ClinicalTrials.gg
TerminatedNCT03396861ACMEUpdated Oct 15, 2024

Treatment of Macular Edema After Cataract Surgery with Subconjunctival Aflibercept

A Phase 1 interventional study of Aflibercept in Irvine-Gass Syndrome, sponsored by Tufts Medical Center. Terminated at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-10-15.

Sponsored by Tufts Medical Center · Phase 1, Interventional, and Treatment

Why this study was terminated
Low enrollment

From the registry’s dates

  • Primary completion was Aug 2019, 7 years 2 months ago, and no results have been posted to the registry.
Phase
Phase 1
Study type
Interventional
Enrollment
1
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

This research study is being conducted to determine the safety and tolerability of subconjunctival injections of aflibercept in the treatment of pseudophakic cystoid macular edema that has not responded well to first-line standard of care treatment (eye drops).

Pseudophakic cystoid macular edema (CME) is swelling of the retina that can occur weeks or years after cataract surgery and typically results in decreased vision. Subconjunctival injections are injections placed just beneath the clear membrane (conjunctiva) of the eye.

A recent report of one patient who received two subconjunctival injections of a similar medication to the one being studied here indicated that subconjunctival injections of this class of medication may be an effective and less invasive alternative to intravitreal injections for pseudophakic CME. Because of the similarity of the drugs and the patient's treatment success, we would like to see if subconjunctival injection(s) of aflibercept will work in treating pseudophakic CME. If successful, the risk of an intraocular infection and glaucoma that comes with standard of care treatments might be greatly reduced.

02

Conditions studied

  • Irvine-Gass Syndrome

Keywords

  • macular edema
  • pseudophakia
  • pseudophakic macular edema
  • retinal swelling
  • aflibercept
  • anti-vascular endothelial growth factor
  • subconjunctival injection
03

In context

Macular Edema

756 studies on the registry are indexed under Macular Edema; 65 are open to participants now.

This study's enrollment of 1 is below the median of 56 across 584 interventional studies indexed under Macular Edema.

Browse Macular Edema studies →

Lead sponsor

Tufts Medical Center is the lead sponsor of 200 studies on the registry; 28 are open to participants now.

Of its 32 completed or terminated interventional studies of FDA-regulated products, 16 (50%) have results posted.

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

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

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

  1. Diagnosed with pseudophakic CME defined as central retinal thickness (CRT)>300 microns, presence of intraretinal cysts on optical coherence tomography (OCT) and visual acuity \<=20/32 with petaloid leakage on fluorescein angiogram and late leakage at the disc
  2. Diagnosed with "recalcitrant" CME, defined as less than a 15% decrease in CRT after at least 6 weeks of topical non-steroidal anti-inflammatory drug
  3. Has had cataract surgery in the study eye with posterior chamber or anterior chamber intraocular lens implantation
  4. Willing and able to comply with clinic visits and study-related procedures
  5. Provide signed

Exclusion criteria

Exclusion Criteria:

  1. Retinal diseases (including diabetic retinopathy, retinal vein or artery occlusion, neovascular age-related macular degeneration, radiation retinopathy, vitreomacular traction, epiretinal membrane).
  2. Active intraocular inflammation (grade trace or above) in the study eye, or history of idiopathic or -associated uveitis in either eye.
  3. Active infectious conjunctivitis, keratitis, scleritis or endophthalmitis in either eye.
  4. Prior treatment with sub-Tenon's or intravitreal .
  5. Prior treatment with an intravitreal anti-vascular endothelial growth factor (VEGF) agent in the study eye or systemic administration of anti-VEGF.
  6. Use of topical prostaglandin analogues or pilocarpine.
  7. Uncontrolled glaucoma in the study eye (defined as intraocular pressure ≥30 mmHg despite treatment with glaucoma medications.
  8. Previous subfoveal focal laser photocoagulation involving the foveal center in the study eye.
  9. Vision loss in the study eye, determined by the investigator to be from a cause other than CME, e.g. optic neuropathy, end-stage glaucoma.
  10. Any significant media opacity including vitreous hemorrhage or corneal scarring.
  11. Fluorescein dye allergy or intolerance
  12. Allergy to aflibercept or any of the components
  13. Cerebrovascular accident or myocardial infarction within 1 year of the screening visit.
  14. Pregnant or breast-feeding women
  15. Sexually active men or women of who are unwilling to practice adequate starting at least 2 menstrual cycles prior to the baseline visit, during the study and in the 3 months immediately following the last dose of study drug.
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.

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.

Autoimmune disease

A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.

Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.

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.

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.

05

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
1 participant (actual)

Study arms

  • Experimental
    Subconjunctival aflibercept

    Subconjunctival aflibercept 2 milligrams (mg) /0.05 milliliters (mL) administered at baseline visit and possibly again at Month 1 visit depending on initial response.

    Drug: Aflibercept

Interventions

06

What researchers measure

Primary outcomes

  1. Adverse Events

    Systemic and ocular adverse events of subconjunctivally administered aflibercept injection in the treatment of pseudophakic cystoid macular edema at Month 2

    Time frame: Month 2

Secondary outcomes

  1. Change in visual acuity

    Change in best-corrected visual acuity at Months 2 and 6

    Time frame: Month 2 and Month 6

  2. Change in central retinal thickness

    Change in central retinal thickness as measured by optical coherence tomography at Months 2 and 6

    Time frame: Month 2 and Month 6

  3. Proportion of patients needing re-treatment

    Proportion of patients needing subconjunctival aflibercept injection treatment at Month 1

    Time frame: Month 1

  4. Proportion of patients needing additional non-study treatment though Month 6

    Proportion of patients receiving additional non-study treatment (e.g. periocular or intravitreal steroid) through Month 6

    Time frame: Month 6

  5. Adverse Events - end of study period

    Incidence and severity of systemic and ocular events at Month 6

    Time frame: Month 6

07

Study locations

1 site
  • Tufts Medical Center
    Boston, Massachusetts 02111, United States
08

References and documents

Publications

  • Muakkassa NW, Klein KA, Hamrah P, Reichel E. Subconjunctival Bevacizumab for the Treatment of Keratoprosthesis-Associated Cystoid Macular Edema. Ophthalmic Surg Lasers Imaging Retina. 2016 Mar;47(3):276-9. doi: 10.3928/23258160-20160229-11. PubMed 26985802 ↗
  • Guo S, Patel S, Baumrind B, Johnson K, Levinsohn D, Marcus E, Tannen B, Roy M, Bhagat N, Zarbin M. Management of pseudophakic cystoid macular edema. Surv Ophthalmol. 2015 Mar-Apr;60(2):123-37. doi: 10.1016/j.survophthal.2014.08.005. Epub 2014 Sep 2. PubMed 25438734 ↗
  • Arevalo JF, Garcia-Amaris RA, Roca JA, Sanchez JG, Wu L, Berrocal MH, Maia M; Pan-American Collaborative Retina Study Group. Primary intravitreal bevacizumab for the management of pseudophakic cystoid macular edema: pilot study of the Pan-American Collaborative Retina Study Group. J Cataract Refract Surg. 2007 Dec;33(12):2098-105. doi: 10.1016/j.jcrs.2007.07.046. PubMed 18053911 ↗
  • Lin CJ, Tsai YY. USE OF AFLIBERCEPT FOR THE MANAGEMENT OF REFRACTORY PSEUDOPHAKIC MACULAR EDEMA IN IRVINE-GASS SYNDROME AND LITERATURE REVIEW. Retin Cases Brief Rep. 2018 Winter;12(1):59-62. doi: 10.1097/ICB.0000000000000414. PubMed 27617392 ↗
  • Raghava S, Hammond M, Kompella UB. Periocular routes for retinal drug delivery. Expert Opin Drug Deliv. 2004 Nov;1(1):99-114. doi: 10.1517/17425247.1.1.99. PubMed 16296723 ↗
  • Bahar I, Yeung SN, Sella R, Slomovic A. Anterior segment uses of bevacizumab. Curr Opin Ophthalmol. 2012 Jul;23(4):303-16. doi: 10.1097/ICU.0b013e3283548459. PubMed 22634640 ↗
  • Papadopoulos N, Martin J, Ruan Q, Rafique A, Rosconi MP, Shi E, Pyles EA, Yancopoulos GD, Stahl N, Wiegand SJ. Binding and neutralization of vascular endothelial growth factor (VEGF) and related ligands by VEGF Trap, ranibizumab and bevacizumab. Angiogenesis. 2012 Jun;15(2):171-85. doi: 10.1007/s10456-011-9249-6. PubMed 22302382 ↗
  • Stewart MW, Rosenfeld PJ. Predicted biological activity of intravitreal VEGF Trap. Br J Ophthalmol. 2008 May;92(5):667-8. doi: 10.1136/bjo.2007.134874. Epub 2008 Mar 20. PubMed 18356264 ↗
  • Kitchens JW, Do DV, Boyer DS, Thompson D, Gibson A, Saroj N, Vitti R, Berliner AJ, Kaiser PK. Comprehensive Review of Ocular and Systemic Safety Events with Intravitreal Aflibercept Injection in Randomized Controlled Trials. Ophthalmology. 2016 Jul;123(7):1511-20. doi: 10.1016/j.ophtha.2016.02.046. Epub 2016 Apr 12. PubMed 27084563 ↗

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Feb 2019 to primary completion in Aug 2019, 5 months.

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

Registered
Jan 5, 2018
First posted
Jan 11, 2018
StartActual
Feb 22, 2019
Primary completionActual
Aug 18, 2019
CompletionActual
Jan 2, 2020
Last update
Oct 15, 2024
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 Oct 15, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT03396861
Responsible party
Sponsor
First posted
Jan 11, 2018
Start date
Feb 22, 2019
Primary completion
Aug 18, 2019
Completion
Jan 2, 2020
Last update
Oct 15, 2024

Study contacts

Elias Reichel, MD
principal investigator · Tufts Medical Center

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is terminated, as verified in Oct 2024. You cannot join it, but the record below documents what was studied.

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Studies of the drug tested here: Aflibercept

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