ClinicalTrials.gg
CompletedNCT05662943Updated Dec 14, 2023

Outcomes of Tolerating Subretinal Fluid in Type 1 MNV and PCV

An observational study in Polypoidal Choroidal Vasculopathy, Choroidal Neovascularization and Age-Related Macular Degeneration, sponsored by Kim's Eye Hospital. Completed at 1 site in Korea, Republic of. Open to participants aged 50 Years and older. Per ClinicalTrials.gov, last updated 2023-12-14.

Sponsored by Kim's Eye Hospital · Observational

Study type
Observational
Model
Case-only
Time perspective
Retrospective
Enrollment
135
Ages
50 Years and older
Sex
All
01

Study summary

The purpose of the present study was to evaluate the outcomes of type 1 macular neovascularization (MNV), including polypoidal choroidal vasculopathy in patients treated tolerating subretinal fluid (SRF) using Aflibercept in a clinical setting. Approximately 150 patients are anticipated to be enrolled in this study. SRF is a primary type of fluid compartment prevalent in type 1 aneurysmal MNV. In a recent study, the prevalence of SRF during 24-month follow-up period was 36.7% to 38.8% in type 1 MNV and polypoidal choroidal vasculopathy (PCV), 20.0% in type 2 MNV, and 7.7% in type 3 MNV. In addition, patients with SRF showed better visual prognosis in type 1 MNV/PCV. For this reason, type 1 MNV is an appropriate candidate for evaluating the influence of tolerating SRF.

Read the detailed description

Tolerating subretinal fluid (SRF) is one of the current major issues in the field of neovascular age-related macular degeneration. Previous post-hoc analysis studies have demonstrated that SRF is not associated with poor visual acuity as well as poor visual outcome. In addition, previous studies showed that tolerating small amount of SRF may not influence visual outcome when using treat-and-extend regimen. Based on these observations, it is generally accepted that small stable amounts of SRF can be tolerated.

To date, several clinical trials evaluated association of residual SRF with visual outcome. In these clinical trials, treatment was performed based on strict study protocol. In addition, strict rescue treatment criteria impeded definite under-treatment. However, in a clinical setting, non-scientific factors such as financial or time burden, fear to injection and compliance can influence treatment decisions. As a result, in some patients, more intensive treatment cannot be performed despite substantial amount of persistent retinal fluid.

Unlike clinical trials, in real-world practice it is difficult to precisely measure and tolerate fluid in strict amounts. As a result, large degree of fluctuation of fluid volume can occur in some patients. In addition, large amounts of fluid, which may not be tolerated in clinical trials, can persist for a relatively long period. Such cases are usually difficult to encounter in clinical trials because these patients are either treated more intensively or are dropped from the trial. Investigating the outcomes in these cases can provide useful information that cannot be obtained from clinical trials.

The purpose of the present study was to evaluate the outcomes of type 1 macular neovascularization (MNV), including polypoidal choroidal vasculopathy in patients treated tolerating SRF using Aflibercept in a clinical setting. Approximately 150 patients are anticipated to be enrolled in this study. SRF is a primary type of fluid compartment prevalent in type 1 aneurysmal MNV. In a recent study, the prevalence of SRF during 24-month follow-up period was 36.7% to 38.8% in type 1 MNV and PCV, 20.0% in type 2 MNV, and 7.7% in type 3 MNV. In addition, patients with SRF showed better visual prognosis in type 1 MNV/PCV. For this reason, type 1 MNV is an appropriate candidate for evaluating the influence of tolerating SRF.

This study may contribute to the better understanding the influence of tolerating SRF on treatment outcomes in patients diagnosed with this subtype of neovascular age-related macular degeneration (AMD). In addition, it may also contribute to the evolution of aflibercept T\&E therapy, and provide evidence for physicians to guide treatment decisions.

02

Conditions studied

  • Polypoidal Choroidal Vasculopathy
  • Choroidal Neovascularization
  • Age-Related Macular Degeneration

Keywords

  • Type 1 macular neovascularization
  • Polypoidal Choroidal Vasculopathy
  • Subretinal fluid
  • Aflibercept
  • Age-related macular degeneration
03

In context

Polypoidal Choroidal Vasculopathy

54 studies on the registry are indexed under Polypoidal Choroidal Vasculopathy; 6 are open to participants now.

This study's enrollment of 135 is close to the median of 135 across 13 observational studies indexed under Polypoidal Choroidal Vasculopathy.

Browse Polypoidal Choroidal Vasculopathy studies →

Lead sponsor

Kim's Eye Hospital is the lead sponsor of 9 studies on the registry; 1 is open to participants now.

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

04

Who can participate

Ages eligible
50 Years and older
Sexes eligible
All
Sampling method
Non-probability sample

Study population

Patients were diagnosed with type 3 MNV or PCV and underwent continuous aflibercept injections with tolerating subfoveal retinal fluid more than 6 months

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

  • Patient who were diagnosed with type 1 MNV or PCV
  • Patients who were treated using aflibercept between January 2021 and December 2022
  • Patients underwent continuous aflibercept injections with tolerating subfoveal retinal fluid more than 6 months.

Exclusion criteria

Exclusion Criteria:

  • Less than 6 months of tolerating-fluid phase
  • Patients without indocyanine green angiography (ICGA) result
  • Patients who received other treatment for neovascular age-related macular degeneration (AMD), except for aflibercept (eg. ranibizumab, bevacizumab, or PDT)
  • History of intraocular or periocular injection
  • History of vitreoretinal surgery or glaucoma surgery
  • History of intraocular inflammation
  • Uncontrolled glaucoma (IOP ≥ 25mmHg)
Terms in these criteria, in plain language(1)

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.

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.

05

Study design

Observational model
Case-only
Time perspective
Retrospective
Enrollment
135 participants (actual)
Patient registry
No

Groups and cohorts

  • Type 1 Macular Neovascularization and Polypoidal Choroidal Vasculopathy

    Patients with type 1 macular neovascularization and polypoidal choroidal vasculopathy who underwent continuous aflibercept injections with tolerating subfoveal retinal fluid more than 6 months

    Drug: Intravitreal aflibercept injection

Interventions

06

What researchers measure

Primary outcomes

  1. Changes in visual acuity

    Change in best-corrected visual acuity (BCVA) between the start and the end of treatment tolerating subretinal fluid

    Time frame: Through study completion, an average of 20 months

Secondary outcomes

  1. Proportion of patients who exhibited deterioration of ≥0.3 logMAR BCVA

    Proportion of patients who exhibited deterioration of ≥0.3 logMAR BCVA between the start and the end of treatment tolerating subretinal fluid

    Time frame: Through study completion, an average of 20 months

  2. Difference in the BCVA change, according to MNV subtype

    Difference in the BCVA change, according to MNV subtype (type 1 MNV vs PCV)

    Time frame: Through study completion, an average of 20 months

  3. Degree of visual deterioration according to the treatment period

    Degree of visual deterioration according to the treatment period

    Time frame: Through study completion, an average of 20 months

  4. Degree of visual deterioration according to the height of SRF

    Degree of visual deterioration according to the height of SRF

    Time frame: Through study completion, an average of 20 months

  5. Degree of visual deterioration according to the fluctuation of SRF height

    Degree of visual deterioration according to the fluctuation of SRF height

    Time frame: Through study completion, an average of 20 months

  6. Comparison of visual outcomes between the following three groups (mean SRF height <100 µm vs ≥100 µm, <200 µm vs ≥200 µm)

    Comparison of visual outcomes between the following three groups (mean SRF height \<100 µm vs ≥100 µm, \<200 µm vs ≥200 µm)

    Time frame: Through study completion, an average of 20 months

  7. Risk factor of developing deterioration of ≥0.2 logMAR BCVA

    Risk factor of developing deterioration of ≥0.2 logMAR BCVA

    Time frame: Through study completion, an average of 20 months

  8. Proportion of patients in whom the intraretinal fluid (IRF) developed during treatment tolerating SRF

    Proportion of patients in whom the IRF developed during treatment tolerating SRF

    Time frame: Through study completion, an average of 20 months

  9. Difference in visual outcome between patients with and without IRF development

    Difference in visual outcome between patients with and without IRF development

    Time frame: Through study completion, an average of 20 months

  10. Risk factors of IRF development

    Risk factors of IRF development

    Time frame: Through study completion, an average of 20 months

  11. The incidence of vision-threatening event such as large submacular hemorrhage or tear of retinal pigment epithelium

    The incidence of vision-threatening event such as large submacular hemorrhage or tear of retinal pigment epithelium

    Time frame: Through study completion, an average of 20 months

  12. The incidence of SRF resolution without shortening injection interval

    The incidence of SRF resolution without shortening injection interval

    Time frame: Through study completion, an average of 20 months

07

Study locations

1 site
  • Jae Hui Kim
    Seoul, 150-034, Korea, Republic of
08

References and documents

Publications

  • Sharma A, Parachuri N, Kumar N, Bandello F, Kuppermann BD, Loewenstein A, Regillo CD, Chakravarthy U. Notion of tolerating subretinal fluid in neovascular AMD: understanding the fine print before the injection pause. Br J Ophthalmol. 2021 Feb;105(2):149-150. doi: 10.1136/bjophthalmol-2020-317933. Epub 2020 Sep 26. No abstract available. PubMed 32980815 ↗
  • Chaudhary V, Matonti F, Zarranz-Ventura J, Stewart MW. IMPACT OF FLUID COMPARTMENTS ON FUNCTIONAL OUTCOMES FOR PATIENTS WITH NEOVASCULAR AGE-RELATED MACULAR DEGENERATION: A Systematic Literature Review. Retina. 2022 Apr 1;42(4):589-606. doi: 10.1097/IAE.0000000000003283. PubMed 34393212 ↗
  • Mitchell P, Holz FG, Hykin P, Midena E, Souied E, Allmeier H, Lambrou G, Schmelter T, Wolf S; ARIES study investigators. EFFICACY AND SAFETY OF INTRAVITREAL AFLIBERCEPT USING A TREAT-AND-EXTEND REGIMEN FOR NEOVASCULAR AGE-RELATED MACULAR DEGENERATION: The ARIES Study: A Randomized Clinical Trial. Retina. 2021 Sep 1;41(9):1911-1920. doi: 10.1097/IAE.0000000000003128. Erratum In: Retina. 2022 Sep 01;42(9):e43. doi: 10.1097/IAE.0000000000003560. PubMed 33782365 ↗
  • Chaikitmongkol V, Sagong M, Lai TYY, Tan GSW, Ngah NF, Ohji M, Mitchell P, Yang CH, Ruamviboonsuk P, Wong I, Sakamoto T, Rajendran A, Chen Y, Lam DSC, Lai CC, Wong TY, Cheung CMG, Chang A, Koh A. Treat-and-Extend Regimens for the Management of Neovascular Age-related Macular Degeneration and Polypoidal Choroidal Vasculopathy: Consensus and Recommendations From the Asia-Pacific Vitreo-retina Society. Asia Pac J Ophthalmol (Phila). 2021 Nov 24;10(6):507-518. doi: 10.1097/APO.0000000000000445. PubMed 34839342 ↗
  • Cheng CK, Chen SJ, Chen JT, Chen LJ, Chen SN, Chen WL, Hsu SM, Lai CH, Sheu SJ, Wu PC, Wu WC, Wu WC, Yang CM, Yeung L, Chen TC, Yang CH. Optimal approaches and criteria to treat-and-extend regimen implementation for Neovascular age-related macular degeneration: experts consensus in Taiwan. BMC Ophthalmol. 2022 Jan 15;22(1):25. doi: 10.1186/s12886-021-02231-8. PubMed 35033037 ↗
  • Kim JH, Kim JW, Kim CG. Difference Between the Incidence of Retinal Fluid Subtypes and Their Association with Visual Outcomes According to the Types of Macular Neovascularization in a Korean Population. J Ocul Pharmacol Ther. 2022 Apr;38(3):261-268. doi: 10.1089/jop.2021.0103. Epub 2022 Feb 3. PubMed 35119292 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Dec 14, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT05662943
Lead sponsor
Kim's Eye Hospital
Responsible party
Sponsor
First posted
Dec 23, 2022
Start date
Dec 5, 2022
Primary completion
May 31, 2023
Completion
Nov 30, 2023
Last update
Dec 14, 2023

Study contacts

Jae Hui Kim, M.D.
principal investigator · Kim's Eye Hospital

Oversight

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

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