Effect of Dexamethasone on Reduction of Macular Thickness in Diabetic Patients, a Randomized Clinical Trial (EDRMT)

October 5, 2019 updated by: Rodrigo Pessoa Cavalcanti Lira, Universidade Federal de Pernambuco

Purpose: To determine the impact of short-term 4mg/ml dexamethasone solution treatment in diabetic macular edema (DME).

Design: Phase II, randomized, prospective, parallel, interventional study.

Participants: Pseudophakic patients with central-involved DME.

Methods: Twenty-seven patients with visual impairment caused by DME were randomized in a 1:1:1 ratio, in order to investigate treatment with 0.01 ml, 0.03 ml and 0.05 ml intravitreous dexamethasone solutions, and followed-up over 28 days

Outcome Measures: The primary outcome was macular thickness at three days after intravitreous dexamethasone. The secondary outcomes were macular thickness at 28 days after intravitreous dexamethasone, best-corrected visual acuity (BCVA) and intraocular pressure (IOP) at three and 28 days after intravitreous dexamethasone

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This is a prospective, phase II, randomized, interventional, monocentric study. Data of consecutive patients with DME who volunteered to participate in the research at the department of ophthalmology of State University of Campinas (UNICAMP) - Brazil between May 2016 and December 2017 were analysed.

At the screening visit, all patients underwent complete ophthalmic evaluation, including best corrected visual acuity (BCVA), slit-lamp biomicroscopy, applanation tonometry, fundus biomicroscopy, fluorescein angiography (Visucam NM/ FA Carl Zeiss; Carl Zeiss Meditec, California, USA), SD- OCT (Spectralis; Heidelberg Engineering, Heidelberg, Germany). Central macular thickness was obtained through 7 horizontal lines ( 30° x 5° area), centered on the fovea, with 1536 A scans per line at 240 µm intervals.

At the baseline study visit, patients were randomized with a 1:1:1 allocation to receive dexamethasone solution 4 mg/ml: 0,01 ml (40 µg) ; or 0,03 ml (120 µg); or 0,05 ml (200 µg). In follow up visits (1, 3, 7, 14, 21, 28 days after) were performed BCVA, slit-lamp biomicroscopy, applanation tonometry, fundus biomicroscopy, SD- OCT.

Study Type

Interventional

Enrollment (Actual)

27

Phase

  • Phase 2

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

  • Brazil
    • Sao Paulo
      • Campinas, Sao Paulo, Brazil, 13083887
        • State University of Campinas

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

18 years to 90 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • age > = 18 years;
  • diagnosis of DM type 2;
  • pseudophakic patients
  • presence of clinically significant DME according to ETDRS guidelines;
  • best correct visual acuity (BCVA) between 20/400 and 20/40;
  • central macular thickness (CMT) >= 300 µm measured by spectral domain optical coherence tomography ( Spectralis® Heidelberg). If both eyes of the patient met the elegibility criteria, the eye with worse BCVA at baseline was designated as the study eye.

Exclusion Criteria:

  • any treatment of DME in the previous 4 months;
  • pan retinal photocoagulation (PRP) in the previous 4 months or antecipated need of PRP for the next 6 months;
  • any ophthalmologic surgery performed in the previous 4 months;
  • history of pars plana vitrectomy;
  • history of open-angle glaucoma or intraocular pressure elevation induced by corticosteroids that required anti-glaucomatous treatment or anti- hypertensive ocular treatment;
  • intraocular pressure >= 21 mmHg;
  • patients with characteristics that meet the inclusion criteria, but refused to sign the written general consent.

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: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: 0,01ml dexamethasone solution
One intravitreous injection of 0,01 ml dexamethasone solution 4 mg/ml.
Drug: Intravitreous Dexamethasone Solution 4mg/ml - vol 0,01 ml
0,01 ml intravitreous dexamethasone solution 4mg/ml injection.
Other Names:
  • 0,01 ml intravitreous dexamethasone solution
Experimental: 0,03 ml dexamethasone solution
One intravitreous injection of 0,03 ml dexamethasone solution 4 mg/ml.
Drug: Intravitreous Dexamethasone Solution 4mg/ml - vol 0,03 ml
0,03 ml intravitreous dexamethasone solution 4mg/ml injection.
Other Names:
  • 0,03 ml intravitreous dexamethasone solution
Experimental: 0,05 ml dexamethasone solution
One intravitreous injection of 0,05 ml dexamethasone solution 4 mg/ml.
Drug: Intravitreous Dexamethasone Solution 4mg/ml - vol 0,05 ml
0,05 ml intravitreous dexamethasone solution 4mg/ml injection.
Other Names:
  • 0,05 ml intravitreous dexamethasone solution

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Macular Thickness at 3 Days After Intravitreous Dexamethasone
Time Frame: Three days after intravitreous dexamethasone
Measure macular thickness at 3 days after intravitreous dexamethasone with OCT - unit µm
Three days after intravitreous dexamethasone

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Macular Thickness at 28 Days After Intravitreous Dexamethasone
Time Frame: 28 days after intravitreous dexamethasone
Measure macular thickness at 28 days after intravitreous dexamethasone with OCT - unit µm
28 days after intravitreous dexamethasone
Best Corrected Visual Acuity (BCVA) at 3 Days After Intravitreous Dexamethasone
Time Frame: Three days after intravitreous dexamethasone
Measure best corrected visual acuity (BCVA) at 3 days after intravitreous dexamethasone with ETDRS chart
Three days after intravitreous dexamethasone
Best Corrected Visual Acuity (BCVA) at 28 Days After Intravitreous Dexamethasone
Time Frame: 28 days after intravitreous dexamethasone
Measure best corrected visual acuity (BCVA) at 28 days after intravitreous dexamethasone with ETDRS chart
28 days after intravitreous dexamethasone
Intraocular Pressure (IOP) at 3 Days After Intravitreous Dexamethasone
Time Frame: 3 days after intravitreous dexamethasone
Measure intraocular pressure (IOP) 3 days after intravitreous dexamethasone - unit mmHg
3 days after intravitreous dexamethasone
Intraocular Pressure (IOP) at 28 Days After Intravitreous Dexamethasone
Time Frame: 28 days after intravitreous dexamethasone
Measure intraocular pressure (IOP) 28 days intravitreous dexamethasone - unit mmHg
28 days after intravitreous dexamethasone

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Universidade Federal de Pernambuco

Investigators

  • Study Chair: Rodrigo PC Lira, MD, University of Campinas, Brazil

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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)

May 1, 2016

Primary Completion (Actual)

December 20, 2017

Study Completion (Actual)

October 5, 2018

Study Registration Dates

First Submitted

July 12, 2018

First Submitted That Met QC Criteria

July 30, 2018

First Posted (Actual)

August 1, 2018

Study Record Updates

Last Update Posted (Actual)

October 8, 2019

Last Update Submitted That Met QC Criteria

October 5, 2019

Last Verified

October 1, 2019

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 003 (NuSkin International)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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