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出境医 / 临床实验 / Evaluating the Safety of the SPECTRALIS CENTAURUS Device (CENTAURUS)

Evaluating the Safety of the SPECTRALIS CENTAURUS Device (CENTAURUS)

Study Description
Brief Summary:
The objective of this clinical trial is to evaluate the safety of the SPECTRALIS CENTAURUS device (HuCE-optoLab, BFH TI, Biel, CH) in a clinical setting on patients with retinal diseases.

Condition or disease Intervention/treatment Phase
Retinal Diseases Device: Selective retina therapy SPECTRALIS CENTAURUS device Early Phase 1

Detailed Description:

Optical microsurgery of the retinal pigment epithelium (RPE) requires reliable real-time dosimetry to prevent unwanted overexposure of the neuroretina. The SPECTRALIS CENTAURUS device implements optical coherence tomography (OCT) to detect intentional elimination of RPE cells caused by a prototype laser for selective retina therapy (SRT).

Within this clinical trial the safety of the SPECTRALIS CENTAURUS device and its ability to detect RPE cell damage towards selective real-time laser microsurgery will be evaluated.

Study Design
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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 30 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Open Label Early Feasibility Study Evaluating the Safety of the SPECTRALIS CENTAURUS Device for Dosimetry of Selective Retina Therapy With Optical Coherence Tomography
Estimated Study Start Date : September 2021
Estimated Primary Completion Date : July 2023
Estimated Study Completion Date : July 2023
Arms and Interventions
Arm Intervention/treatment
Experimental: Treatment with the SPECTRALIS CENTAURUS device

In Stage 1, two laser pattern will be applied in areas of the retina that require ablative laser photocoagulation.

In Stage 2, a laser pattern will be applied along and on the outside of the arcades. Furthermore, a treatment pattern will be applied to an area temporal to the fovea affected by intermediary age-related macular degeneration (AMD) and confluent soft drusen.

Device: Selective retina therapy SPECTRALIS CENTAURUS device
Microsecond laser microsurgery by using the SPECTRALIS CENTAURUS device

Outcome Measures
Primary Outcome Measures :
  1. Safety SPECTRALIS CENTAURUS - AEs [ Time Frame: 26 weeks ]

    The primary objective of this study is to assess the safety of the SPECTRALIS CENTAURUS device in clinical use by the evaluation of any adverse events (AEs) that may be related to the study device or the study intervention, including device deficiencies (DDs)

    The following potential AEs are evaluated throughout the study regarding the laser treatment:

    • Decrease in visual acuity
    • Choroidal neovascularization at treatment location (laser lesion)
    • Transient increased edema / decreased vision
    • Development or worsening of macular edema
    • Bruch's membrane rupture
    • Retinal and choroidal haemorrhage
    • Inadvertent foveal burns

  2. Safety SPECTRALIS CENTAURUS - DDs [ Time Frame: At treatment (baseline) ]

    In addition to the AEs, the following potential device deficiencies (DDs) can be listed in relation to the treatment and the SPECTRALIS CENTAURUS device:

    • Unintentional laser delivery
    • Unintentional OCT (M-scan) failure during the treatment
    • Unintentional scanning laser ophthalmoscope (SLO) failure during the treatment
    • Unintentional treatment software failure during the treatment
    • Unintentional treatment laser failure during the treatment
    • Basic system failure during the treatment

    Beside the DDs mentioned above, additional sub-criteria are assessed by default in advance to the treatment visit according to an acceptance test protocol (ATP). The ATP establishes the acceptance test framework for the SPECTRALIS CENTAURUS and describes the scope of the work performed and the approach taken to validate that the system performs as required. An acceptance test is carried out on each day on which a patient is to be treated.



Secondary Outcome Measures :
  1. Evaluation of OCT for SRT dosimetry [ Time Frame: At treatment (baseline) ]
    During treatment, OCT M-scans are recorded collinear to the treatment laser application. Post-treatment, all lesions are examined by fluorescein angiography (FA) for RPE cell damage. In addition, the OCT-M scan data is examined for fringe washouts (signal washouts) that occur with RPE cell damage. An analysis of these data (RPE cell damage vs. OCT fringe washouts) will reveal whether OCT is suitable for real-time dosimetry of SRT.

  2. Progression of AMD after laser treatment according to best-corrected visual acuity (BCVA) [ Time Frame: At treatment (baseline) and after 1, 4, 12 and 26 weeks ]
    Course of disease monitoring on AMD and confluent soft drusen with BCVA: Visual acuity is assessed using the Early Treatment Diabetic Retinopathy Study (ETDRS) chart (consisting of rows of letters) / LogMAR chart (Logarithm of the Minimum Angle of Resolution), after appropriate refraction. Visual acuity represents the basic and most clinically relevant functional test to evaluate of central visual acuity.

  3. Progression of AMD after laser treatment according to OCT imaging [ Time Frame: At treatment (baseline) and after 1, 4, 12 and 26 weeks ]
    Course of disease monitoring on intermediary AMD and confluent soft drusen with OCT: OCT provides non-invasive morphological assessment of the retinal layers including the RPE and the choroid. It is a commonly used objective method during clinical assessment. OCT allows to identify structural changes such as Bruch's membrane ruptures, choroidal neovascularizations (CNV) with exudative macular edema, photoreceptor damage and drusen evolution. A macular volume OCT scan centered at the fovea will be acquired routinely. Additionally, volume OCT scans across the laser area will be acquired. This allows, for example, that a change in retinal thickness (μm) can be observed in the short term as well as in the long term. No single endpoint is given for this examination. However, experience shows that CNV would be the most likely case which can be expected with this laser treatment.

  4. Progression of AMD after laser treatment according to FA imaging [ Time Frame: At treatment (baseline) and after 12 weeks ]
    Course of disease monitoring on intermediary AMD and confluent soft drusen with FA: Fluorescein is injected intravenously before serial fundus image are taken after excitation of the fluorescein dye. No single endpoint is given for this examination. However, experience shows that CNV and subtle laser scars would be the most likely cases which can be expected with this laser treatment.

  5. Progression of AMD after laser treatment according to color fundus photography (CFP) [ Time Frame: At treatment (baseline) and after 1, 4, 12 and 26 weeks ]
    Course of disease monitoring on intermediary AMD and confluent soft drusen with CFP: CFP will be used to document and monitor pigmentary changes of the fundus and potential formation of scars after laser application. Since it is difficult to quantify fundus image changes, the principal investigator as well as a safety committee will evaluate fundus changes on an individual basis, taking into account the location and laser parameters used in the participant.


Eligibility Criteria
Layout table for eligibility information
Ages Eligible for Study:   18 Years to 95 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Written Informed Consent
  • For Stage 1, any patient aged >18 years with the need for conventional laser retina ablation
  • For Stage 2, will be restricted to people aged 50 to <95 years with lesion characteristics that meet the criteria for intermediate AMD

Exclusion Criteria:

  • Presence of reticular pseudodrusen
  • Any manifestation of late-stage AMD
  • Known hypersensitivity or allergy to fluorescein or uncontrolled hypertension
  • Concomitant systemic corticosteroid treatment for continuous period longer than 2 weeks
  • History of any vitreous haemorrhage within 4 weeks prior to screening or current haemorrhage in the study eye
  • Inability to obtain fundus photographs or fluorescein angiogram of sufficient quality
  • Photosensitive epilepsy
  • Insufficient retinal pigmentation (albinism)
  • Corneal opacity / lens opacity
  • Women of child-bearing potential
  • Contralateral eye is at an advanced stage of disease and has poor visual acuity
  • Inability to follow the procedures of the study
  • Participation in another study with investigational drug within the 30 days preceding and during the present study - Inability or lack of willingness to commit to return for all clinical visits and complete all study-related procedures
Contacts and Locations

Contacts
Layout table for location contacts
Contact: Sebastian Wolf, MD PhD +41 (0)31 632 85 03 sebastian.wolf@insel.ch
Contact: Chantal Dysli, MD PhD +41 (0)31 632 25 01 chantal.dysli@insel.ch

Locations
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Switzerland
University Hospital Inselspital Recruiting
Bern, Switzerland, 3010
Contact: Chantal Dysli, PhD Dr. med.         
Sponsors and Collaborators
University Hospital Inselspital, Berne
Bern University of Applied Sciences
Investigators
Layout table for investigator information
Principal Investigator: Chantal Dysli, MD PhD University of Bern
Tracking Information
First Submitted Date  ICMJE April 26, 2021
First Posted Date  ICMJE July 20, 2021
Last Update Posted Date September 16, 2021
Estimated Study Start Date  ICMJE September 2021
Estimated Primary Completion Date July 2023   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: July 8, 2021)
  • Safety SPECTRALIS CENTAURUS - AEs [ Time Frame: 26 weeks ]
    The primary objective of this study is to assess the safety of the SPECTRALIS CENTAURUS device in clinical use by the evaluation of any adverse events (AEs) that may be related to the study device or the study intervention, including device deficiencies (DDs) The following potential AEs are evaluated throughout the study regarding the laser treatment:
    • Decrease in visual acuity
    • Choroidal neovascularization at treatment location (laser lesion)
    • Transient increased edema / decreased vision
    • Development or worsening of macular edema
    • Bruch's membrane rupture
    • Retinal and choroidal haemorrhage
    • Inadvertent foveal burns
  • Safety SPECTRALIS CENTAURUS - DDs [ Time Frame: At treatment (baseline) ]
    In addition to the AEs, the following potential device deficiencies (DDs) can be listed in relation to the treatment and the SPECTRALIS CENTAURUS device:
    • Unintentional laser delivery
    • Unintentional OCT (M-scan) failure during the treatment
    • Unintentional scanning laser ophthalmoscope (SLO) failure during the treatment
    • Unintentional treatment software failure during the treatment
    • Unintentional treatment laser failure during the treatment
    • Basic system failure during the treatment
    Beside the DDs mentioned above, additional sub-criteria are assessed by default in advance to the treatment visit according to an acceptance test protocol (ATP). The ATP establishes the acceptance test framework for the SPECTRALIS CENTAURUS and describes the scope of the work performed and the approach taken to validate that the system performs as required. An acceptance test is carried out on each day on which a patient is to be treated.
Original Primary Outcome Measures  ICMJE Same as current
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: July 8, 2021)
  • Evaluation of OCT for SRT dosimetry [ Time Frame: At treatment (baseline) ]
    During treatment, OCT M-scans are recorded collinear to the treatment laser application. Post-treatment, all lesions are examined by fluorescein angiography (FA) for RPE cell damage. In addition, the OCT-M scan data is examined for fringe washouts (signal washouts) that occur with RPE cell damage. An analysis of these data (RPE cell damage vs. OCT fringe washouts) will reveal whether OCT is suitable for real-time dosimetry of SRT.
  • Progression of AMD after laser treatment according to best-corrected visual acuity (BCVA) [ Time Frame: At treatment (baseline) and after 1, 4, 12 and 26 weeks ]
    Course of disease monitoring on AMD and confluent soft drusen with BCVA: Visual acuity is assessed using the Early Treatment Diabetic Retinopathy Study (ETDRS) chart (consisting of rows of letters) / LogMAR chart (Logarithm of the Minimum Angle of Resolution), after appropriate refraction. Visual acuity represents the basic and most clinically relevant functional test to evaluate of central visual acuity.
  • Progression of AMD after laser treatment according to OCT imaging [ Time Frame: At treatment (baseline) and after 1, 4, 12 and 26 weeks ]
    Course of disease monitoring on intermediary AMD and confluent soft drusen with OCT: OCT provides non-invasive morphological assessment of the retinal layers including the RPE and the choroid. It is a commonly used objective method during clinical assessment. OCT allows to identify structural changes such as Bruch's membrane ruptures, choroidal neovascularizations (CNV) with exudative macular edema, photoreceptor damage and drusen evolution. A macular volume OCT scan centered at the fovea will be acquired routinely. Additionally, volume OCT scans across the laser area will be acquired. This allows, for example, that a change in retinal thickness (μm) can be observed in the short term as well as in the long term. No single endpoint is given for this examination. However, experience shows that CNV would be the most likely case which can be expected with this laser treatment.
  • Progression of AMD after laser treatment according to FA imaging [ Time Frame: At treatment (baseline) and after 12 weeks ]
    Course of disease monitoring on intermediary AMD and confluent soft drusen with FA: Fluorescein is injected intravenously before serial fundus image are taken after excitation of the fluorescein dye. No single endpoint is given for this examination. However, experience shows that CNV and subtle laser scars would be the most likely cases which can be expected with this laser treatment.
  • Progression of AMD after laser treatment according to color fundus photography (CFP) [ Time Frame: At treatment (baseline) and after 1, 4, 12 and 26 weeks ]
    Course of disease monitoring on intermediary AMD and confluent soft drusen with CFP: CFP will be used to document and monitor pigmentary changes of the fundus and potential formation of scars after laser application. Since it is difficult to quantify fundus image changes, the principal investigator as well as a safety committee will evaluate fundus changes on an individual basis, taking into account the location and laser parameters used in the participant.
Original Secondary Outcome Measures  ICMJE Same as current
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Evaluating the Safety of the SPECTRALIS CENTAURUS Device
Official Title  ICMJE Open Label Early Feasibility Study Evaluating the Safety of the SPECTRALIS CENTAURUS Device for Dosimetry of Selective Retina Therapy With Optical Coherence Tomography
Brief Summary The objective of this clinical trial is to evaluate the safety of the SPECTRALIS CENTAURUS device (HuCE-optoLab, BFH TI, Biel, CH) in a clinical setting on patients with retinal diseases.
Detailed Description

Optical microsurgery of the retinal pigment epithelium (RPE) requires reliable real-time dosimetry to prevent unwanted overexposure of the neuroretina. The SPECTRALIS CENTAURUS device implements optical coherence tomography (OCT) to detect intentional elimination of RPE cells caused by a prototype laser for selective retina therapy (SRT).

Within this clinical trial the safety of the SPECTRALIS CENTAURUS device and its ability to detect RPE cell damage towards selective real-time laser microsurgery will be evaluated.

Study Type  ICMJE Interventional
Study Phase  ICMJE Early Phase 1
Study Design  ICMJE Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE Retinal Diseases
Intervention  ICMJE Device: Selective retina therapy SPECTRALIS CENTAURUS device
Microsecond laser microsurgery by using the SPECTRALIS CENTAURUS device
Study Arms  ICMJE Experimental: Treatment with the SPECTRALIS CENTAURUS device

In Stage 1, two laser pattern will be applied in areas of the retina that require ablative laser photocoagulation.

In Stage 2, a laser pattern will be applied along and on the outside of the arcades. Furthermore, a treatment pattern will be applied to an area temporal to the fovea affected by intermediary age-related macular degeneration (AMD) and confluent soft drusen.

Intervention: Device: Selective retina therapy SPECTRALIS CENTAURUS device
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Recruiting
Estimated Enrollment  ICMJE
 (submitted: July 8, 2021)
30
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE July 2023
Estimated Primary Completion Date July 2023   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  • Written Informed Consent
  • For Stage 1, any patient aged >18 years with the need for conventional laser retina ablation
  • For Stage 2, will be restricted to people aged 50 to <95 years with lesion characteristics that meet the criteria for intermediate AMD

Exclusion Criteria:

  • Presence of reticular pseudodrusen
  • Any manifestation of late-stage AMD
  • Known hypersensitivity or allergy to fluorescein or uncontrolled hypertension
  • Concomitant systemic corticosteroid treatment for continuous period longer than 2 weeks
  • History of any vitreous haemorrhage within 4 weeks prior to screening or current haemorrhage in the study eye
  • Inability to obtain fundus photographs or fluorescein angiogram of sufficient quality
  • Photosensitive epilepsy
  • Insufficient retinal pigmentation (albinism)
  • Corneal opacity / lens opacity
  • Women of child-bearing potential
  • Contralateral eye is at an advanced stage of disease and has poor visual acuity
  • Inability to follow the procedures of the study
  • Participation in another study with investigational drug within the 30 days preceding and during the present study - Inability or lack of willingness to commit to return for all clinical visits and complete all study-related procedures
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years to 95 Years   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE
Contact: Sebastian Wolf, MD PhD +41 (0)31 632 85 03 sebastian.wolf@insel.ch
Contact: Chantal Dysli, MD PhD +41 (0)31 632 25 01 chantal.dysli@insel.ch
Listed Location Countries  ICMJE Switzerland
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT04968756
Other Study ID Numbers  ICMJE CENTAURUS
Has Data Monitoring Committee Yes
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE
Plan to Share IPD: No
Responsible Party University Hospital Inselspital, Berne
Study Sponsor  ICMJE University Hospital Inselspital, Berne
Collaborators  ICMJE Bern University of Applied Sciences
Investigators  ICMJE
Principal Investigator: Chantal Dysli, MD PhD University of Bern
PRS Account University Hospital Inselspital, Berne
Verification Date September 2021

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP