- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03686436
Vitreomacular Interface Abnormalities in Diabetic Retinopathy Using OCT
Vitreomacular Interface Abnormalities Indiabetic Retinopathy Using Ocular Coherence Tomography
Study Overview
Status
Intervention / Treatment
Detailed Description
Diabetic retinopathy (DR) is a leading health concern and a major cause of blindness .DR can be complicated by scar tissue formation, macular edema tractional retinal detachment. Optical coherence tomography has found patient with DR has diffuse retinal thickening , cystoid macular edema ,posterior hayaloid traction ,tractional retinal detachment.
The VMI in patient with DR can influence the emergence ,progression ,and treatment of DR.
The role of posterior hyaloid and vitreous on viteromacular interface abnormalities The anomalous separation of vitreous cortex from ILM can lead to abnormal vitreomacular interface. This separation can happen when liquefaction occur faster than detachment of the vitreous cortex or when an abnormal adhesion of the vitreous cortex to the ILM occur.
The VMI abnormalities in DR include I. Vitreomacular adhesion The International Vitreomacular Traction Study group has defined the vitremacular adhesion as specific stage of vitreous separation when partial detachment of the vitreous in perifoveal area has occurred without any abnormalities to the retinal contour.
II. Vitreomacular traction There is abnormal vitreous adhesion, there can be excessive traction on the macula from the vitreous that change the contour of foveal surface. By OCT any distortion of foveal contour together with partial posterior vitreous detachment is considered vitreomacular traction . In accordance with the International Vitreomacular Traction Study Group definition vitreomacular traction can be classified as focal or broad based on horizontal area of adhesion.
III. Cystoid macular edema The vitreous has been implicated as a cause of macular edema via mechanical and physiologic mechanisms.One of the most constructive hypothesis on how vitreomacular traction may result in macular edema was given by Schubert in 1989,and was summarized by Bringmann and Wiedmann Vitro retinal traction can also exert forces at the level of retinal pigment epithelium ,which can eventually result in morphological retinal pigment epithelial changes .
IV. Epiretinal membrane The epiretinal membrane is a cellular proliferation that creates a semi translucent, fibrocellular proliferation on the surface of the inner retina. Because epiretinal membrane contain contractile cellular elements they can be associated with retinal folding and macular thickening thereby leading to decreased visual acuity, metamorphopsia, monocular diplopia .
V. Full thickness hole Is a full thickness defect in the fovea, include the complete interruption of all retinal layers from the ILM to the retinal pigment epithelium. antero posterior traction, secondary to abnormal attachment at the fovea, and tangential contraction of the perifoveal vitreous cortex may be responsible for the development of the macular hole.
VI. Lamellar holes These include an irregular foveal contour, a defect or break in the inner fovea, a splitting of the inner and outer retina , lack of a full thickness foveal defect, and intact photo receptors.
VII. Macular pseudo hole By OCT the pseudo hole has no loss of retinal tissue. They have invaginated or heaped foveal edge, an epiretinal membrane with a central opening ,and a steep macular contour to the central fovea .the steep foveal contour creates the appearance of hole, even though there is no loss of retinal tissue.
Aim of work Primary outcome : To evaluate the changes in vitreomacular interface in diabetic retinopathy by using Spectral Domain Ocular Coherence Tomography ( SD OCT) Secondary outcome : To evaluate other macular changes in Spectral Domain Ocular Coherence Tomography ( SD OCT) in diabetic patient with vitreomacular interface abnormalities
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Contact
- Name: dahy seham, M.B.B.CH
- Phone Number: +2001012060672
- Email: dahyseham@yahoo.com
Study Contact Backup
- Name: sharaf mohamed
- Phone Number: 01001088252
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- diabetic patient with or without treatment and with or without evidence of vitreomacular traction on clinical examination
Exclusion Criteria:
- diabetic patient with unclear media as dense cataract,
- vitreous Hemorrhage and corneal opacity
Study Plan
How is the study designed?
Design Details
- Observational Models: Case-Only
- Time Perspectives: Prospective
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
measuring visual acuity by snellen chart
Time Frame: two hours
|
measuring visual acuity by snellen chart full ophthalmic examination dilating the pupil by mydriatic 1-tropicamide1%drop phenylephrine 2.5%eye drop fundus photography is achived by using TRC 8PLUS TOPCON MEDICAL System,Inc OCT imaging is achived by using Spectral domain OCT (hiedelbrge)
|
two hours
|
Collaborators and Investigators
Sponsor
Investigators
- Study Chair: abdalnaser kamil, Asiut university
Publications and helpful links
General Publications
- 1- Agarwal D, Gelman R, Ponce CP, Stevenson W, and . Christoforidis J B the vitreo macular interface abnormalities in diabetic retinopathy . review. . journal of ophthalmology . 2015. 2- Bottós J, Elizalde J, Arevalo JF, Rodrigues EB, Maia M. Vitreomacular traction syndrome. J Ophthalmic Vis Res 2012 3- Duker JS, Kaiser PK, Binder S, de Smet MD, Gaudric A, Reichel E, et al. The International Vitreomacular Traction Study Group classification of vitreomacular adhesion, traction, and macular hole. Ophthalmology 2013 4- konsantanidis L , Wolfensberger TJ .cystoid macular edema and vitreomacular traction . a review .2015 5- Ryan SJ, Puliafito CA, Davis JL, Parel JM, Milne P. Retina. 4th ed. Philadelphia, PA:Elsevier Mosby; 2006. 6- Chandra A, Charteris DG, Yorston D. Posturing after macular hole surgery: a review. Ophthalmologica 2011
Study record dates
Study Major Dates
Study Start (Anticipated)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- seham dahy
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- Study Protocol
- Statistical Analysis Plan (SAP)
- Informed Consent Form (ICF)
- Clinical Study Report (CSR)
- Analytic Code
Study Data/Documents
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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