Efficacy and Safety of Topically Applied Medical Therapy for the Treatment of Pediatric Glaucoma

Study Overview
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Brief Summary
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Objectives: The study will assess the ocular hypotensive effect of latanoprost and dorzolamide in a selected sample of patients affected by primary Pediatric Glaucoma (PG), refractory to surgical procedures. Safety will be assessed, too.In the first version of the protocol 96 eyes were forecasted to complete the enrolment. The protocol was then amended and now to complete the study 68 eyes should be included. This number of eyes could be achieved by recruiting from 34 to 68 patients due to not in all patients both eyes should be eligible for the study.

Detailed Description
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Study design: Single arm, prospective, experimental study. Due to ethical reasons and in order to adhere as much as possible to current clinical practice, the presence of a control arm is not planned. Due to the non-comparative nature of the study, no blinding of treatment is planned.

Official Title
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Efficacy and Safety of Prostaglandin Analogue and Carbonic Anhydrase Inhibitor for the Treatment of Pediatric Glaucoma

Conditions
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Childhood Glaucoma

Intervention / Treatment
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* Drug: Latanoprost, Dorzolamide


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Children of either sexes, aged 0-12 years Diagnosis of mono- or bilateral primary congenital glaucoma IOP greater than or equal to 22 mmHg and lower than 27 mmHg Only one previous ocular hypotensive surgical procedure for treatment of glaucoma among the following: goniotomy, trabeculotomy, trabeculotomy with adjunct of mitomycin C) (only for medical treatment at least one month before) Parent informed consent to data processing (at registration) Parent informed consent before any study procedure Exclusion Criteria: Secondary glaucoma (Sturge-Weber syndrome, type I neurofibromatosis, retinoblastoma, steroid-induced glaucoma, etc.) Presence of concomitant abnormalities of the anterior segment of the eye (cataract, iridocorneal dysgenesia, congenital uveal ectropion uvea, etc.) Previous treatment with the study drugs Presence of concomitant systemic diseases (asthma, hypertension, cardiac disease, renal failure, etc.) that needs treatment with drugs, that could influence IOP (steroids, beta-blockers, angiotensin-converting-enzyme inhibitor -inhibitors diuretics, etc.) Abnormalities of the cornea that could influence IOP readings (marked cornea edema)

Ages Eligible for Study
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Minimum Age: 1 Month
Maximum Age: 12 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Latanoprost, Dorzolamide<br>According to intraocular (IOP) assessment, the eye will receive Latanoprost, Dorzolamide or both. | Drug: Latanoprost, Dorzolamide<br>* Latanoprost 0.005% ophthalmic solution given once a day at nighttime (9.00 PM) Dorzolamide 2% ophthalmic solution given three times a day as a monotherapy, two times a day if in combination with latanoprost<br>* Other names: - Dorzolamide, a potent inhibitor of carbonic anhydrase II;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage of Eyes With Response | defined as those eyes in which the decrease of intraocular pressure (IOP) of at least 20% with respect to baseline assessment will be achieved and maintained during the 3-year period of study duration | 3 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time to Treatment Failure (TTF) | calculated as the time from the date of baseline visit to the date in which the medical treatment will be stopped, since IOP control will be considered not satisfactory | 3 years | 
| Number of Eyes With an Adverse Event (AE) | The occurrence of the following events will be monitored: growth of the eyelashes (hypertrichosis), changes iris colour, corneal epitheliopathy, allergic conjunctivitis, increase of central corneal thickness, non-serious and serious adverse event occurrence. | 3 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Latanoprost, Intraocular pressure, Dorzolamide