Trial Review

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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/ct2/show/NCT05200624




Registration number
NCT05200624
Ethics application status
Date submitted
9/12/2021
Date registered
21/01/2022
Date last updated
27/03/2023

Titles & IDs
Public title
Subthreshold Laser Treatment in Intermediate Age-related Macular Degeneration With Nascent Geographic Atrophy Study
Scientific title
Subthreshold Laser Treatment in Intermediate Age-related Macular Degeneration With Nascent Geographic Atrophy Study
Secondary ID [1] 0 0
LIANA
Universal Trial Number (UTN)
Trial acronym
LIANA
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Age-Related Macular Degeneration 0 0
Condition category
Condition code
Eye 0 0 0 0
Diseases / disorders of the eye
Other 0 0 0 0
Research that is not of generic health relevance and not applicable to specific health categories listed above

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Devices - 2RT subthreshold nanosecond laser

Active Comparator: Active laser - Application of the active 2RT sub threshold laser

Sham Comparator: Sham laser - Application of sham laser (i.e. flashing lights which replicate the look of active laser to the participant)


Treatment: Devices: 2RT subthreshold nanosecond laser
The 2RT™ Q-switched YAG laser (532nm) delivering 3 nanosecond pulses; 400 um spot size, is a pulsed subthreshold nanosecond (SNL) laser, which uses low energy levels to produce limited effects that selectively target melanosomes within the pigmented retinal pigment epithelial (RPE) cells.
Intervention code [1] 0 0
Treatment: Devices
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Rate of progression to advanced AMD in study eyes
Timepoint [1] 0 0
12 months
Secondary outcome [1] 0 0
Rate of retinal sensitivity change in study eyes
Timepoint [1] 0 0
12 months

Eligibility
Key inclusion criteria
1. Age 50 years or older at time of consent

2. Best corrected visual acuity (BCVA) of 59 letters (Snellen equivalent of 6/19) or
better in both eyes

3. Bilateral large (>125µm) drusen as seen on colour fundus photographs (CFP) as assessed
within a circle with radius of 3000µm centred on the fovea

4. Between 1 to 5 (inclusive) discrete area/s of nascent geographic atrophy (nGA) as seen
on SD-OCT B-scan/s within a 20°x20° volume scan centred on the fovea in the study eye
NOTE: The non-study eye may have no nGA or any number of nGA lesions but not cRORA (on
B-scan) or GA (on CFP).

5. Ability, willingness and sufficient cognitive awareness to consent to the trial,
received randomized SNL treatment or sham procedure, and complete all visits as per
the study schedule
Minimum age
50 Years
Maximum age
No limit
Sex
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
1. A cluster of definitely present reticular pseudodrusen (RPD) of >1 disc area (DA) as
seen on infrared (IR) imaging, or fundus autofluorescence (FAF) within a 20°x20° field
centred on the fovea

2. Any evidence of definite geographic atrophy (GA)

3. Any evidence of OCT-atrophy greater than nGA i.e. complete RPE and outer retinal
atrophy (cRORA) as determined on a SD-OCT 20°x20° volume scan centred on the fovea

4. Any evidence of active, regressed or treated macular neovascularization (MNV), in
either eye, or active peripapillary CNV in the study eye (determined on multi-modal
imaging and a fundus fluorescein angiogram is only required if in the investigator's
medical judgement) NB: Subretinal fluid (SRF) <100µm or SRF associated with a
subfoveal pseudovitelliform lesion permitted (i.e. slither/draping/ vitelliform with
no evidence of new vessels on OCT-A) is not considered MNV and can be enrolled.

5. A subfoveal pigment epithelial detachment (PED)/drusenoid detachment >1000µm in
diameter (measured on the central B-scan) with hyperreflective foci (HRF) and
increased choroidal transmission or any PED >2000µm measured at the central foveal
B-scan

6. Any other investigational treatment for AMD, excluding dietary supplements, received
in the past 12 months or thought, in the opinion of the investigator, likely to
chronically change the course of the subject's retinal disease

7. Current participation in any other investigational ophthalmological clinical trial

8. Any ocular disease in the study eye, other than AMD, which in the opinion of the
investigator may significantly compromise assessment of the retina, or which would
compromise the ability to assess any effect following SNL treatment including, but not
limited to:

1. Diabetic retinopathy (unless limited to fewer than 10 microaneurysms and/or small
retinal hemorrhages, without retinal thickening on OCT)

2. Macular pathology or pigmentary abnormalities atypical of AMD, including but not
limited to: pattern dystrophy, myopic maculopathy, angioid streaks, resumed
ocular histoplasmosis syndrome, central serous choroidopathy,
visually-significant epiretinal membranes, macular hole or pseudohole

3. Optic nerve pathology, including optic atrophy, history of optic neuropathy

4. Myopic crescent wider than 50% of the longest diameter of the optic disc, or
closer than 1500 µm to the fovea

5. Retinal vascular diseases including branch or central vein or artery occlusion

6. Choroidal nevus within 2 disc diameters (DD) of the fovea associated with
depigmentation or overlying drusen, if these drusen are used to determine
eligibility

7. Active uveitis or ocular inflammation

9. History or presence of uncontrolled glaucoma

10. Intraocular pressure which would preclude safe dilation of the pupil to allow adequate
assessment and application of SNL treatment

11. History of prior laser surgery to the retina including subthreshold laser (focal
retinopexy for a peripheral break and/or focal retinal tears performed more than 90
days prior to the entry into the study is permitted)

12. Significant cataract or other ocular media which, in the opinion of the investigator,
significantly limits the visual acuity or view of the retina

13. Previous retinal or ocular surgery, the effects of which may now or in the future
complicate assessment of the progression of AMD. (Cataract surgery is allowed as long
as it was performed over 90 days prior to entry into the study)

14. Known hypersensitivity to fluorescein

15. Sensitivity to application of a contact lens

16. Corneal pathology precluding visualization of fundus or increasing the risk of using a
contact lens, such as corneal dystrophy, recurrent corneal erosion syndrome or
sensitivity to the application of a contact lens.

17. Use of any systemic or ocular medication known to be toxic to the retina, excluding
tamoxifen unless there is evidence of toxicity.

18. Pregnant or lactating women

19. Subject who is considered ineligible for this study in the investigator's medical
judgment

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Blinded (masking used)
Who is / are masked / blinded?
The people receiving the treatment/s

The people assessing the outcomes
Intervention assignment
Parallel
Other design features
Phase
Not Applicable
Type of endpoint/s
Statistical methods / analysis

Recruitment
Recruitment status
Recruiting
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
13/12/2021
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
31/12/2024
Actual
Sample size
Target
60
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
VIC
Recruitment hospital [1] 0 0
Centre for Eye Research Australia - East Melbourne
Recruitment postcode(s) [1] 0 0
3002 - East Melbourne

Funding & Sponsors
Primary sponsor type
Other
Name
Center for Eye Research Australia
Address
Country
Other collaborator category [1] 0 0
Commercial sector/Industry
Name [1] 0 0
AlphaRET Pty Ltd.
Address [1] 0 0
Country [1] 0 0

Ethics approval
Ethics application status

Summary
Brief summary
This study is a prospective, single centre, randomized, sham-controlled, double-masked,
clinical trial which aims to investigate the effect of subthreshold nanosecond laser on
disease progression in eyes with intermediate age-related macular degeneration (AMD) and
nascent geographic atrophy by functional and anatomical outcomes.

The study population will be individuals with high-risk intermediate age-related macular
degeneration who meet all eligibility criteria. 60 subjects total (30 randomized to receive
subthreshold nanosecond laser (SNL) treatment and 30 to receive sham treatment as per the 1:1
randomization).

The study has a 12-month study period with four scheduled visits: screening, randomisation
(first treatment), 6-month follow up visit (with second treatment where eligible), 12-month
follow-up.

The primary outcome is the proportion of laser-treated study eyes that develop late AMD
compared to sham-treated study eyes over 12 months. The key secondary outcome is the change
in retinal function of laser-treated study eyes compared to sham-treated study eyes over 12
months. Safety will be the proportion of laser-treated eyes that lose 10+ letters of vision
(measured on a standard vision chart) compared to sham-treated eyes over 12 months.
Trial website
https://clinicaltrials.gov/ct2/show/NCT05200624
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 0 0
Robyn H Guymer, MBBS FRANZCO
Address 0 0
Centre for Eye Research Australia
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Carly Parfett
Address 0 0
Country 0 0
Phone 0 0
+61399298263
Fax 0 0
Email 0 0
cera-rgo@cera.org.au
Contact person for scientific queries



Summary Results

For IPD and results data, please see https://clinicaltrials.gov/ct2/show/NCT05200624