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TerminatedNCT01851434Updated Sep 29, 2022

Natural History of Optic Neuritis

An observational study in Multiple Sclerosis, sponsored by National Institute of Neurological Disorders and Stroke (NINDS). Terminated at 3 sites in 2 countries. Open to participants aged 18 Years to 50 Years. Per ClinicalTrials.gov, last updated 2022-09-29.

Sponsored by National Institute of Neurological Disorders and Stroke (NINDS) · Observational

Why this study was terminated
The original analyses could not be performed due to data inconsistencies across the study sites.
Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
8
Ages
18 Years to 50 Years
Sex
All
01

Study summary

Background:

  • Optic neuritis often is a symptom of multiple sclerosis (MS). Many people who experience optic neuritis are later diagnosed with MS. MS disease activity seen on magnetic resonance imaging (MRI) scans is often greater than that seen in tests given during regular doctor's visits. Even though MRI is a helpful tool for studying optic neuritis and MS, more information is needed on how MS symptoms show up on MRI scans. Researchers want to use MRI scans to track changes in the optic nerve after an optic neuritis episode. This approach will help them study the relationship between optic neuritis and MS.

Objectives:

  • To collect more information about the relationship between optic neuritis and multiple sclerosis.

Eligibility:

  • Individuals between 18 and 50 years of age who have new optic neuritis.
  • Individuals between 18 and 50 years of age who have new symptoms of MS other than optic neuritis.
  • Healthy volunteers between 18 and 50 years of age.

Design:

  • Participants will be screened with a physical exam and medical history. They may provide blood or urine samples.
  • Participants with optic neuritis or other MS symptoms will have a baseline study visit. They will have a physical exam and full eye exam. To look for signs of MS, they will have evoked potential tests to see how the body responds to stimulation. They will also have an MRI scan to study any changes in the brain and optic nerves.
  • After the first visit, participants will have steroid treatment for 5 days for the optic neuritis.
  • Additional study visits will be given 1, 3, 6, 9, and 12 months after the baseline visit. The tests from the first visit, including the MRI scans, will be repeated at these visits.
  • Healthy volunteers will have a baseline study visit. They will have a physical exam and full eye exam. They will have evoked potential tests to see how the body responds to stimulation. They will also have an MRI scan to study any changes in the brain and optic nerves.
  • Healthy volunteers will have additional study visits 2 and 11 months after the baseline visit. The tests from the first visit, including the MRI scans, will be repeated at these visits.
Read the detailed description

Objective

The goals of this pilot study are:

  1. To assess the degree to which subacute changes in clinical, electrophysiological, and imaging measures can robustly predict retinal neuronal loss 12 months after acute optic neuritis.
  2. To construct a composite score that integrates these subacute changes, can itself robustly predict retinal neuronal loss 12 months after acute optic neuritis, can be validated in future trials, and is likely to be modulated by drugs that promote tissue repair and neuroprotection in multiple sclerosis (MS).
  3. To evaluate the usefulness of specialized magnetic resonance imaging (MRI) measures of the optic nerve in future clinical trials of drugs designed to promote tissue repair and neuroprotection. The primary hypothesis of the study is that peripapillary retinal nerve fiber layer (RNFL) thickness, which is generally agreed to reflect the integrity of optic nerve axons following optic neuritis, and which can be measured using spectral-domain optical coherence tomography (OCT) in the affected eye 12 months following optic neuritis, can be robustly predicted by changes in RNFL thickness between 1 and 3 months following symptom onset.

Study Population

The following cohorts will be recruited at each of the three study sites:

  • Up to 30 participants with acute optic neuritis.
  • Up to 15 healthy volunteers who are group-wise age- and sex-matched to the participants with unilateral optic neuritis.

Design

This is a one-year, prospective, multi-cohort, multi-site, pilot natural history study. Data obtained at NIH will be compared and aggregated with data obtained at other study sites, specifically the University of Utah-Moran Eye Center (in Salt Lake City) and Hebrew University-Hadassah Medical Center (in Jerusalem, Israel). Data will be gathered at baseline (optional) and at 1, 3, 6, 9, and 12 months in the patient cohort, and at 1, 3, and 12 months in the healthy volunteers.

Outcome Measures

The primary outcome measure is the RNFL thickness in the affected eye 12 months after optic neuritis.

Secondary outcome measures, all measured at 12 months, include:

  • Measures of optic nerve structure: mean cross-sectional optic-nerve area; mean, parallel, and perpendicular diffusivity; and MTR all within the optic nerve lesion as visualized at baseline.
  • Measures of brain structure: ventricular volume; T2 lesion volume along the visual pathway both sides considered together.
  • Measures of retinal structure: ganglion cell layer + inner plexiform layer thickness in the affected eye.
  • Measures of visual function: low-contrast letter acuity; high-contrast letter acuity; Pelli-Robson contrast sensitivity; object-from-motion detection; visual fields; and critical flicker-fusion frequency all in the affected eye.
  • Measures of visual physiology: VEP amplitude; VEP latency all in the effected eye.
02

Conditions studied

  • Multiple Sclerosis

Keywords

  • OCT
  • Multiple Sclerosis
  • Optic Neuritis
  • Magnetic Resonance Imaging (MRI)
  • Natural History
03

In context

Multiple Sclerosis

3,264 studies on the registry are indexed under Multiple Sclerosis; 659 are open to participants now.

This study's enrollment of 8 is below the median of 100 across 970 observational studies indexed under Multiple Sclerosis.

Browse Multiple Sclerosis studies →

Lead sponsor

National Institute of Neurological Disorders and Stroke (NINDS) is the lead sponsor of 601 studies on the registry; 56 are open to participants now.

Of its 18 completed or terminated interventional studies of FDA-regulated products, 8 (44%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 50 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

  • Up to 30 participants with unilateral optic neuritis. Recruitment will proceed until 10 participants with a brain MRI suggestive of MS (obtained at any time point during the study) have completed the study. - Up to 15 healthy volunteers, age- and sex-matched to the participants with unilateral optic neuritis and a brain MRI suggestive of MS.

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

COHORT 1: Unilateral optic neuritis.

  • Typical demyelinating optic neuritis based on the best clinical judgment of the investigators.
  • Symptom onset within 46 weeks of enrollment OR patients with history of optic neuritis who were followed from symptom onset under a Neuroimmunology Branch natural history or screening protocol.
  • For women of , willing to use acceptable forms of (i.e. hormonal contraception (birth control pills, injected hormones, vaginal ring), intrauterine device, barrier methods (condom or diaphragm) with spermicide or they have undergone surgical sterilization (hysterectomy, tubal ligation, or vasectomy in a partner) for the study duration.
  • Able to provide .
  • Willing and able to participate in all aspects of the trial.

COHORT 2: Healthy volunteers.

  • No medical history that would interfere with study result interpretation, in the best clinical judgment of the investigators.
  • Age greater than or equal to 18 years and less than or equal to 50 years.
  • Able to provide informed consent.
  • Willing and able to participate in all aspects of the trial.

Exclusion criteria

EXCLUSION CRITERIA:

  • History of signs or symptoms suspicious for MS, in the best clinical judgment of the investigators.
  • Pateints-Disease-modifying therapy for MS prior to the onset of the current episode of optic neuritis (excludes oral or intravenous : Healthy Volunteers - Previous or current use of disease-modifying therapy for MS (excluding oral or intravenous glucocorticoids.
  • Previous history of clinical optic neuritis or a systemic disease associated with optic neuritis (e.g. sarcoidosis, lymphoma).
  • Current or prior optic neuropathy (e.g. trauma, ischemia, glaucoma, optic nerve drusen).
  • Previous history of a retinal disease (e.g. diabetic retinopathy, retinal drusen) other than uveitis.
  • Previous history of an ophthalmic disease that in the best judgment of the investigator could affect ophthalmic imaging results.
  • Previous history of a systemic disease that may mimic MS (e.g. neurosyphilis, neurosarcoidosis, CNS ymphoma, Si(SqrRoot)(Delta)gren s syndrome).
  • Previous history of a systemic disease that in the best judgment of the investigator could confound study outcome.
  • Current use of a TNF-alpha inhibitor (e.g. etanercept).
  • Habitual use of illicit drugs that in the best judgment of the investigators could confound study outcome.
  • Pregnant or breast-feeding.
  • Unwilling to co-enroll on a Neuroimmunology Branch natural history or screening protocol currently 89-N-0045.
  • to MRI scanning.
Terms in these criteria, in plain language(5)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

05

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
8 participants (actual)

Groups and cohorts

  • healthy volunteers

    age- and sex-matched to the participants with unilateral optic neuritis and a brain MRI suggestive of MS

  • Patients with unilateral optic neuritis

    Recruitment will proceed until 10 participants with a brain MRI suggestive of MS (obtained at any time point during the study) have completed the study.

06

What researchers measure

Primary outcomes

  1. The primary outcome measure is the RNFL thickness in the affected eye 12 months after optic neuritis

    RNFL thickness in the affected eye 12 months after optic neuritis.

    Time frame: 12 months after optic neuritis

07

Study locations

3 sites
  • National Institutes of Health Clinical Center
    Bethesda, Maryland 20892, United States
  • University of Utah
    Salt Lake City, Utah 84112, United States
  • Hadassah Hospital/Hebrew University Medical Center
    Jerusalem, Israel
08

References and documents

Publications

  • Leaney J, Klistorner A, Arvind H, Graham SL. Dichoptic suppression of mfVEP amplitude: effect of retinal eccentricity and simulated unilateral visual impairment. Invest Ophthalmol Vis Sci. 2010 Dec;51(12):6549-55. doi: 10.1167/iovs.10-5769. Epub 2010 Jul 29. PubMed 20671270 ↗
  • Klistorner A, Arvind H, Garrick R, Yiannikas C, Paine M, Graham SL. Remyelination of optic nerve lesions: spatial and temporal factors. Mult Scler. 2010 Jul;16(7):786-95. doi: 10.1177/1352458510371408. Epub 2010 Jun 7. PubMed 20530125 ↗
  • Klistorner A, Arvind H, Garrick R, Graham SL, Paine M, Yiannikas C. Interrelationship of optical coherence tomography and multifocal visual-evoked potentials after optic neuritis. Invest Ophthalmol Vis Sci. 2010 May;51(5):2770-7. doi: 10.1167/iovs.09-4577. Epub 2009 Dec 30. PubMed 20042660 ↗
09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Mar 2013 to primary completion in Sep 2014, 17 months.

How these figures are worked out, and which studies are left out of them.

Registered
May 9, 2013
First posted
May 10, 2013
StartActual
Mar 20, 2013
Primary completionActual
Sep 5, 2014
CompletionActual
Oct 26, 2017
Last update
Sep 29, 2022
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Sep 29, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT01851434
Responsible party
Sponsor
First posted
May 10, 2013
Start date
Mar 20, 2013
Primary completion
Sep 5, 2014
Completion
Oct 26, 2017
Last update
Sep 29, 2022

Study contacts

Daniel S Reich, M.D.
principal investigator · National Institute of Neurological Disorders and Stroke (NINDS)
View the source record on ClinicalTrials.gov ↗

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This study is terminated, as verified in Sep 2022. You cannot join it, but the record below documents what was studied.

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