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Trial registered on ANZCTR
Registration number
ACTRN12613000249752
Ethics application status
Approved
Date submitted
25/02/2013
Date registered
4/03/2013
Date last updated
4/03/2013
Type of registration
Retrospectively registered
Titles & IDs
Public title
The Use of Intravitreal Injection of Triamcinolone Acetonide in Diabetic Patients to Reduce Diabetic Macular Edema
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Scientific title
The Use of Intravitreal Injection of Triamcinolone Acetonide in Diabetic Patients to Reduce Diabetic Macular Edema
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Secondary ID [1]
282027
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None
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Universal Trial Number (UTN)
None
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Trial acronym
None
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Diabetic macular edema
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Condition category
Condition code
Eye
288821
288821
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0
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Diseases / disorders of the eye
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Nineteen patients with bilateral diabetic macular edema were included, one eye for every patient underwent intravitreal injection of 4mg triamcinolone acetonide (group A, 19 eyes) and the other eye of the same patient underwent intravitreal injection of 8mg triamcinolone acetonide (group B, 19 eyes), the selection of which eye to receive either dose was random. The patients were followed up for six months after injection , complete Ophthalmological examination and optical coherent topography were done.
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Intervention code [1]
286615
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Treatment: Drugs
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Comparator / control treatment
Group A and Group B both were active Intervention
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Control group
Active
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Outcomes
Primary outcome [1]
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control of diabetic macular edema (DME), detection of DME was done with Optical Coherence Tomography.( medical Equipment)
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Assessment method [1]
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Timepoint [1]
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six months follow up after injection.
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Secondary outcome [1]
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follow up of intraocular pressure (IOP) rise after injection. measurement was done by Goldmann applanation Tonometer mounted on slit lamp..
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Assessment method [1]
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Timepoint [1]
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follow up of intraocular pressure rise after injection for six months after injection
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Eligibility
Key inclusion criteria
The major eligibility criteria for the study eyes included the following: (1) best-corrected visual acuity letter score between 20/40 and 20/320; (2) definite retinal thickening resulting from DME on clinical examination involving the center of the macula assessed to be the main cause of visual loss; (3) retinal thickness measured with optical coherence tomography (OCT) of 250 micro m or more in the central subfield ;(4) Grid laser treatment was done at least three months earlier.
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Minimum age
20
Years
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Maximum age
60
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Principal exclusion criteria included; (1) prior treatment with intravitreal corticosteroids (at any time), peribulbar steroid injection within the prior 6 months, or pars plana vitrectomy (at any time); (2) a history of glaucoma or steroid-induced IOP elevation that required IOP-lowering treatment; (3) average intraocular pressure of 23 mm Hg or more after three preinjection evaluations; (4) eyes with ischemic maculopathy and (5) patients with foveal traction detected with OCT.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Patients with bilateral diffuse DME were included where one eye received intravitreal TA 4mg and the other eye of the same patient received intravitreal TA 8mg. The selection of which eye to receive either dose was random ( central randomisation was done by computer).Allocation involved contacting the holder of the allocation schedule who was at central administration site.
The time for intravitreal injection between both eyes of the same patient was one week
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Patients with bilateral advanced diabetic macular edema was selected.
randomization was done in selection of which eye will receive 4mg and the other eye will receive 8mg. Simple randomisation by using a randomisation table created by computer software
so sometimes the right eye receive either 4 or 8 mg and vice verse.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
patients) with diabetic macular edema, defined according to the Early Treatment Diabetic Retinopathy This prospective Interventional two-arm dose-response study included 38 eyes (19 Study (ETDRS) (2). The patients were 17 females and two males.
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Phase
Phase 4
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
Collected data were coded, entered and analyzed using Microsoft Excel software. Data were then imported into Statistical Package for the Social Sciences (SPSS version 16.0) software for analysis. Baseline characteristics of the study population were presented as frequencies and percentages (%) in qualitative data or mean values and standard deviations (SD) in quantitative data. Differences between frequencies were compared by Chi-square. Differences between means were compared by Wilcoxon rank-sum test. P-value of < 0.05 was considered significant. Pearson correlation coefficient test was used to evaluate the correlations between the studied variables. Analysis Of Variance (ANOVA) test was performed for repeated measures.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
25/03/2010
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Actual
30/03/2010
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Date of last participant enrolment
Anticipated
16/03/2011
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Actual
29/03/2011
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
19
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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Egypt
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State/province [1]
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Ismailia
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Suez Canal University Hospital
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Address [1]
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Suez Canal University Hospital
Four KM Road
box 3324
Ismailia
Egypt
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Country [1]
286801
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Egypt
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Primary sponsor type
Hospital
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Name
suez canal university hospital
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Address
Suez Canal University Hospital
Four KM Road
box 3324
Ismailia
Egypt
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Country
Egypt
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Secondary sponsor category [1]
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None
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Name [1]
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None
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Address [1]
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None
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Country [1]
285592
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Suez Canal University Hospital Ethics Committe.
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Ethics committee address [1]
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Suez Canal University Hospital Ethics Committe. Suez Canal University Hospital Professor Amged Matter box 3324 Ismailia Egypt
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Ethics committee country [1]
288869
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Egypt
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Date submitted for ethics approval [1]
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01/09/2009
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Approval date [1]
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10/02/2010
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Ethics approval number [1]
288869
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Summary
Brief summary
Aim: To evaluate the changes of intraocular pressure after intravitreal injection of triamcinolone acetonide for the management of diabetic macular edema . Design: This prospective interventional two-arm dose-response study. Materials and Methods: Nineteen patients with bilateral diabetic macular edema were included, one eye for every patient underwent intravitreal injection of 4m triamcinolone acetonide (group A, 19 eyes) and the other eye of the same patient underwent intravitreal injection of 8mg triamcinolone acetonide (group B, 19 eyes), the selection of which eye to receive either dose was random. The patients were followed up for six months after injection , complete Ophthalmological examination and optical coherent topography were done. Results: Intravitreal triamcinolone acetonide was effective in reduction of diabetic macular edema in group A in the first three months only, while in group B with high dose (8mg) the improvement continued for 6 months after injection. Significant intraocular pressure rise was observed in both groups with an incidence of 68.1 % and 73.7% in group A and B respectively. Intraocular pressure lowering drugs were used to control intraocular pressure, two eyes, however, in each group of the same patients needed glaucoma filtration surgery after intractable glaucoma with failure of medical treatment. Conclusions: Although intravitreal injection of triamcinolone acetonide is very effective in managing diabetic macular edema and has a lower cost than other modalities, the rise of intraocular pressure and glaucoma burden is another major concern .High corticosteroid responder is an individualized reaction irrespective of the intravitreal triamcinolone acetonide dose used.
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Trial website
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Trial related presentations / publications
Oral presentation at Suez canal University ,Ophthalmology department scientific day 25 /12/2012 .mercure hotel ,Ismailia , Egypt.
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Public notes
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Contacts
Principal investigator
Name
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A/Prof ehab ghoneim
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Address
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el tammem street
borg el haramen, 6TH floor
Box5643
portfoad
portsaid
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Country
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Egypt
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Phone
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+201223639848
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Fax
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+2066308822
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Email
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[email protected]
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Contact person for public queries
Name
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ehab ghoneim
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Address
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el tammem street
borg el haramen , 6TH floor
Box5643
portfoad
portsaid
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Country
38139
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Egypt
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Phone
38139
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+201223639848
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Fax
38139
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+2066308822
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Email
38139
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[email protected]
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Contact person for scientific queries
Name
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ehab ghoneim
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Address
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el tammem street
borg el haramen, 6TH floor
Box564
portfoad
portsaid
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Country
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Egypt
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Phone
38140
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+201223639848
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Fax
38140
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+2066308822
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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