Clinical trial NCT06881771: FECD-TRACE: Fuchs' Endothelial Corneal Dystrophy TRAjectory and Correlation With Genotype in the United Kingdom
Official title: Investigating Genetic Causes and Molecular Mechanisms Responsible for Inherited Corneal Disease
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Fuchs Dystrophy
Fuchs' Endothelial Dystrophy
Fuchs' Endothelial Corneal Dystrophy of Bilateral Eyes
Corneal Dystrophy Fuchs
Corneal Dystrophy
Keywords: Fuchs' Corneal Endothelial Dystrophy
FECD
Corneal Dystrophies
Corneal Endothelial Dystrophy
Lead sponsor: University College, London
Sponsor class: OTHER
First posted: 2025-03-18
Enrollment: 500
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Participants meeting the recruitment criteria across multiple sites will be enrolled

Brief summary: FECD-TRACE is an integral component of a large research program dedicated to Fuchs Endothelial Corneal Dystrophy (FECD) in the United Kingdom. This longitudinal, observational study aims to comprehensively characterize a cohort of younger research participants who have a genetic predisposition to developing FECD. By utilizing advanced anterior segment imaging techniques, the study will monitor these individuals over a span of several years, capturing phenotypic changes that reflect the progression of the disease. Concurrently, genetic biomarkers will be examined to establish correlations with the observed phenotypic changes. The primary objective of FECD-TRACE is to enhance our understanding of the intricate genetic mechanisms underlying FECD and establish connections between these genetic findings and clinical outcomes. Ultimately, this research strives to facilitate the development of personalized care approaches for individuals affected by FECD.

Detailed description: FECD is the most prevalent repeat expansion disease in humans. Clinical anticipation and intergenerational expansion of disease-associated repeats are features of other repeat expansion diseases, but this area has not been comprehensively addressed in FECD. Due to its insidious onset and slow disease progression, early diagnosis of FECD in pre-symptomatic patients is challenging.

To gain insights into the variable penetrance of FECD and to identify early signs of the disease in genetically predisposed but asymptomatic individuals (i.e., a pre-symptomatic cohort), we aim to recruit biological relatives of FECD patients receiving care at study sites, as well as individuals with early-stage disease. By combining genotyping and clinical phenotyping, we seek to elucidate the underlying factors influencing disease manifestation.

Our deep phenotyping approach encompasses an array of advanced imaging techniques such as visual acuity assessment, contrast sensitivity evaluation, slit-lamp photography, specular microscopy, Scheimpflug tomography, and anterior segment optical coherence tomography. These cutting-edge modalities enable the detection of subclinical corneal edema by revealing subtle changes in corneal shape, volume, and reflectivity at a high resolution.

The imaging data obtained from participants will undergo meticulous quantitative analysis, allowing for the classification of anterior segment features and extraction of image-derived phenotypes. To capture the dynamic nature of FECD, eligible participants will be invited for follow-up examinations, facilitating a longitudinal assessment of disease progression.

Eligibility criteria: Inclusion Criteria:

* Willing and able to provide informed consent for participation in the study
* Willing to attend scheduled study visits and undergo a clinical examination
* Willing to donate blood/saliva samples
* Fulfil the abovementioned cohort criteria

Exclusion Criteria:

* Presence of a secondary cause for corneal endothelial dysfunction or oedema
* Presence of clinically evident corneal oedema
* History of concurrent corneal diseases
* History of corneal surgeries, including corneal transplantation
* Cognitive impairment or inability to provide informed consent for participation in the study

Primary outcomes:
measure: Endothelial cell density measurement (cells/mm2)
timeFrame: Baseline
measure: CTG18.1 allele length (in number)
timeFrame: Baseline
measure: Detection of guttata (cells/mm2)
timeFrame: Baseline
measure: Corneal thickness (in micrometers)
timeFrame: Baseline
measure: Documentation of early corneal guttata development (Binary)
timeFrame: Baseline
measure: Best-corrected visual acuity in LogMAR scale
timeFrame: Baseline
measure: Corneal nerve density (nerves/mm2)
timeFrame: Baseline
Secondary outcomes:
Other outcomes:
Locations:
city: London
country: United Kingdom
facility: University College London
Study officials:
affiliation: University College, London
name: Alice Davidson, PhD
role: PRINCIPAL_INVESTIGATOR
References: