Clinical trial NCT00709657: The Effect of a Single Intravitreal Anti-VEGF Therapy on Optic Nerve Head Perfusion
Official title: The Effect of a Single Intravitreal Anti-VEGF Therapy on Optic Nerve Head Perfusion
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: NA
Conditions: Macular Degeneration
Regional Blood Flow
Vascular Endothelial Growth Factor
Keywords: Age-related macular degeneration
anti-VEGF
Lead sponsor: Medical University of Vienna
Sponsor class: OTHER
First posted: 2008-07-03
Enrollment: 8
Sex: ALL
Minimum age (years): 50
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: SINGLE_GROUP
Primary purpose: BASIC_SCIENCE

Brief summary: Age related macula degeneration is one of the most common sight threatening diseases of the elderly. The so called wet form of AMD is caused by choroidal neovascularisation (CNV) of pathological vessels, which lead to leakage, bleeding and macular edema. Several lines of evidence suggest that vascular endothelial growth factor (VEGF) plays a key role in the induction CNV. Recent evidence indicates that overexpression of VEGF in the retinal pigment epithelium may lead to the development of CNV in experimental models, and intravitreal injection of a VEGF blocker prevents the development of experimental CNV. This hypothesis is also supported by the promising effects of anti-VEGF treatment in patients with choroidal neovascularisation. The substances currently in clinical use include ranibizumab (Lucentis®), bevacizumab (Avastin®) and pegaptanib (Macugen®).

However, from a physiological point of view, VEGF also serves as a survival factor for existing vessels and for neuronal cells. Moreover, it has been reported that VEGF induces vasodilatation, most probably by an increased production of nitric oxide. Accordingly one may hypothesize that anti-VEGF treatment is associated with ocular vasoconstriction with unknown long term results. Thus, in the current study, the investigators set out to investigate whether the ocular perfusion is affected by a single intravitreal anti-VEGF.


Eligibility criteria: Inclusion Criteria:

* 40 subjects ≥ 50 years of age
* Subjects with all angiographic subtypes of neovascular wet AMD, already scheduled for intravitreal anti-VEGF therapy in one eye
* Good central or eccentric fixation

Exclusion Criteria:

* History or previous Anti-VEGF therapy
* History or previous intravitreal injection with any drug
* Intraocular pressure ≥ 25
* Glaucoma
* History or presence of thromboembolic events
* Diabetes mellitus
* Blood donation during the previous 3 weeks
* Ametropy ≥ 6 dpt

Primary outcomes:
measure: Optic nerve head blood flow
timeFrame: before, one week after and three weeks after intravitreal injection with an anti-VEGF drug
Secondary outcomes:
measure: Choroidal blood flow
timeFrame: before, one week after and three weeks after intravitreal injection with an anti-VEGF drug
measure: Retrobulbar blood flow
timeFrame: before, one week after and three weeks after intravitreal injection with an anti-VEGF drug
measure: Intraocular pressure
timeFrame: before, one week after and three weeks after intravitreal injection with an anti-VEGF drug
measure: Systemic blood pressure
timeFrame: before, one week after and three weeks after intravitreal injection with an anti-VEGF drug
Other outcomes:
Locations:
city: Vienna
country: Austria
facility: Department of Clinical Pharmacology, Medical University of Vienna
Study officials:
affiliation: Depatement of Clinical Pharmacology, Medical University of Vienna
name: Gerhard Garhöfer, MD
role: PRINCIPAL_INVESTIGATOR
References: