra-widefield fluorescein angiography, is associated with diabetic macular oedema. Br J Ophthalmol. 2012 May;96(5):694-8. doi: 10.1136/bjophthalmol-2011-300774. Epub 2012 Mar 15.
PubMed 22423055Price LD, Au S, Chong NV. Optomap ultrawide field imaging identifies additional retinal abnormalities in patients with diabetic retinopathy. Clin Ophthalmol. 2015 Mar 24;9:527-31. doi: 10.2147/OPTH.S79448. eCollection 2015.
PubMed 25848202Matsui Y, Ichio A, Sugawara A, Uchiyama E, Suimon H, Matsubara H, Sugimoto M, Ikesugi K, Kondo M. Comparisons of Effective Fields of Two Ultra-Widefield Ophthalmoscopes, Optos 200Tx and Clarus 500. Biomed Res Int. 2019 Dec 5;2019:7436293. doi: 10.1155/2019/7436293. eCollection 2019.
PubMed 31886247Hirano T, Imai A, Kasamatsu H, Kakihara S, Toriyama Y, Murata T. Assessment of diabetic retinopathy using two ultra-wide-field fundus imaging systems, the Clarus(R) and Optos systems. BMC Ophthalmol. 2018 Dec 20;18(1):332. doi: 10.1186/s12886-018-1011-z.
PubMed 30572870Aiello LP, Odia I, Glassman AR, Melia M, Jampol LM, Bressler NM, Kiss S, Silva PS, Wykoff CC, Sun JK; Diabetic Retinopathy Clinical Research Network. Comparison of Early Treatment Diabetic Retinopathy Study Standard 7-Field Imaging With Ultrawide-Field Imaging for Determining Severity of Diabetic Retinopathy. JAMA Ophthalmol. 2019 Jan 1;137(1):65-73. doi: 10.1001/jamaophthalmol.2018.4982.
PubMed 30347105Grading diabetic retinopathy from stereoscopic color fundus photographs--an extension of the modified Airlie House classification. ETDRS report number 10. Early Treatment Diabetic Retinopathy Study Research Group. Ophthalmology. 1991 May;98(5 Suppl):786-806.
PubMed 2062513International Conference on Harmonisation of technical requirements for registration of pharmaceuticals for human use.. ICH harmonized tripartite guideline: Guideline for Good Clinical Practice. J Postgrad Med. 2001 Jan-Mar;47(1):45-50. No abstract available.
PubMed 11590294World Medical Association.. World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. Bull World Health Organ. 2001;79(4):373-4. Epub 2003 Jul 2. No abstract available.
PubMed 11357217
Study at a glance
From the registry record, last updated by the sponsor on 27 Nov 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Diabetic Retinopathy Classification: ETDRS 7-fields vs Widefield Imaging (Clarus 500 and Optos California)
- ClinicalTrials.gov ID
- NCT05746975
- Acronym / sponsor ID
- ClarusDR / 4C-2023-12
- Conditions
- Retinopathy, Diabetic
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 81 participants (actual)
- Lead sponsor
- Association for Innovation and Biomedical Research on Light and ImageUniversity, hospital or other
- Study start
- 3 Apr 2023 (actual)
- Primary completion
- 4 Nov 2024 (actual)
- Study completion
- 4 Nov 2024 (actual)
- First posted
- 28 Feb 2023 (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 goal of this observational study is to analyse and compare Diabetic Retinopathy severity level using 30º ETDRS 7-fields and Wide-field Imaging techniques using Clarus 500 (Carl Zeiss Meditech Inc., Dublin, USA) and Optos (Optos, Dunfermline, UK) in diabetic patients with mild to moderate diabetic retinopathy. The main questions it aims to answer are:
- To compare the Clarus 500TM wide-field imaging technique with the ETDRS 7-fields method in the assessment of DR severity level using the ETDRS DRSS.2. To compare the two wide-field imaging techniques (Clarus 500TM vs OptosTM) in the assessment of DR severity level using the ETDRS DRSS.3. To evaluate the peripheral area imaged by the wide-field Clarus 500TM and OptosTM to characterize DR lesions distribution (predominantly observed within or outside the ETDRS 7-fields) and severity (according to the ETDRS standard photos).4. To determine the relevance and frequency of DR PPL, located outside the ETDRS 7-fields area, and to explore PPL occurrence in different DR severity levels.
Participants will undergo a non-invasive ophthalmological examination, which includes BCVA, 7-fields CFP and UWF FP to assess ETDRS DRSS level.
Detailed description
Diabetic Retinopathy (DR) remains a significant cause of blindness in working-age populations across the world. The gold-standard method for assessing its severity is the modified Airlie House classification developed for the Early Treatment Diabetic Retinopathy Study (ETDRS), still used by clinical trials for developing of DR therapeutic and management guidelines.
ETDRS Diabetic Retinopathy Severity Score (DRSS) is based on the identification of DR lesions on colour fundus photography's (CFP) obtained in different locations of the retina. The photography acquisition protocol consists in acquiring seven stereoscopic pairs of overlapping 30° fields images of the ocular fundus to map out the macula and mid-peripheral retina. Photographers and fundus camera systems usually need training and certification by external reading centres to guarantee proper images quality and fields definition in a process that can be challenging with a considerable learning curve. Patient collaboration to follow a fixation point in different locations and withstand intense flashes of light, a good dilation of eye pupil and the difficulty to obtain well focused images in peripherical gaze positions are some of the main difficulties for obtaining gradable images using this 7-fields acquisition protocol.
On the other side, the grading process of ETDRS 7-fields images can be extremely labour-intensive and strongly dependent on the quality of the images, presence of artifacts and the definition of the peripherical fields, requiring well-trained people to identify and recognise features that can be very subtle or easily get unnoticed.
Moreover, the retinal area documented with the ETDRS 7-fields protocol represents approximately only 35% of the retina surface. Substantial diabetic retinal pathology can exist in the retinal periphery located outside this area which is being emphasized by advanced retinal imaging technology. Predominantly Peripheral Lesions (PPL) like the presence of venous beading, new-vessels, haemorrhages and microaneurysms in the extreme periphery have been correlated with peripheral non-perfusion, neurodegenerative changes and consequent increase of DR progression.
Recent instrumentation like OptosTM (Optos, Dunfermline, UK) or Clarus 500TM (Carl Zeiss Meditech Inc., Dublin, USA) allow wide-field acquisitions that document up to 90% of the retina surface in just one or two images decreasing patients tiredness and discomfort and overcoming most of the quality and fields definition issues described above.
OptosTM equipment can acquire almost 200º of the retina in just one picture without the need for pupil dilation and using ultra-widefield scanning laser ophthalmoscopy (SLO) technology. Its final image is based on the superimposition of two images acquired with 2 different laser wavelengths: a green and a red wavelength, giving a semirealistic colour image that despite its high contrast and sharpness, gives the retina a greenish and unreal aspect. Also, its 200º field amplitude is usually disturbed by artifacts caused by the presence of eyelashes or eyelids, that mainly obscure the peripherical area of the retina.
On the other hand, Clarus 500 TM equipment uses an imaging technique called Broad Line Fundus Imaging that is a hybrid of confocal SLO (cSLO) and traditional fundus photography. This technology provides higher resolution images with more accurate coloration of the fundus. A single image capture with this system obtains 133-degrees of view but with the acquisition of just two pictures (a temporal and nasal image of the retina), a 200-degree of view can be achieved.
Several studies have suggested moderate to substantial agreement between Optos ultra-wide field (UWF) and ETDRS 7-fields imaging and have shown that DR occurs in areas peripheral to the ETDRS fields in up to 40% of eyes, which may imply a more severe level of DR in 9% to 15% of eyes. However, there is only limited data regarding the validity of DR assessment using Clarus 500TM imagine technique obtained in cross-sectional studies with few patients.
On this basis, the aim of this work is to identify and compare the ETDRS severity level of diabetic patients using 3 different images modalities: the 30º ETDRS 7-fields colour fundus photography's protocol, the 2 wide-field images technique with Clarus 500 TM and the 1 wide-field image of OptosTM, in a prospective, longitudinal, and randomized study. The ETDRS 7-fields area will be superimposed on both wide-field equipment's images so equivalent retinal areas will be analysed. Our goal is to demonstrate that ETDRS severity level can be accurately evaluated using only two Clarus 500TM high quality images with wider amplitude, decreasing the effort and collaboration skills that are required in older techniques, while improving the quality and identification capability of key disease features with less artifacts than other wide-field systems. Additionally, peripheral retina outside the ETDRS 7-fields area will also be analysed to assess the presence of PPL and evaluate its relevance and association with disease severity level and progression.
Finally, the investigators expect to evaluate patients' opinion about their experience in each imaging modality, evaluating their discomfort and satisfaction degree while submitted to each procedure.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
Who may qualify
- Ages
- 35 to 80 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Diabetic type 2 patients with mild to moderate/severe NPDR
Key inclusion criteria (5 listed)
- DM type 2 according to 1985 World Health Organization (WHO) criteria
- Age between 35 and 80 years
- BCVA ≥ 75 letters (20 /32)
- Refraction with a spherical equivalent less than 5 Diopters
- NPDR levels 35 and 43-47 (based on the ETDRS criteria - 7 fields CFP)
Key exclusion criteria (6 listed)
- Cataract or other eye disease that may interfere with fundus examinations
- Glaucoma
- Other retinal vascular disease than DR
- Refractive errors > to + or - 5 Diopters
- Pupil diameter of less than 5 mm
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
ETDRS severity level according to the Early Treatment Diabetic Retinopathy Study - Diabetic Retinopathy Severity Scale (ETDRS-DRSS).
Time frame: 12 months
Compare DR severity level between the ETDRS 7-fields imaging and the wide-field imaging techniques: Clarus 500TM and OptosTM. The ETDRS - DRSS goes from level 10 - no presence of DR to level 75 - Severe proliferative DR
One or more than 2-steps change on ETDRS - DRSS severity level
Time frame: 12 months
Compare ETDRS -DRSS between the two imaging techniques and evaluate the presence of 1 step or more than 2 steps difference between ETDRS 7-fields imaging and the wide-field imaging techniques: Clarus 500TM and OptosTM
Peripheral DR lesions characterization
Time frame: 12 months
Investigate the peripheral area and analyze the presence, distribution, and severity of peripheral DR lesions, in wide-field images: Clarus 500TM and OptosTM. Presence and distribution of lesions in the periphery will be evaluated as 1) Not observed; 2) predominantly observed outside ETDRS fields; 3) Uniformly distributed within and outside ETDRS fields. 4) Ungradable. Severity of the peripheral lesions will be evaluated using the same ETDRS-DRSS scale described above and will vary between level 35 and level 65. Also, it will then be compared with the ETDRS 7-field area and graded as less, equivalent or greater than the observed inside ETDRS 7-fields area.
3 secondary outcomes
Evaluation of Images quality in each imaging modality.
Time frame: 12 months
Evaluation of Patients satisfaction about each imagining modality.
Time frame: 12 months
Correlate and analysed DR findings in each imaging technique with disease severity
Time frame: 12 months
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 27 Nov 2024.
- Background: PubMed 6167923Shimizu K, Kobayashi Y, Muraoka K. Midperipheral fundus involvement in diabetic retinopathy. Ophthalmology. 1981 Jul;88(7):601-12. doi: 10.1016/s0161-6420(81)34983-5.
- Background: PubMed 22080911Wessel MM, Aaker GD, Parlitsis G, Cho M, D'Amico DJ, Kiss S. Ultra-wide-field angiography improves the detection and classification of diabetic retinopathy. Retina. 2012 Apr;32(4):785-91. doi: 10.1097/IAE.0b013e3182278b64.
- Background: PubMed 25704318Silva PS, Cavallerano JD, Haddad NM, Kwak H, Dyer KH, Omar AF, Shikari H, Aiello LM, Sun JK, Aiello LP. Peripheral Lesions Identified on Ultrawide Field Imaging Predict Increased Risk of Diabetic Retinopathy Progression over 4 Years. Ophthalmology. 2015 May;122(5):949-56. doi: 10.1016/j.ophtha.2015.01.008. Epub 2015 Feb 19.
- Background: PubMed 23778092Silva PS, Cavallerano JD, Sun JK, Soliman AZ, Aiello LM, Aiello LP. Peripheral lesions identified by mydriatic ultrawide field imaging: distribution and potential impact on diabetic retinopathy severity. Ophthalmology. 2013 Dec;120(12):2587-2595. doi: 10.1016/j.ophtha.2013.05.004. Epub 2013 Jun 15.
- Background: PubMed 32866664Chen A, Dang S, Chung MM, Ramchandran RS, Bessette AP, DiLoreto DA, Kleinman DM, Sridhar J, Wykoff CC, Kuriyan AE. Quantitative Comparison of Fundus Images by 2 Ultra-Widefield Fundus Cameras. Ophthalmol Retina. 2021 May;5(5):450-457. doi: 10.1016/j.oret.2020.08.017. Epub 2020 Aug 29.
- Background: PubMed 25240716Rasmussen ML, Broe R, Frydkjaer-Olsen U, Olsen BS, Mortensen HB, Peto T, Grauslund J. Comparison between Early Treatment Diabetic Retinopathy Study 7-field retinal photos and non-mydriatic, mydriatic and mydriatic steered widefield scanning laser ophthalmoscopy for assessment of diabetic retinopathy. J Diabetes Complications. 2015 Jan-Feb;29(1):99-104. doi: 10.1016/j.jdiacomp.2014.08.009. Epub 2014 Aug 28.
- Background: PubMed 22626617Silva PS, Cavallerano JD, Sun JK, Noble J, Aiello LM, Aiello LP. Nonmydriatic ultrawide field retinal imaging compared with dilated standard 7-field 35-mm photography and retinal specialist examination for evaluation of diabetic retinopathy. Am J Ophthalmol. 2012 Sep;154(3):549-559.e2. doi: 10.1016/j.ajo.2012.03.019. Epub 2012 May 23.
- Background: PubMed 22423055Wessel MM, Nair N, Aaker GD, Ehrlich JR, D'Amico DJ, Kiss S. Peripheral retinal ischaemia, as evaluated by ultra-widefield fluorescein angiography, is associated with diabetic macular oedema. Br J Ophthalmol. 2012 May;96(5):694-8. doi: 10.1136/bjophthalmol-2011-300774. Epub 2012 Mar 15.
- Background: PubMed 25848202Price LD, Au S, Chong NV. Optomap ultrawide field imaging identifies additional retinal abnormalities in patients with diabetic retinopathy. Clin Ophthalmol. 2015 Mar 24;9:527-31. doi: 10.2147/OPTH.S79448. eCollection 2015.
- Background: PubMed 31886247Matsui Y, Ichio A, Sugawara A, Uchiyama E, Suimon H, Matsubara H, Sugimoto M, Ikesugi K, Kondo M. Comparisons of Effective Fields of Two Ultra-Widefield Ophthalmoscopes, Optos 200Tx and Clarus 500. Biomed Res Int. 2019 Dec 5;2019:7436293. doi: 10.1155/2019/7436293. eCollection 2019.
- Background: PubMed 30572870Hirano T, Imai A, Kasamatsu H, Kakihara S, Toriyama Y, Murata T. Assessment of diabetic retinopathy using two ultra-wide-field fundus imaging systems, the Clarus(R) and Optos systems. BMC Ophthalmol. 2018 Dec 20;18(1):332. doi: 10.1186/s12886-018-1011-z.
- Background: PubMed 30347105Aiello LP, Odia I, Glassman AR, Melia M, Jampol LM, Bressler NM, Kiss S, Silva PS, Wykoff CC, Sun JK; Diabetic Retinopathy Clinical Research Network. Comparison of Early Treatment Diabetic Retinopathy Study Standard 7-Field Imaging With Ultrawide-Field Imaging for Determining Severity of Diabetic Retinopathy. JAMA Ophthalmol. 2019 Jan 1;137(1):65-73. doi: 10.1001/jamaophthalmol.2018.4982.
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A Randomized, Phase 2 Study of Oral BGE-102 in Participants With Center-Involved Diabetic Macular Edema
Diabetic Macular Edema (DME)
Not yet recruitingObservational study
A Case-Control Study Revealing Intraocular Microenvironment Characteristics in Patients With Ocular Diseases Based on Multi-Omics Analysis
Age- Related Macular Degeneration, Diabetic Retinopathy
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.
Ana R Santos, PhD principal investigator
Association for Innovation and Biomedical Research on Light and Image
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Retinopathy, Diabetic, run by Association for Innovation and Biomedical Research on Light and Image at 1 site in Portugal.
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 5 inclusion and 6 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 27 Nov 2024. 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 Portugal. 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 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?
ETDRS severity level according to the Early Treatment Diabetic Retinopathy Study - Diabetic Retinopathy Severity Scale (ETDRS-DRSS). (time frame: 12 months). The study lists 3 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 NCT05746975, which also lists 17 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 27 Nov 2024; AzTrials last refreshed its copy on 2 Nov 2026.