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Macular HolesNCT06233500

Macular Micro Vascular Changes Following Macular Hole Repair : Optical Coherence Tomography Angiography Study

A study testing pars plana vitrectomy in people with Macular Holes, run by Fayoum University at 1 site in Egypt.

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 The sponsor has not verified this record for over two years, so it may be out of date.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

The goal of this prospective interventional study is to to compare the micro vascular and structural changes between surgery with and without ILM flap to repair macular hole. The main questions it aims to answer are: What are the macular micro vascular and structural changes pre and post repair of idiopathic full… Read more about this study

Who is it for?
Ages 16 years and older
Conditions the study is for
Macular Holes
What is being tested?
pars plana vitrectomy
Could I receive a placebo?
No, everyone receives an active treatment
How many people
28 participants
Where
1 siteEgypt
Study dates
1 Dec 2021to 15 Mar 2024
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 16 years and older
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Idiopathic full thickness Macular hole without retinal detachment

Who cannot join

  • Previous pars plana vitrectomy
  • High myopia with axial length ≥ 26 mm.
  • Uncertain symptom duration or ≥ 6 month .
  • History of same eye trauma
  • Poor image quality.
  • Patients with diabetic retinopathy or other retinal diseases, e.g. ischemic, inflammatory.
  • Any patient with significant cataract which needs combined phaco-vitrectomy.

Trial locations and contacts

1 site in 1 country.

Mohamed Husssein contact

+201015479856

mhmm1004@hotmail.com

Egypt1 site, 1 recruiting
  • research institute of ophthalmology, Egypt

    Giza, 12511

    Abeer Salem, +201125666006, A.salem@Rio.edu.eg

    Heba Ahmed, +201020020157, heba_rio2000@yahoo.com

    Recruiting

Other trials in Egypt

About this study

The goal of this prospective interventional study is to to compare the micro vascular and structural changes between surgery with and without ILM flap to repair macular hole.

The main questions it aims to answer are:

Read more
  • What are the macular micro vascular and structural changes pre and post repair of idiopathic full thickness macular hole and what is the correlation between these changes and visual recovery.
  • Is there are any prognostic values of the micro vascular status of the macula could be assessed preoperatively.
  • What are the differences regarding these micro vascular and structural changes between repair with and without ILM flap.

Participants will be:

  • Subjected to pars plana vitrectomy to repair macular hole.
  • Examined by optical coherence tomography angiography pre and post operative

Researchers will compare:

Group A: eyes treated without ILM flap Group B : eyes treated by ILM flap to see if there are differences regarding the micro vascular and structural changes in the macular area.

Read the detailed description

This study will include 28 eyes with idiopathic full thickness macular hole; they will be divided into two groups:

Group A: 14 eyes will be treated without ILM flap Group B : 14 eyes will be treated by ILM flap

  • Sample size: 28 eyes. (based on ELM recovery rate in ILM flap 70% versus 21.4% with inverted flap (Iwasaki et al., 2019), and at power of study 80% and confidence level 95%, sample size is calculated using openEpi software to be 14 eyes in each group
  • Study setting: Ophthalmology Department, Fayoum University and the Research Institute of Ophthalmology
  • Data Collection :
  • History :
  1. Demographic data ( age , gender )
  2. General medical history ( DM, HTN )
  3. Symptom duration
  4. Previous ocular history
  • Clinical examination:
  1. Best corrected visual acuity using snellen chart (converted to log MAR for statiscal analysis).
  2. Slit lamp biomicroscopy for anterior segment examination.
  3. Posterior segment examination using binocular indirect ophthalmoscope and indirect slit lamp bio microscopy (+90 volk lens for detailed evaluation of macula)
  4. Axial length measurement
  • Optical Coherence Tomography:

We use SD- OCT and OCTA for pre and post-operative evaluation of retinal layers microstructure and vasculature.

  • Surgical Procedure

All eyes in this study will be subjected to pars plana vitrectomy procedure with these main steps:

  • 23 G trocar system will be used
  • Posterior vitreous detachment will be induced with the aid of triamcinolone acetate injection, and core vitrectomy will be done
  • Brilliant blue stain will be injected, and ILM forceps will be used for ILM peeling

Patients will be divided then into two groups:

Group A: Only wide ILM peeling up to the arcades well be done Group B: ILM peeling with flap well be done

  • Shaving of the vitreous base, and then fluid air exchange
  • SF 6 gas tamponade will be used
  • Study procedures:
  • Regular clinical assessment pre and at 1 and 6 months post-operative including:
  • Best corrected visual acuity measurement using Snellen chart with conversion to log. MAR notation for statistical analysis
  • Posterior segment examination using binocular indirect ophthalmoscope and indirect slit lamp bio microscopy (+90 volk lens for detailed evaluation of macula)
  • Standard Optical coherence tomography of the macula at 1 and 6 months post-operative using (SD-OCT) scans (512 A-scans, 20°×20°) with the following protocol:

Macula thickness map for measurement of central retinal thickness, and photoreceptor inner segment/outer segment complex.

  • Optical coherence tomography angiography of the macula at 1 and 6 months post-operative studying Superficial Capillary plexus, Deep Capillary plexus and Fovea avascular zone.
Conditions
Macular Holes
Being tested
pars plana vitrectomy
Keywords
macular hole, ILM peeling, Temporal flap, OCTA, Optical Coherence Tomography Angiography
Medical subject headings
Retinal Perforations

What participants receive

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

  • pars plana vitrectomyProcedure or surgery

    Also called PPV with ILM peeling

    All eyes in this study will be subjected to pars plana vitrectomy procedure with these main steps:

    • 23 G trocar system will be used
    • Posterior vitreous detachment will be induced with the aid of triamcinolone acetate injection, and core vitrectomy will be done
    • Brilliant blue stain will be injected, and ILM forceps will be used for ILM peeling

    Patients will be divided then into two groups:

    Group A: Only wide ILM peeling up to the arcades well be done Group B: ILM peeling with flap well be done

    • Shaving of the vitreous base, and then fluid air exchange
    • SF 6 gas tamponade will be used
Study groups in NCT06233500
Study groupRoleWhat they receive
Group A: eyes will be treated without ILM flapActive comparatorGroup A: Only wide ILM peeling up to the arcades well be done
Receives: Procedure: pars plana vitrectomy
Group B : eyes will be treated by ILM flapActive comparatorGroup B: ILM peeling with flap well be done
Receives: Procedure: pars plana vitrectomy

What is being measured

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

  1. visual acuity

    Best corrected visual acuity measurement using Snellen chart with conversion to log. MAR notation for statistical analysis

    Measured: It will be measured preoperative and at 1 and 6 months post-operative

  2. Fovea avascular zone FAZ

    Optical coherence tomography angiography used to measure FAZ area in mm2 (mm square)

    Measured: It will be measured preoperative and at 1 and 6 months post-operative

Secondary outcomes (1)
  1. central retinal thickness

    Standard Optical coherence tomography of the macula using (SD-OCT) scans (512 A-scans, 20°×20°) to measure central retinal thickness in µm

    Measured: It will be measured preoperative and at 1 and 6 months post-operative

Timeline

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

  1. First posted31 Jan 2024
  2. Study start1 Dec 2021
  3. Primary completion1 Mar 2024 (estimated)
  4. Study completion15 Mar 2024 (estimated)

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
Model description
This study will include 28 eyes with idiopathic full thickness macular hole; All eyes in this study will be subjected to pars plana vitrectomy procedure, they will be divided into two groups: Group A: 16 eyes will be treated with only wide internal limiting membrane (ILM) peeling up to the arcades without ILM flap Group B : 16 eyes will be treated by ILM peeling with ILM flap.
Masking
Single blind
Who is masked
Participant
Enrolment
28 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06233500
Sponsor's protocol ID
FayoumU_28
Status last verified
Jan 2024
First submitted
22 Jan 2024
Last updated
31 Jan 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: IPD that underlie results in a publication

Publications

  • Demirel S, Degirmenci MFK, Bilici S, Yanik O, Batioglu F, Ozmert E, Alp N. The Recovery of Microvascular Status Evaluated by Optical Coherence Tomography Angiography in Patients after Successful Macular Hole Surgery. Ophthalmic Res. 2018;59(1):53-57. doi: 10.1159/000484092. Epub 2017 Nov 29.

    PubMed 29183023
  • Kelly NE, Wendel RT. Vitreous surgery for idiopathic macular holes. Results of a pilot study. Arch Ophthalmol. 1991 May;109(5):654-9. doi: 10.1001/archopht.1991.01080050068031.

    PubMed 2025167
  • Lai MM, Williams GA. Anatomical and visual outcomes of idiopathic macular hole surgery with internal limiting membrane removal using low-concentration indocyanine green. Retina. 2007 Apr-May;27(4):477-82. doi: 10.1097/01.iae.0000247166.11120.21.

    PubMed 17420702
  • Casini G, Mura M, Figus M, Loiudice P, Peiretti E, De Cilla S, Fuentes T, Nasini F. INVERTED INTERNAL LIMITING MEMBRANE FLAP TECHNIQUE FOR MACULAR HOLE SURGERY WITHOUT EXTRA MANIPULATION OF THE FLAP. Retina. 2017 Nov;37(11):2138-2144. doi: 10.1097/IAE.0000000000001470.

    PubMed 28129215
  • Yun C, Ahn J, Kim M, Kim JT, Hwang SY, Kim SW, Oh J. Characteristics of retinal vessels in surgically closed macular hole: an optical coherence tomography angiography study. Graefes Arch Clin Exp Ophthalmol. 2017 Oct;255(10):1923-1934. doi: 10.1007/s00417-017-3742-6. Epub 2017 Jul 25.

    PubMed 28744658
  • Woon WH, Greig D, Savage MD, Wilson MC, Grant CA, Mokete B, Bishop F. Movement of the inner retina complex during the development of primary full-thickness macular holes: implications for hypotheses of pathogenesis. Graefes Arch Clin Exp Ophthalmol. 2015 Dec;253(12):2103-9. doi: 10.1007/s00417-015-2951-0. Epub 2015 Feb 13.

    PubMed 25673252
  • Itoh Y, Inoue M, Rii T, Ando Y, Hirakata A. Asymmetrical recovery of cone outer segment tips line and foveal displacement after successful macular hole surgery. Invest Ophthalmol Vis Sci. 2014 May 6;55(5):3003-11. doi: 10.1167/iovs.14-13973.

    PubMed 24736052
  • Spaide RF, Klancnik JM Jr, Cooney MJ. Retinal vascular layers imaged by fluorescein angiography and optical coherence tomography angiography. JAMA Ophthalmol. 2015 Jan;133(1):45-50. doi: 10.1001/jamaophthalmol.2014.3616.

    PubMed 25317632
  • Lupidi M, Coscas F, Cagini C, Fiore T, Spaccini E, Fruttini D, Coscas G. Automated Quantitative Analysis of Retinal Microvasculature in Normal Eyes on Optical Coherence Tomography Angiography. Am J Ophthalmol. 2016 Sep;169:9-23. doi: 10.1016/j.ajo.2016.06.008. Epub 2016 Jun 11.

    PubMed 27296485
  • Samara WA, Say EA, Khoo CT, Higgins TP, Magrath G, Ferenczy S, Shields CL. CORRELATION OF FOVEAL AVASCULAR ZONE SIZE WITH FOVEAL MORPHOLOGY IN NORMAL EYES USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY. Retina. 2015 Nov;35(11):2188-95. doi: 10.1097/IAE.0000000000000847.

    PubMed 26469536
  • Kim YJ, Jo J, Lee JY, Yoon YH, Kim JG. Macular capillary plexuses after macular hole surgery: an optical coherence tomography angiography study. Br J Ophthalmol. 2018 Jul;102(7):966-970. doi: 10.1136/bjophthalmol-2017-311132. Epub 2017 Oct 5.

    PubMed 28982954

Questions about this trial

What is this clinical trial studying?

A study testing pars plana vitrectomy in people with Macular Holes, run by Fayoum University at 1 site in Egypt.

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 1 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: status not confirmed, as of the sponsor's last update on 31 Jan 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 Egypt. 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 Mohamed Husssein (+201015479856, mhmm1004@hotmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

visual acuity (time frame: It will be measured preoperative and at 1 and 6 months post-operative). 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 NCT06233500, which also lists 11 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 31 Jan 2024.

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