- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT01051739
Variability in Perimetry Study (VIPII)
Improved Assessment of Visual Field Change
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
Disease of the optic nerve, including glaucoma, is the leading cause of blindness in the United States. Treatment decisions for optic nerve diseases are based largely on the changes in visual function that occur mostly as a consequence of disease progression. Unfortunately, the decision as to whether change of visual function has occurred is often difficult because of the high retest variability of conventional visual field testing (perimetry). This variability is so high that with moderate visual loss, a minimum of six tests are often needed in patients with optic nerve damage to reliably distinguish visual field deterioration from random variation. The preliminary data show that a substantial portion of the variability of perimetry lies in the type of stimulus used and the testing strategy applied.
OBJECTIVES: The investigators propose to test the hypothesis that a large portion of total perimetric variability in patients with visual loss is due to a poor signal-to-noise ratio associated with using a small fixed-size stimulus.
RESEARCH PLAN AND METHODS: To test this hypothesis, the investigators are examining patients with optic nerve diseases with conventional automated perimetry (size III) and tests having large-sized and scaled stimuli (size V, size VI (custom perimeter) and luminance size threshold perimetry - a test where threshold is found by changing stimulus size rather than stimulus intensity). Over four years the investigators will test 100 patients with and glaucoma and 60 normals each eight times. In addition, the investigators are retesting 50 subjects once a week for 5 weeks. The investigators are also studying the associated structural-functional correlations using OCT and developing a statistical model that accounts for correlations of neighboring test locations.
Perimetric variability and the reliable identification of visual field change is the single most difficult problem in visual testing today. The investigators anticipate identifying a method that allows efficient and accurate determination of visual field change. Identification of a superior method would (1) reduce the number of examinations needed, thereby reducing the costs of medical care; (2) minimize misdiagnosis, unnecessary testing and even unnecessary surgery that results from mistakenly interpreting fluctuation of the visual field as progression or improvement; (3) allow earlier disease intervention and (4) reduce the costs of clinical trials.
Type d'étude
Inscription (Réel)
Contacts et emplacements
Lieux d'étude
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Iowa
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Iowa City, Iowa, États-Unis, 52246-2208
- Iowa City VA Health Care System, Iowa City, IA
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
Méthode d'échantillonnage
Population étudiée
La description
Inclusion Criteria:
- Mean deviation of -20 or better with 5-8 points (optimally 10 points) with a value of p= 0.05 or better on the total deviation plot
- Mild cataract with VA of 20/30 or better pinholed
- Refractive error of = to or less than 6 diopters with = or less than 3.50 diopters of cylinder
- Pupil diameter of 3 mm minimum
- Controlled hypertension, diabetes, migraine
- Pseudophakic/refractive surgery if no vision problems
- Trabeculectomy okay
Exclusion Criteria:
- History of other ocular or neurologic disease or surgery
- History of stroke
- Systemic disease [lupus, graves, cancer (within the last 5 yrs), AIDS, other]
- History of amblyopia
- Unreliable patient
- Frequently misses appointments
- Tests poorly
- Ocular hypertension
- Retinal problems
- Diabetic retinopathy
- Neurological disease (IIH, ON, AION)
- Cancer not in remission for the last 5 years
- Vein or artery occlusions
- Macular degeneration
- Trauma with vision loss
- Ocular inflammation (pars planitis, iritis, temporal aeuritis)
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Modèles d'observation: Cas-témoins
- Perspectives temporelles: Éventuel
Cohortes et interventions
Groupe / Cohorte |
Intervention / Traitement |
---|---|
Group 1
glaucoma
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We compared the ability of four perimetric strategies to detect visual field change in the glaucoma arm.
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Groupe 2
Ordinaire
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We compared the ability of four perimetric strategies to detect visual field change in the glaucoma arm.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
Number of Subjects Progressing in Each Group Using Pointwise Linear Regression
Délai: 4 years
|
Perimetric method that most efficiently detects visual field change.
secondary outcome: number of subjects progressing in each group using pointwise linear regression Linear regression was used to determine visual field worsening (progression) at each of 52 test locations.
We required 3 or more worsening test locations at a p = 0.05 significance level for their to be significant progression.
|
4 years
|
Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chercheur principal: Michael Wall, MD, Iowa City VA Health Care System, Iowa City, IA
Publications et liens utiles
Publications générales
- Wall M, Doyle CK, Eden T, Zamba KD, Johnson CA. Size threshold perimetry performs as well as conventional automated perimetry with stimulus sizes III, V, and VI for glaucomatous loss. Invest Ophthalmol Vis Sci. 2013 Jun 7;54(6):3975-83. doi: 10.1167/iovs.12-11300.
- Kummet CM, Zamba KD, Doyle CK, Johnson CA, Wall M. Refinement of pointwise linear regression criteria for determining glaucoma progression. Invest Ophthalmol Vis Sci. 2013 Sep 19;54(9):6234-41. doi: 10.1167/iovs.13-11680.
- Wall M, Doyle CK, Zamba KD, Artes P, Johnson CA. The repeatability of mean defect with size III and size V standard automated perimetry. Invest Ophthalmol Vis Sci. 2013 Feb 15;54(2):1345-51. doi: 10.1167/iovs.12-10299.
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- C7098-R
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
Informations sur les médicaments et les dispositifs, documents d'étude
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