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Status unknownNCT03422965Updated Jul 29, 2020

Perifoveal Vascular Network Assessed by OCT-Angiography in Type I Diabetes Mellitus

An interventional study of Optical Coherence Tomography Angiography and Blood test in Retinal Vascular, Retinal Disease and Retinal Ischemia, sponsored by Hospital Clinic of Barcelona. Status unknown at 2 sites in Spain. Open to participants aged 18 Years to 100 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2020-07-29.

Sponsored by Hospital Clinic of Barcelona · Not applicable, Interventional, and Diagnostic

The sponsor has not verified this record recently (last verified Jul 2020), so the status shown — last known as Active, not recruiting — may be out of date.
Phase
Not applicable
Study type
Interventional
Enrollment
600
Allocation
Non-randomized
Ages
18 Years to 100 Years
Sex
All
01

Study summary

This study is directed to evaluate the role of Optical Coherence Tomography Angiography (OCT-A) in the evaluation of the perifoveal vascular network in type 1 diabetic patients, and to investigate the relationship between OCT-A-derived parameters and demographic and clinical factors, as metabolic control and duration of the disease.

Read the detailed description

Diabetic retinopathy (DR) is the leading cause of blindness in type 1 Diabetes Mellitus (DM) patients, as a consequence of impaired blood flow in the retina. Optical coherence tomography angiography (OCT-A) is a newly developed, non-invasive, retinal imaging technique that allows detection of perfused and non perfused areas of the retina without the injection of dye. This OCT-based method permits adequate delineation of the perifoveal vascular network, and allows objective identification of microvascular changes, such as capillary dilation or presence of microaneurisms. It is also capable to detect paramacular areas of capillary non perfusion and/or enlargement of the foveal avascular zone (FAZ), representing an excellent tool for assessment of diabetic retinopathy.

Given that all these features are commonly seen in diabetic patients, the relationship of these microvascular changes with systemic factors such as metabolic control or duration of the disease still need to be elucidated. Interestingly, further studies are required to investigate whether these changes reflect those occurring elsewhere in the body affected by diabetic microvascular disease, as the kidneys or the brain. If these relationships were demonstrated, early detection of these microvascular changes could lead to modifications in the pharmacological management of diabetic patients, as a way to reduce the risk of future complications in both the eye and other organs. The aim of this study is to evaluate the role of OCT-A in the evaluation of the perifoveal vascular network in type 1 diabetic patients, and to investigate the relationship between these OCT-A-derived parameters and demographic and clinical factors, as metabolic control and duration of the disease.

02

Conditions studied

  • Retinal Vascular
  • Retinal Disease
  • Retinal Ischemia
  • Retinal Ischaemia Due to Type 1 Diabetes Mellitus
  • Diabetes Mellitus
  • Diabetic Retinopathy
  • Diabetes Mellitus, Type 1
  • Vessels; Retina, Tortuous

Keywords

  • Retina
  • OCT
  • Optical Coherence Tomography
  • Optical Coherence Tomography Angiography
  • Systemic
  • Blood
  • Diabetes Mellitus
  • Diabetic Retinopathy
03

Who can participate

Ages eligible
18 Years to 100 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • Type 1 Diabetes Mellitus
  • Healthy controls

Exclusion criteria

Exclusion Criteria:

  • Ocular pathologies other than diabetic retinopathy (i.e. age-related macular degeneration, retinal vein occlusions, uveitis, glaucoma, etc.)
  • Axial length: \<-6.00 to >+3.00 diopters
  • Media Opacities
  • Unability to capture OCT images
04

Study design

Phase
Not applicable
Primary purpose
Diagnostic
Allocation
Non-randomized
Intervention model
Parallel assignment
Masking
Double (Investigator, Outcomes assessor)
Enrollment
600 participants (actual)

Study arms

  • Active comparator
    Type 1 Diabetes Mellitus

    Cohort of Type 1 DM patients

    Diagnostic Test: Optical Coherence Tomography Angiography · Diagnostic Test: Blood test · Diagnostic Test: Urine test

  • Sham comparator
    Healthy controls

    Cohort of Healthy controls

    Diagnostic Test: Optical Coherence Tomography Angiography · Diagnostic Test: Blood test · Diagnostic Test: Urine test

Interventions

  • Diagnostic testOptical Coherence Tomography Angiography

    Optical Coherence Tomography Angiography images capture.

  • Diagnostic testBlood test

    Blood test, systemic markers

  • Diagnostic testUrine test

    Urine test, systemic markers

05

What researchers measure

Primary outcomes

  1. Perifoveal vessel density

    OCTA images will be processed to obtain vascular density measurements in this area (mm-1)

    Time frame: 24 months

Secondary outcomes

  1. Parafoveal vessel density

    OCTA images will be processed to obtain vascular density measurements in this area (mm-1)

    Time frame: 24 months

  2. Total Avascular Area

    OCTA images will be processed to obtain total avascular area measurements (mm2)

    Time frame: 24 months

  3. Foveal Avascular Zone

    OCTA images will be processed to obtain foveal avascular zone area measurements (mm2)

    Time frame: 24 months

06

Study locations

2 sites
  • Institut Clinic de Oftalmologia (ICOF), Hospital Clínic de Barcelona
    Barcelona, 08028, Spain
  • Diabetes Unit, Institut Clinic de Malalties Digestives i Métaboliques (ICMDM), Hospital Clínic de Barcelona
    Barcelona, 08036, Spain
07

References and documents

Publications

  • Song SJ, Wong TY. Current concepts in diabetic retinopathy. Diabetes Metab J. 2014 Dec;38(6):416-25. doi: 10.4093/dmj.2014.38.6.416. PubMed 25541604 ↗
  • Klein R, Klein BE, Moss SE, Davis MD, DeMets DL. The Wisconsin epidemiologic study of diabetic retinopathy. II. Prevalence and risk of diabetic retinopathy when age at diagnosis is less than 30 years. Arch Ophthalmol. 1984 Apr;102(4):520-6. doi: 10.1001/archopht.1984.01040030398010. PubMed 6367724 ↗
  • Shah CA. Diabetic retinopathy: A comprehensive review. Indian J Med Sci. 2008 Dec;62(12):500-19. PubMed 19265246 ↗
  • Roser P, Kalscheuer H, Groener JB, Lehnhoff D, Klein R, Auffarth GU, Nawroth PP, Schuett F, Rudofsky G. Diabetic Retinopathy Screening Ratio Is Improved When Using a Digital, Nonmydriatic Fundus Camera Onsite in a Diabetes Outpatient Clinic. J Diabetes Res. 2016;2016:4101890. doi: 10.1155/2016/4101890. Epub 2016 Jan 21. PubMed 26904690 ↗
  • Looker HC, Nyangoma SO, Cromie DT, Olson JA, Leese GP, Philip S, Black MW, Doig J, Lee N, Briggs A, Hothersall EJ, Morris AD, Lindsay RS, McKnight JA, Pearson DW, Sattar NA, Wild SH, McKeigue P, Colhoun HM; Scottish Diabetes Research Network (SDRN) Epidemiology Group and the Scottish Diabetic Retinopathy Collaborative. Predicted impact of extending the screening interval for diabetic retinopathy: the Scottish Diabetic Retinopathy Screening programme. Diabetologia. 2013 Aug;56(8):1716-25. doi: 10.1007/s00125-013-2928-7. Epub 2013 May 21. PubMed 23689796 ↗
  • Zimmer-Galler IE, Kimura AE, Gupta S. Diabetic retinopathy screening and the use of telemedicine. Curr Opin Ophthalmol. 2015 May;26(3):167-72. doi: 10.1097/ICU.0000000000000142. PubMed 25759962 ↗
  • Gass JD. A fluorescein angiographic study of macular dysfunction secondary to retinal vascular disease. IV. Diabetic retinal angiopathy. Arch Ophthalmol. 1968 Nov;80(5):583-91. doi: 10.1001/archopht.1968.00980050585004. No abstract available. PubMed 5684307 ↗
  • Fioretto P, Mauer M, Brocco E, Velussi M, Frigato F, Muollo B, Sambataro M, Abaterusso C, Baggio B, Crepaldi G, Nosadini R. Patterns of renal injury in NIDDM patients with microalbuminuria. Diabetologia. 1996 Dec;39(12):1569-76. doi: 10.1007/s001250050616. PubMed 8960844 ↗
  • Kwiterovich KA, Maguire MG, Murphy RP, Schachat AP, Bressler NM, Bressler SB, Fine SL. Frequency of adverse systemic reactions after fluorescein angiography. Results of a prospective study. Ophthalmology. 1991 Jul;98(7):1139-42. doi: 10.1016/s0161-6420(91)32165-1. PubMed 1891225 ↗
  • Yeung L, Lima VC, Garcia P, Landa G, Rosen RB. Correlation between spectral domain optical coherence tomography findings and fluorescein angiography patterns in diabetic macular edema. Ophthalmology. 2009 Jun;116(6):1158-67. doi: 10.1016/j.ophtha.2008.12.063. Epub 2009 Apr 23. PubMed 19395034 ↗
  • Jia Y, Tan O, Tokayer J, Potsaid B, Wang Y, Liu JJ, Kraus MF, Subhash H, Fujimoto JG, Hornegger J, Huang D. Split-spectrum amplitude-decorrelation angiography with optical coherence tomography. Opt Express. 2012 Feb 13;20(4):4710-25. doi: 10.1364/OE.20.004710. PubMed 22418228 ↗
  • Jia Y, Bailey ST, Hwang TS, McClintic SM, Gao SS, Pennesi ME, Flaxel CJ, Lauer AK, Wilson DJ, Hornegger J, Fujimoto JG, Huang D. Quantitative optical coherence tomography angiography of vascular abnormalities in the living human eye. Proc Natl Acad Sci U S A. 2015 May 5;112(18):E2395-402. doi: 10.1073/pnas.1500185112. Epub 2015 Apr 20. PubMed 25897021 ↗
  • Ishibazawa A, Nagaoka T, Takahashi A, Omae T, Tani T, Sogawa K, Yokota H, Yoshida A. Optical Coherence Tomography Angiography in Diabetic Retinopathy: A Prospective Pilot Study. Am J Ophthalmol. 2015 Jul;160(1):35-44.e1. doi: 10.1016/j.ajo.2015.04.021. Epub 2015 Apr 18. PubMed 25896459 ↗
  • de Carlo TE, Chin AT, Bonini Filho MA, Adhi M, Branchini L, Salz DA, Baumal CR, Crawford C, Reichel E, Witkin AJ, Duker JS, Waheed NK. DETECTION OF MICROVASCULAR CHANGES IN EYES OF PATIENTS WITH DIABETES BUT NOT CLINICAL DIABETIC RETINOPATHY USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY. Retina. 2015 Nov;35(11):2364-70. doi: 10.1097/IAE.0000000000000882. PubMed 26469537 ↗
  • Takase N, Nozaki M, Kato A, Ozeki H, Yoshida M, Ogura Y. ENLARGEMENT OF FOVEAL AVASCULAR ZONE IN DIABETIC EYES EVALUATED BY EN FACE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY. Retina. 2015 Nov;35(11):2377-83. doi: 10.1097/IAE.0000000000000849. PubMed 26457396 ↗
  • Hwang TS, Gao SS, Liu L, Lauer AK, Bailey ST, Flaxel CJ, Wilson DJ, Huang D, Jia Y. Automated Quantification of Capillary Nonperfusion Using Optical Coherence Tomography Angiography in Diabetic Retinopathy. JAMA Ophthalmol. 2016 Apr;134(4):367-73. doi: 10.1001/jamaophthalmol.2015.5658. PubMed 26795548 ↗
  • Bernal-Morales C, Ale-Chilet A, Martin-Pinardel R, Barraso M, Hernandez T, Oliva C, Vinagre I, Ortega E, Figueras-Roca M, Sala-Puigdollers A, Gimenez M, Esmatjes E, Adan A, Zarranz-Ventura J. Optical Coherence Tomography Angiography in Type 1 Diabetes Mellitus. Report 4: Glycated Haemoglobin. Diagnostics (Basel). 2021 Aug 25;11(9):1537. doi: 10.3390/diagnostics11091537. PubMed 34573883 ↗
  • Barraso M, Ale-Chilet A, Hernandez T, Oliva C, Vinagre I, Ortega E, Figueras-Roca M, Sala-Puigdollers A, Esquinas C, Esmatjes E, Adan A, Zarranz-Ventura J. Optical Coherence Tomography Angiography in Type 1 Diabetes Mellitus. Report 1: Diabetic Retinopathy. Transl Vis Sci Technol. 2020 Sep 30;9(10):34. doi: 10.1167/tvst.9.10.34. eCollection 2020 Sep. PubMed 33062397 ↗
  • Zarranz-Ventura J, Barraso M, Ale-Chilet A, Hernandez T, Oliva C, Gascon J, Sala-Puigdollers A, Figueras-Roca M, Vinagre I, Ortega E, Esmatjes E, Adan A. Evaluation of microvascular changes in the perifoveal vascular network using optical coherence tomography angiography (OCTA) in type I diabetes mellitus: a large scale prospective trial. BMC Med Imaging. 2019 Nov 21;19(1):91. doi: 10.1186/s12880-019-0391-8. PubMed 31752726 ↗

Individual participant data

Plan to share: Undecided

08

Registry details

Key details

Study ID
NCT03422965
Lead sponsor
Hospital Clinic of Barcelona
Collaborators
Fundació La Marató de TV3
Responsible party
Javier Zarranz-Ventura (MD, PhD, FEBO, Hospital Clinic of Barcelona) — Principal investigator
First posted
Feb 6, 2018
Start date
May 8, 2017
Primary completion
Mar 8, 2021 (estimated)
Completion
May 31, 2021 (estimated)
Last update
Jul 29, 2020

Study contacts

Javier Zarranz-Ventura, MD PhD FEBO
principal investigator · Hospital Clinic of Barcelona

Oversight

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

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