ClinicalTrials.gg
CompletedNCT05223478MIRA-4Updated Oct 30, 2026Results posted

Nyxol (0.75% Phentolamine Ophthalmic Solution) to Reverse Pharmacologically-Induced Mydriasis in Pediatric Subjects

A Phase 3 interventional study of Phentolamine Ophthalmic Solution 0.75% and Phentolamine Ophthalmic Solution Vehicle in Mydriasis and Dilation, sponsored by Opus Genetics, Inc. Completed at 2 sites in United States. Open to participants aged 3 Years to 11 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-10-30.

Sponsored by Opus Genetics, Inc · Phase 3, Interventional, and Treatment

Updated Oct 30, 2026Sponsor changedGo to Updates ↓
Phase
Phase 3
Study type
Interventional
Enrollment
23
Allocation
Randomized
Ages
3 Years to 11 Years
Sex
All
01

Study summary

The objectives of this study are:

  • To evaluate the safety of Nyxol in pediatric subjects
  • To evaluate the efficacy of Nyxol to expedite the reversal of pharmacologically induced mydriasis in pediatric subjects The Sponsor intends to use this study to evaluate Nyxol in pediatric subjects aged 3 to 11 for the indication "the treatment of pharmacologically induced mydriasis produced by adrenergic (phenylephrine) or parasympatholytic (tropicamide) agents, or a combination thereof."
Read the detailed description

This is a randomized, parallel-arm, double-masked, placebo-controlled study in approximately 20 randomized pediatric subjects evaluating the safety and efficacy of Nyxol in pediatric subjects with pharmacologically induced mydriasis with three dilating agents (e.g., phenylephrine, tropicamide, and Paremyd). Pediatric subjects will be recruited for the study into 2 age groups as follows:1) 3 to 5 years of age: 10 subjects 2) 6 to 11 years of age: 10 subjects.

02

Conditions studied

  • Mydriasis
  • Dilation

Keywords

  • Nyxol
  • Pharmacologically Induced Mydriasis
  • Dilation
  • Pediatrics
  • Phentolamine
  • Mydriasis
  • Phenylephrine
  • Tropicamide
  • Paremyd
03

In context

Mydriasis

37 studies on the registry are indexed under Mydriasis; 4 are open to participants now.

This study's enrollment of 23 is below the median of 61 across 35 interventional studies indexed under Mydriasis.

Browse Mydriasis studies →

Lead sponsor

Opus Genetics, Inc is the lead sponsor of 17 studies on the registry; 4 are open to participants now.

Of its 13 completed or terminated interventional studies of FDA-regulated products, 13 (100%) have results posted.

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

04

Who can participate

Ages eligible
3 Years to 11 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

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. Males or premenstrual females 3 to 11 years of age
  2. Ability to comply with all protocol-mandated procedures independently and to attend all scheduled office visits
  3. Parent/Legal guardian willing to give written to participate in this study. Children aged 7 to 11 years to provide signed assent form, as well as a separate parental/legal guardian consent.

Exclusion criteria

Exclusion Criteria:

  1. ocular disease as deemed by the Investigator(eg, amblyopia, congenital cataract, congenital glaucoma) that might interfere with the study
  2. Unwilling or unable to discontinue use of contact lenses at screening until study completion
  3. Unwilling or unable to suspend use of topical medication at screening until study completion
  4. Ocular trauma or ocular surgery within the 6 months prior to screening
  5. Use of any topical prescription or over-the-counter (OTC)ophthalmic medications of any kind within 7 days of screening
  6. Recent or current evidence of ocular infection or inflammation in either eye (such as current evidence of clinically significant blepharitis, conjunctivitis, or keratitis). Subjects must be symptom-free for at least 7 days prior to screening
  7. Closed or very narrow-angle that in the Investigator's opinion is potentially occludable if the subject's pupil is dilated
  8. History of any traumatic (surgical or nonsurgical) or non-traumatic condition affecting the pupil or iris
  9. Known allergy, , or to any component of the phentolamine ophthalmic solution or to any component of the mydriatic agents or vehicle formulation

    Systemic:

  10. Known hypersensitivity or contraindication to α- and/or β-adrenoceptor antagonists
  11. Clinically significant systemic disease (eg, uncontrolled diabetes, cancer, hepatic, renal, endocrine, or cardiovascular disorders) that in the opinion of the Investigator could interfere with the study
  12. Subjects with learning disabilities that in the opinion of the investigator could interfere with the study
  13. Initiation of treatment with or any changes to the current dosage, drug, or regimen of any systemic adrenergic or cholinergic drugs within 7 days prior to screening or during the study(Appendix 4)
  14. Participation in any study within 30 days prior to screening
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.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

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.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Investigator, Outcomes assessor)
Enrollment
23 participants (actual)

Study arms

  • Active comparator
    Phentolamine Ophthalmic Solution 0.75%

    One drop of study medication in each eye.

    Drug: Phentolamine Ophthalmic Solution 0.75%

  • Placebo comparator
    Phentolamine Ophthalmic Solution Vehicle

    One drop of study medication in each eye.

    Drug: Phentolamine Ophthalmic Solution Vehicle

Interventions

  • 0.75% phentolamine ophthalmic solution (Nyxol), a non-selective alpha-1 and alpha-2 adrenergic antagonist

    Also known as: Nyxol®, Nyxol

  • DrugPhentolamine Ophthalmic Solution Vehicle

    Phentolamine Ophthalmic Solution Vehicle

06

What researchers measure

Primary outcomes

  1. Safety Measurements

    Study Eye Change from Baseline (-1 Hour) Conjunctival Hyperemia Grading; Cornea and Contact Lens Research Unit (CCLRU scale) Grades range from 0 to 3, with 3 being considered the most severe.

    Time frame: 0 Minutes, 90 Minutes, 3 Hours, 24 Hours

  2. Vital Signs

    Change from Screening Heart Rate

    Time frame: 3 Hours, 24 Hours

  3. Vital Signs

    Change from Screening Blood Pressure (Systolic)

    Time frame: 3 Hours, 24 Hours

  4. Safety Measurement

    Study Eye Change from Baseline (-1 Hour) in Best Corrected Distance Visual Acuity

    Time frame: 0 Minutes, 3 Hours, 24 Hours

  5. Change From Screening Blood Pressure (Diastolic)

    Time frame: 3 Hours, 24 Hours

Secondary outcomes

  1. Efficacy Measurement: Pupil Diameter

    Percentage of Subjects Returning to ≤ 0.2 mm from Baseline (-1 hour) Pupil Diameter (Study Eye)

    Time frame: 90 Minutes, 3 Hours, and 24 Hours

  2. Efficacy Measurement: Pupil Diameter

    Change (in mm) in Pupil Diameter from Max Pupil Dilation (0 minutes) (Study Eye)

    Time frame: 90 Minutes, 3 Hours, and 24 Hours

  3. Efficacy Measurement: Pupil Diameter

    Time (Hours) to Return to ≤ 0.2 mm from Baseline (-1 Hour) Pupil Diameter (Time-savings Analysis) (Study Eye)

    Time frame: Up to 24 Hours

07

Results

Posted Aug 2, 2023

Participant flow

Participant flow — Overall Study
MilestonePhentolamine Ophthalmic Solution 0.75%Phentolamine Ophthalmic Solution Vehicle
Started1112
Completed1112
Not completed00

Outcome measures

PrimarySafety Measurements

Study Eye Change from Baseline (-1 Hour) Conjunctival Hyperemia Grading; Cornea and Contact Lens Research Unit (CCLRU scale) Grades range from 0 to 3, with 3 being considered the most severe.

Time frame:
0 Minutes, 90 Minutes, 3 Hours, 24 Hours
Reported as:
Mean · score on a scale
Safety Measurements
score on a scalePhentolamine Ophthalmic Solution 0.75%Phentolamine Ophthalmic Solution Vehicle
0 Minutes0.3 ± 0.65-0.2 ± 0.58
90 Minutes1.6 ± 0.500.0 ± 0.43
3 Hours1.1 ± 0.54-0.1 ± 0.29
24 Hours0.1 ± 0.30-0.2 ± 0.58
PrimaryVital Signs

Change from Screening Heart Rate

Time frame:
3 Hours, 24 Hours
Reported as:
Mean · beats per minute
Vital Signs
beats per minutePhentolamine Ophthalmic Solution 0.75%Phentolamine Ophthalmic Solution Vehicle
3 Hours-1.1 ± 7.92-2.0 ± 14.24
24 Hours-2.5 ± 10.10-3.5 ± 12.69
PrimaryVital Signs

Change from Screening Blood Pressure (Systolic)

Time frame:
3 Hours, 24 Hours
Reported as:
Mean · mmHg
Vital Signs
mmHgPhentolamine Ophthalmic Solution 0.75%Phentolamine Ophthalmic Solution Vehicle
3 Hours-4.6 ± 8.91-0.8 ± 12.39
24 Hours-2.8 ± 7.48-5.8 ± 6.98
PrimarySafety Measurement

Study Eye Change from Baseline (-1 Hour) in Best Corrected Distance Visual Acuity

Time frame:
0 Minutes, 3 Hours, 24 Hours
Reported as:
Mean · letters
Safety Measurement
lettersPhentolamine Ophthalmic Solution 0.75%Phentolamine Ophthalmic Solution Vehicle
0 Minutes-1.2 ± 1.66-0.3 ± 1.23
3 Hours1.2 ± 1.890.1 ± 0.67
24 Hours1.5 ± 1.970.7 ± 1.15
PrimaryChange From Screening Blood Pressure (Diastolic)
Time frame:
3 Hours, 24 Hours
Reported as:
Mean · mmHg
Change From Screening Blood Pressure (Diastolic)
mmHgPhentolamine Ophthalmic Solution 0.75%Phentolamine Ophthalmic Solution Vehicle
3 Hours-2.4 ± 9.721.0 ± 15.68
24 Hours-1.1 ± 11.63-3.8 ± 7.96
SecondaryEfficacy Measurement: Pupil Diameter

Percentage of Subjects Returning to ≤ 0.2 mm from Baseline (-1 hour) Pupil Diameter (Study Eye)

Time frame:
90 Minutes, 3 Hours, and 24 Hours
Reported as:
Count of participants · Participants
Efficacy Measurement: Pupil Diameter
ParticipantsPhentolamine Ophthalmic Solution 0.75%Phentolamine Ophthalmic Solution Vehicle
90 Minutes73
3 Hours94
24 Hours106
SecondaryEfficacy Measurement: Pupil Diameter

Change (in mm) in Pupil Diameter from Max Pupil Dilation (0 minutes) (Study Eye)

Time frame:
90 Minutes, 3 Hours, and 24 Hours
Reported as:
Mean · millimeters
Efficacy Measurement: Pupil Diameter
millimetersPhentolamine Ophthalmic Solution 0.75%Phentolamine Ophthalmic Solution Vehicle
90 Minutes-1.475 ± 0.7188-0.378 ± 0.4473
3 Hours-2.031 ± 0.6919-0.723 ± 0.6470
24 Hours-2.005 ± 1.2841-1.44 ± 1.2891
SecondaryEfficacy Measurement: Pupil Diameter

Time (Hours) to Return to ≤ 0.2 mm from Baseline (-1 Hour) Pupil Diameter (Time-savings Analysis) (Study Eye)

Time frame:
Up to 24 Hours
Reported as:
Mean · hours
Efficacy Measurement: Pupil Diameter
hoursPhentolamine Ophthalmic Solution 0.75%Phentolamine Ophthalmic Solution Vehicle
Efficacy Measurement: Pupil Diameter2.95 ± 2.5645.54 ± 3.078

Adverse events

Collected over 2 Days. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Phentolamine Ophthalmic Solution 0.75%0/11 (0%)0/11 (0%)0/11 (0%)
Phentolamine Ophthalmic Solution Vehicle0/12 (0%)0/12 (0%)0/12 (0%)

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Phentolamine Ophthalmic Solution 0.75%Phentolamine Ophthalmic Solution VehicleTotal
<=18 years111223
Between 18 and 65 years000
>=65 years000
Age, Continuous
Age, Continuous(years)Phentolamine Ophthalmic Solution 0.75%Phentolamine Ophthalmic Solution VehicleTotal
Mean6.9 ± 2.745.8 ± 2.666.3 ± 2.69
Sex: Female, Male
Sex: Female, Male(Participants)Phentolamine Ophthalmic Solution 0.75%Phentolamine Ophthalmic Solution VehicleTotal
Female5712
Male6511
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Phentolamine Ophthalmic Solution 0.75%Phentolamine Ophthalmic Solution VehicleTotal
Hispanic or Latino213
Not Hispanic or Latino91120
Unknown or Not Reported000
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Phentolamine Ophthalmic Solution 0.75%Phentolamine Ophthalmic Solution VehicleTotal
American Indian or Alaska Native000
Asian000
Native Hawaiian or Other Pacific Islander000
Black or African American022
White111021
More than one race000
Unknown or Not Reported000
Region of Enrollment
Region of Enrollment(participants)Phentolamine Ophthalmic Solution 0.75%Phentolamine Ophthalmic Solution VehicleTotal
United States111223
08

Study locations

2 sites
  • Clinical Site 1
    Longwood, Florida 32779, United States
  • Clinical Site 2
    Athens, Ohio 45701, United States
09

References and documents

Publications

  • Pepose JS, Foster S, Pearson C, Brigell M, Charizanis K. Reversal of Pharmacologic Mydriasis in Pediatric Subjects with Ryzumvi (0.75% Phentolamine Ophthalmic Solution): A Post-Hoc Pooled Analysis from Three Randomized, Placebo-Controlled Phase 3 Trials. Clin Ophthalmol. 2026 Feb 20;20:563499. doi: 10.2147/OPTH.S563499. eCollection 2026. PubMed 41743463 ↗

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: No

10

Updates

1 registry update since Sep 25, 2026
Publications
1 publication citing this study linked from PubMed, e.g. PubMed 41743463 ↗
Oct 30, 2026
Sponsor
Ocuphire Pharma, Inc.→Opus Genetics, Inc
Oct 30, 2026
Show all 1 update
  1. Oct 30, 2026
    Publications 1 publication citing this study linked from PubMed, e.g. PubMed 41743463 ↗
    Sponsor Ocuphire Pharma, Inc.→Opus Genetics, Inc
    + 2 other changes: index terms and identifiers

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

11

Registry details

Key details

Study ID
NCT05223478
Lead sponsor
Opus Genetics, Inc
Responsible party
Sponsor
First posted
Feb 4, 2022
Start date
Dec 17, 2021
Primary completion
Apr 18, 2022
Completion
Apr 28, 2022
Results posted
Aug 2, 2023
Last update
Oct 30, 2026

Study contacts

Charles Slonim, MD
study director · Oculos Development Services

Oversight

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

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