Intravitreal Bevacizumab vs.Combination Therapy for CNV Due to Other Than AMD
Status: | Completed |
---|---|
Conditions: | Cancer, Skin and Soft Tissue Infections, Cardiology, Infectious Disease, Ocular |
Therapuetic Areas: | Cardiology / Vascular Diseases, Dermatology / Plastic Surgery, Immunology / Infectious Diseases, Oncology, Ophthalmology |
Healthy: | No |
Age Range: | 18 - Any |
Updated: | 1/1/2014 |
Start Date: | August 2010 |
End Date: | September 2013 |
Contact: | Ivana K Kim, MD |
Phone: | 617-573-3367 |
Pilot Study of Intravitreal Bevacizumab vs. Combination Therapy for Choroidal Neovascularization Secondary to Causes Other Than Age-related Macular Degeneration
Anti-VEGF therapy has been proven efficacious for the wet (neovascular) form of macular
degeneration and may be beneficial for the treatment of choroidal neovascularization (CNV)
due to other causes. The limitation of this type of treatment is the necessity for frequent
intraocular injections. The purpose of this study is to determine if using anti-VEGF
therapy in combination with photodynamic therapy can reduce the number of treatments needed
with monotherapy while achieving similar visual results. There are ongoing multicenter
trials evaluating combination therapy in patients with wet AMD but no similar trial for
patients with CNV due to non-AMD causes. Therefore, in this study the investigators will
focus on patients with CNV not due to AMD.
degeneration and may be beneficial for the treatment of choroidal neovascularization (CNV)
due to other causes. The limitation of this type of treatment is the necessity for frequent
intraocular injections. The purpose of this study is to determine if using anti-VEGF
therapy in combination with photodynamic therapy can reduce the number of treatments needed
with monotherapy while achieving similar visual results. There are ongoing multicenter
trials evaluating combination therapy in patients with wet AMD but no similar trial for
patients with CNV due to non-AMD causes. Therefore, in this study the investigators will
focus on patients with CNV not due to AMD.
Inclusion Criteria:
- Ability to provide written informed consent and comply with study assessments for the
full duration of the study.
- Age > 18 years
- Clinical diagnosis of choroidal neovascularization secondary to the following causes:
ocular histoplasmosis, toxoplasmosis, idiopathic, angioid streaks, choroidal
ruptures, intraocular inflammation (without signs of active uveitis i.e. multifocal
choroiditis), central serous retinopathy and pathologic Myopia.
Only one eye will be assessed in the study. If both eyes are eligible, the investigator
and patient will determine which eye is to be treated, considering such factors as disease
duration, and likelihood of response to treatment.
- Clear media and dilation to permit good stereo fundus photography
- Evidence of active CNV present on OCT images manifest by subretinal fluid,
intraretinal fluid or retinal thickening ≥ 250 µm
- Best corrected VA in the study eye must be 20/40 and to 20/400 at 4 meters using
ETDRS protocol.
Exclusion Criteria:
Pregnancy or lactation
- Premenopausal women not using adequate contraception The following are considered
effective means of contraception: surgical sterilization; use of oral contraceptives;
barrier contraception with either a condom or diaphragm in conjunction with
spermicidal gel; and IUD; or contraceptive hormone implant or patch.
- CNV secondary to AMD
- Diabetic Retinopathy
- Prior enrollment in clinical studies in the study eye
- Any other condition that the investigator believes would pose a significant hazard to
the subject if the investigational therapy were initiated
- Previous participation in another simultaneous medical investigation or trial within
1 month preceding Day 0 (excluding vitamins and minerals)
- Use of drug or treatment related or unrelated to their condition within 30 days prior
to enrollment (Verteporfin, pegaptanib, ranibizumab, bevacizumab, triamcinilone or
other AMD therapy in study eye)
- Concurrent use of systemic anti-VEGF therapy
- Any other ocular condition the investigator believes would pose a significant hazard
to the subject if investigational treatment were initiated
- History of allergy to fluorescein
- Inability to obtain fundus photographs or FAs of sufficient quality to document CNV
- Inability to comply with study or follow-up procedures
- History of other disease, metabolic dysfunction, physical examination finding or
clinical laboratory finding giving reasonable suspicion of a disease or condition
that contraindicates the use of an investigational drug or that might affect
interpretation of the results of the study or render the subject at high risk for
treatment complications.
- Current treatment for active systemic infection
- History of uncontrolled glaucoma (defined as intraocular pressure >30mmHg despite
treatment with anti-glaucoma medication) or filtering surgery in the study eye
- Family history of glaucoma
- Patients who have undergone intraocular surgery within last 2 months
- Aphakia or absence of the posterior capsule in the study eye Previous violation of
the posterior capsule in the study eye is also excluded unless it occurred as a
result of YAG posterior capsulotomy in association with prior, posterior chamber
intraocular lens implantation.
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