Health Condition 1: H30-H36- Disorders of choroid and retina Health Condition 2: H302- Posterior cyclitis
Conditions
Interventions
Intervention1: Methotrexate: 400 µg methotrexate in 0.1 ml intravitreal,one dose at first visit followed by repeated dose every 4 weeks if required(based on OCT findings). Follow up upto 6 months.
I
Sponsors
Johns Hopkins University Bloomberg School of Public Health
National Eye Institute National Institutes of Health
Eligibility
Inclusion criteria
Inclusion criteria: 1. 18 years of age or older; Eye level inclusion criteria - at least one eye must meet all of the following conditions 2. Inactive or minimally active non-infectious anterior, intermediate, posterior or panuveitis, as defined by SUN132 criteria as 3. Macular edema (ME) defined as the presence of macular thickness greater than the normal range for the OCT machine being used (see cut points below), regardless of the presence of cysts, following most recent intravitreal corticosteroid injection (>= 4 weeks following intravitreal triamcinolone injection or >= 12 weeks following intravitreal dexamethasone implant injection); Greater than 300 μm for Zeiss Cirrus Greater than 320 μm for Heidelberg Spectralis Greater than 300 μm for Topcon 3DOCT 4. Baseline fluorescein angiogram that, as assessed by the study ophthalmologist, is gradable for degree of leakage in the central subfield 5. Best corrected visual acuity (BCVA) 5/200 or better 6. Baseline intraocular pressure > 5 mm Hg and 7. Media clarity and pupillary dilation sufficient to allow OCT testing and assessment of the fundus.
Exclusion criteria
Exclusion criteria: 1. History of infectious uveitis in either eye 2. History of infectious scleritis of any type in either eye (Note: History of noninfectious scleritis that has been active in past 12 months is an eye-level exclusion â??see #13 below) 3. History of keratitis (with the exception of keratitis due to dry eye) in either eye 4. History of central serous retinopathy in either eye 5. Active infectious conjunctivitis in either eye; 6. Oral prednisone dose > 10 mg per day (or of an alternative corticosteroid at a dose higher than that equipotent to prednisone 10 mg per day) OR oral prednisone dose 7. Systemic immunosuppressive drug therapy that has not been stable for at least 4 weeks (note: use of systemic methotrexate is acceptable as long as regimen has been stable for at least 4 weeks) 8. Use of oral acetazolamide or other systemic carbonic anhydrase inhibitor at baseline 9. Known allergy or hypersensitivity to any component of the study drugs; 10. For women of childbearing potential: pregnancy, breastfeeding, or a positive pregnancy test unwilling to practice an adequate birth control method (abstinence, combination barrier and spermicide, or hormonal) for duration of trial Eye level exclusion criteria - at least one eye that meets all inclusion criteria cannot have any of the following conditions 11. History of infectious endophthalmitis 12. History of severe glaucoma as defined by optic nerve damage (cup/disc ratio of >= 0.9 or any notching of optic nerve to the rim); 13. History of active noninfectious scleritis in past 12 months (Note: History of noninfectious scleritis is acceptable if the last episode of active scleritis resolved at least 12 months prior to enrollment); 14. Presence of an epiretinal membrane noted clinically or by OCT that per the judgment of study ophthalmologist may be significant enough to limit improvement of ME (i.e., causing substantial wrinkling of the retinal surface) 15. Torn or ruptured posterior lens capsule 16. Presence of silicone oil; 17. Ozurdex administered in past 12 weeks 18. Anti-VEGF agent, intravitreal methotrexate, or intravitreal/periocular corticosteroid administered in past 4 weeks 19. Fluocinolone acetonide implant (Retisert) placed in past 3 years.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary outcome is the percent change in central subfield thickness from the baseline OCT measurement at the 12-week visit.Timepoint: 12 weeks | — |
Secondary
| Measure | Time frame |
|---|---|
| Rate of IOP elevation of 21 mm Hg or â?¥ 10 mm Hg from baseline change in macular thickness as measured by OCT. Proportion of eyes with macular edema events Mean change in BCVA using ETDRS visual acuity charts Inflammation as graded using the scales used in the MUST Trial. Safety outcomes Cost-effectiveness of treatments for uveitic macular edema Visual function related quality of life as measured by the NEI Visual Function Questionnaire.Timepoint: 24 weeks | — |
Countries
Australia, Canada, India, United Kingdom, United States of America
Contacts
Public ContactDr Sudha Ganesh
Sankara Nethralaya
Outcome results
None listed