- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03188042
A Study Using Transorbital Alternating Current Stimulation for People With Glaucoma
February 7, 2024 updated by: NYU Langone Health
A Multi-site Interventional Pilot Study Using Transorbital Alternating Current Stimulation for People With Glaucoma
This pilot study will test the preliminary efficacy and feasibility of an intervention protocol for one method of electric current stimulation, repetitive transorbital alternating current stimulation (rtACS), to treat visual impairment in people with glaucoma.
We will evaluate a study protocol to use in future clinical trials to test the effectiveness of rtACS to ameliorate the progressive effects of vision loss both structurally and functionally in the eye, the visual pathway, and in regard to people's independence (i.e., functional ability).
In this prospective, randomized controlled, double-masked pilot study, we will: 1) determine an effect of rtACS on ophthalmic structure and function (from retina to visual brain), 2) assess the methodology of procedures for assessment of people's functional ability and quality of life (QoL) to determine an effect of rtACS, and 3) assess the feasibility and implementation of the pilot study protocol for a larger multi-site, randomized controlled trial.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
Participants will engage in baseline, intervention, post-intervention, and follow-up visits over the span of approximately 8 weeks.
The expected outcomes for this project are that (1) rtACS activates viable but poorly or non-functional retinal ganglion cells to improve their structural and functional capabilities, (2) measures of retinal, optic nerve, and visual brain structures and function will correspond with improvement in visual function, and (3) changes in visual function following rtACS will be associated with improvements in participants' functional ability and QoL.
rtACS has successfully been used in the rehabilitation of visual impairments in people with optic neuropathies; however, we do not know the clinical value of rtACS specifically for people with glaucoma, including the effect of rtACS on people's functional ability and QoL.
Study Type
Interventional
Enrollment (Actual)
18
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
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New York
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New York, New York, United States, 10016
- New York University School of Medicine
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
50 years to 70 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Live in a community, residential setting (i.e., non-institutionalized, not homeless)
- Diagnosis of glaucoma (not type-specific, excluding traumatic glaucoma): Moderate defect or worse in both eyes but not total blindness
- Visual field defects present for at least 6 months
- Best-corrected visual acuity of 20/200 (1.0 logMAR) or better in at least one eye
- Commitment to comply with study procedures (2 week period of intervention sessions) with baseline, post-intervention, and follow-up visits
Exclusion Criteria:
- Other optic comorbidity than glaucoma
- End-stage organ disease or medical condition with subsequent vision loss (e.g., diabetes, stroke)
- Other diseases of the retina or cataracts responsible for worse than 20/70 best-corrected visual acuity
- Photosensitivity to flickering lights
Intraocular Pressure (IOP) > 27 mmHg at baseline
* Medically diagnosed memory disorder or Telephone Interview for Cognitive Status-modified (TICS-m) score ≤ 27
- Electric or electronic implants (e.g., cardiac pacemaker)
- Metallic artifacts/implants in head and/or torso
- Diagnosed epilepsy
- Epileptic seizure within the past 3 years of enrollment date
- Auto-immune disease, acute stage (e.g., rheumatoid arthritis)
- Metastatic disease
- Certain mental diseases/psychiatric conditions (e.g., schizophrenia) that would preclude reliable testing and participation
- Unstable medical conditions (e.g., diabetes, diabetes causing diabetic retinopathy)
- Claustrophobia (to limit functional neuroimaging)
- Received rtACS in the past
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: rtACS Stimulation Group
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Electric current stimulation; rtACS is a non-invasive application of electric current to stimulate the retina to induce synaptic efficacy, in particular those cells that have some measure of dysfunction but are not dead, and oscillations of nearby neuronal ensembles.
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Sham Comparator: Sham Intervention Group
Sham stimulation looks like rtACS, but is not active rtACS.
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A computer-controlled sham stimulation function for masking interventionist to study group.
The device will be used to deliver a weak electric current stimulation protocol to participants via electrodes placed transorbitally, with one reference electrode positioned elsewhere.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Peripapillary RNFL Thickness
Time Frame: Baseline, Week 4
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Peripapillary retinal nerve fiber layer (RNFL) thickness (μm) measured using optical coherence tomography (OCT).
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Baseline, Week 4
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Change in Macular Ganglion Cell-Inner Plexiform Layer Thickness
Time Frame: Baseline, Week 4
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Macular ganglion cell-inner plexiform layer thickness (μm) measured using OCT.
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Baseline, Week 4
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Change in Humphrey Visual Field Analyzer Score
Time Frame: Baseline, Week 4
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The Humphrey Visual Field Analyzer assesses the mean deviation (dB), a measure of visual field sensitivity through threshold testing.
dBs tested by the Humphrey analyzer range between 0 and 50 dB (0 is the brightest and 50 is the dimmest).
A value of 0 means the patient could not see the brightest target, and a 50 means the dimmest target was seen.
Most values are around 30 dB, and any numbers below this range imply a possible visual field defect.
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Baseline, Week 4
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Change in Minnesota Low Vision Reading Test (MNRead): Reading Acuity Score
Time Frame: Baseline, Week 4
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An estimate of reading acuity is given by the smallest print size at which the patient can read the entire sentence without making significant errors.
This method measures acuity to the nearest 0.1 logMAR.
Each sentence in the MNRead Reading Acuity chart has 60 characters, which corresponds to 10 standard length words, assuming a standard word length of 6 characters (including a space).
Reading acuity is calculated as follows: Reading acuity = size of smallest sentence read + 0.01 x number of errors.
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Baseline, Week 4
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Change in Score on National Eye Institute Visual Functioning Questionnaire (VFQ-39)
Time Frame: Baseline, Week 4
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National Eye Institute VFQ-39 measures health-related quality of life in 12 domains: general vision, ocular pain, near activities, distance activities, vision-specific social functioning, vision-specific mental health, vision-specific role difficulties, vision-specific dependency, driving, color vision, peripheral vision, and composite score.
For each domain: the lowest and highest possible scores are 0 and 100 points, respectively.
Higher score means higher functioning.
The total score is the average of the domain scores.
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Baseline, Week 4
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Change in Score on 36-Item Short Form Survey (SF-36)
Time Frame: Baseline, Week 4
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The SF-36 is a 36-item patient-reported questionnaire that covers eight health domains: physical functioning (10 items), bodily pain (2 items), role limitations due to physical health problems (4 items), role limitations due to personal or emotional problems (4 items), emotional well-being (5 items), social functioning (2 items), energy/fatigue (4 items), and general health perceptions (5 items).
Scores for each domain range from 0 to 100, with a higher score defining a more favorable health state.
The total score is the average of the domain scores.
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Baseline, Week 4
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Percentage Change in ON Head Cup-to-Disc Ratio
Time Frame: Baseline, Week 4
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Percentage change in optic nerve (ON) head cup-to-disc ratio measured using OCT.
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Baseline, Week 4
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Change in Score on Assessment of Life Habits (LIFE-H), Short Form 3.1
Time Frame: Baseline, Week 4
|
The LIFE-H short form 3.1 is a 77-item questionnaire developed to measure: (1) how a respondent accomplishes regular activities and social roles and (2) respondent's satisfaction with how regular activities and social roles are accomplished.
The LIFE-H total score is obtained by summing the scores on each item and then dividing by the number of items.
The LIFE-H score ranges from 0 to 9, where a score of 0 indicates total handicap or total disruption in participation and a score of 9 means an optimal level of participation.
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Baseline, Week 4
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VEP-Measured Amplitude (15% Contrast) at Baseline
Time Frame: Baseline
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Visual evoked potential (VEP) identifies decreased visual function and helps with discriminations of glaucomatous changes by measuring amplitude (micro volts) and latency (milliseconds (ms)) with 15% contrast parameters.
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Baseline
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VEP-Measured Latency (15% Contrast) at Baseline
Time Frame: Baseline
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Visual evoked potential (VEP) identifies decreased visual function and helps with discriminations of glaucomatous changes by measuring amplitude (micro volts) and latency (milliseconds (ms)) with 15% contrast parameters.
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Baseline
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VEP-Measured Amplitude (85% Contrast) at Baseline
Time Frame: Baseline
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Visual evoked potential (VEP) identifies decreased visual function and helps with discriminations of glaucomatous changes by measuring amplitude (micro volts) and latency (milliseconds (ms)) with 85% contrast parameters.
|
Baseline
|
VEP-Measured Latency (85% Contrast) at Baseline
Time Frame: Baseline
|
Visual evoked potential (VEP) identifies decreased visual function and helps with discriminations of glaucomatous changes by measuring amplitude (micro volts) and latency (milliseconds (ms)) with 85% contrast parameters.
|
Baseline
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VEP-Measured Amplitude (15% Contrast) at Week 4
Time Frame: Week 4
|
Visual evoked potential (VEP) identifies decreased visual function and helps with discriminations of glaucomatous changes by measuring amplitude (micro volts) and latency (milliseconds (ms)) with 15% contrast parameters.
|
Week 4
|
VEP-Measured Latency (15% Contrast) at Week 4
Time Frame: Week 4
|
Visual evoked potential (VEP) identifies decreased visual function and helps with discriminations of glaucomatous changes by measuring amplitude (micro volts) and latency (milliseconds (ms)) with 15% contrast parameters.
|
Week 4
|
VEP-Measured Amplitude (85% Contrast) at Week 4
Time Frame: Week 4
|
Visual evoked potential (VEP) identifies decreased visual function and helps with discriminations of glaucomatous changes by measuring amplitude (micro volts) and latency (milliseconds (ms)) with 85% contrast parameters.
|
Week 4
|
VEP-Measured Latency (85% Contrast) at Week 4
Time Frame: Week 4
|
Visual evoked potential (VEP) identifies decreased visual function and helps with discriminations of glaucomatous changes by measuring amplitude (micro volts) and latency (milliseconds (ms)) with 85% contrast parameters.
|
Week 4
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Pelli-Robson Contrast Sensitivity Chart Score at Baseline
Time Frame: Baseline
|
The Pelli-Robson test measures contrast sensitivity using a single large letter size (20/60 optotype), with contrast varying across groups of letters.
The chart uses letters (6 per line), arranged in groups whose contrast varies from high to low.
Patients read the letters, starting with the highest contrast, until they are unable to read two or three letters in a single group.
A score is assigned based on the contrast of the last group in which two or three letters were correctly read.
The score, a single number, is a measure of the subject's log contrast sensitivity.
A Pelli-Robson score of 2.0 indicates normal contrast sensitivity of 100 percent.
Scores less than 2.0 signify poorer contrast sensitivity.
Pelli-Robson contrast sensitivity score of less than 1.5 is consistent with visual impairment and a score of less than 1.0 represents in visual disability.
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Baseline
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Pelli-Robson Contrast Sensitivity Chart Score at Week 4
Time Frame: Week 4
|
The Pelli-Robson test measures contrast sensitivity using a single large letter size (20/60 optotype), with contrast varying across groups of letters.
The chart uses letters (6 per line), arranged in groups whose contrast varies from high to low.
Patients read the letters, starting with the highest contrast, until they are unable to read two or three letters in a single group.
A score is assigned based on the contrast of the last group in which two or three letters were correctly read.
The score, a single number, is a measure of the subject's log contrast sensitivity.
A Pelli-Robson score of 2.0 indicates normal contrast sensitivity of 100 percent.
Scores less than 2.0 signify poorer contrast sensitivity.
Pelli-Robson contrast sensitivity score of less than 1.5 is consistent with visual impairment and a score of less than 1.0 represents in visual disability.
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Week 4
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Early Treatment Diabetic Retinopathy Study (ETDRS) Visual Acuity Score (VAS) at Baseline
Time Frame: Baseline
|
ETDRS charts have five Sloan letters on each line; the lines are of equal difficulty, and there is a geometric progression in letter size from line to line.
Beginning with Chart 1, the right eye is tested with the left eye occluded.
Following the completion of testing the right eye, the left eye is tested with Chart 2 while covering the right eye.
Each letter is scored as right or wrong.
Correct letters are circled on the scoresheet.
Each letter read correctly is assigned a score and each line is totaled at the end of testing.
VAS awards one point for every letter correctly guessed.
The total scores range from 0 to 100, with higher scores indicating greater visual acuity.
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Baseline
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Early Treatment Diabetic Retinopathy Study (ETDRS) Visual Acuity Score (VAS) at Week 4
Time Frame: Week 4
|
ETDRS charts have five Sloan letters on each line; the lines are of equal difficulty, and there is a geometric progression in letter size from line to line.
Beginning with Chart 1, the right eye is tested with the left eye occluded.
Following the completion of testing the right eye, the left eye is tested with Chart 2 while covering the right eye.
Each letter is scored as right or wrong.
Correct letters are circled on the scoresheet.
Each letter read correctly is assigned a score and each line is totaled at the end of testing.
VAS awards one point for every letter correctly guessed.
The total scores range from 0 to 100, with higher scores indicating greater visual acuity.
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Week 4
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Joel Schuman, MD, FACS, NYU Langone Health
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
December 14, 2017
Primary Completion (Actual)
October 20, 2022
Study Completion (Actual)
October 20, 2022
Study Registration Dates
First Submitted
June 1, 2017
First Submitted That Met QC Criteria
June 14, 2017
First Posted (Actual)
June 15, 2017
Study Record Updates
Last Update Posted (Actual)
February 9, 2024
Last Update Submitted That Met QC Criteria
February 7, 2024
Last Verified
February 1, 2024
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 16-02005
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
Yes
product manufactured in and exported from the U.S.
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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