Diabetic Macular Edema
Conditions
Keywords
Diabetic Macular Edema, Microglia, Dextromethorphan
Brief summary
Background: Many people with diabetes have macular edema (swelling) at the back of the eye. Macular edema can cause loss of vision. Studies suggest that inflammation may be involved in the swelling. A drug called dextromethorphan may help prevent the inflammation and the swelling. Dextromethorphan is approved for use as a cough medicine, but it has not been studied to see if it can help in diabetic macular edema. Objectives: To see if dextromethorphan can help treat diabetic macular edema. Eligibility: Individuals at least 18 years of age who have diabetic macular edema in at least one eye. Design: * This study lasts 2 years, and will require at least 14 visits to the National Eye Institute outpatient clinic. Study visits will be every month for the first 2 months and then every other month. Each visit will take about 2 to 4 hours. * Participants will be screened with a physical exam, medical history, eye exam, and blood tests. One eye with macular edema will be chosen as the study eye for testing. * Participants will take dextromethorphan twice a day, about 12 hours apart, for 2 years. A study diary will help keep track of the date, time, and number of pills taken. * Participants will have study visits once a month for the first 2 months and then every other month for the rest of the study. Each study visit will involve eye exams and blood and urine tests. * Four months after starting the study medication, participants may have laser surgery or other treatments for the macular edema, if it is needed.
Detailed description
Objective: Diabetic retinopathy (DR) is one of the leading causes of blindness in the United States. A frequent manifestation of DR is diabetic macular edema (DME) for which the only proven treatment is laser photocoagulation. In the retina, microglia are capable of migrating through the retina to sites of inflammation to associate closely with neurons and the vasculature, and are key cellular players in the mediation of processes of chronic inflammation implicated in DME. For these reasons, microglia represent a promising cellular target for forms of therapy that limit the deleterious inflammatory changes found in DR. The objective of this study is to investigate the safety and efficacy of dextromethorphan as a microglia inhibitor in participants with DME. Study Population: Eligibility criteria include presence of diabetic retinopathy with retinal thickening due to diabetic macular edema within 3000 μm of the center of the macula as measured by optical coherence tomography (OCT), and visual acuity better than 20/200 in the study eye. Design: Five participants will be initially enrolled in this unmasked pilot study. However, up to an additional three participants may be enrolled to account for participants who withdraw from the study prior to receipt of six months of study treatment. Participants will take an oral dose of 60 mg of dextromethorphan twice daily for 24 months. During each visit, participants will have their visual acuity measured and will undergo OCT testing to measure retinal thickness. Beginning at the Month 4 visit, participants will be assessed for worsening disease defined as loss of ≥ 15 Early Treatment Diabetic Retinopathy Study (ETDRS) letters of vision compared to baseline or a ≥ 50% increase in total central retinal thickness as measured by OCT. Individual participants deemed to have worsening disease may stay on the study and continue to receive study medication, but will be allowed to receive focal laser therapy for any amenable leaking microaneurysms and/or anti-vascular endothelial growth factor (VEGF) intravitreal injections (such as bevacizumab or ranibizumab) at the discretion of the treating physician. Additionally, beginning at the Month 6 visit, participants will be eligible for treatment, with either focal laser or anti-VEGF injections if they have center-involving macular edema. Outcome Measures: The primary outcome is the change in retinal thickness measured by OCT at 6 months compared to baseline. Secondary outcomes include the change in retinal thickness as measured by OCT at 12, 18 and 24 months compared to baseline, change in best-corrected visual acuity (BCVA) at 6, 12, 18 and 24 months compared to baseline, change in mean macular sensitivity as measured by microperimetry at 6, 12, 18 and 24 months compared to baseline, as well as changes in fluid leakage in the macula as demonstrated by fluorescein angiography at 6, 12, 18 and 24 months compared to baseline. Safety outcomes include the number and severity of systemic and ocular toxicities, and adverse events.
Interventions
Participants instructed to take 60 mg dextromethorphan capsules orally two times a day for 24 months.
Sponsors
The Emmes Company, LLC
National Eye Institute (NEI)
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Participant is 18 years of age or older. 2. Participant must understand and sign the protocol's informed consent document. 3. Female participants of childbearing potential must not be pregnant or breast-feeding, must have a negative urine pregnancy test within 24 hours prior to initiation of study medication and must be willing to undergo urine pregnancy tests throughout the study. 4. Female participants of childbearing potential and male participants able to father children must have (or have a partner who has) had a hysterectomy or vasectomy, be completely abstinent from intercourse or must agree to practice two acceptable methods of contraception throughout the course of the study and for one week after study medication discontinuation. Acceptable methods of contraception include: * hormonal contraception (i.e., birth control pills, injected hormones, dermal patch or vaginal ring), * intrauterine device, * barrier methods (diaphragm, condom) with spermicide, or * surgical sterilization (hysterectomy or tubal ligation). 5. Participant must agree to notify the study investigator or coordinator if any of his/her doctors initiate a new medication during the course of this study. 6. Participant must agree not to take medications containing dextromethorphan during the course of this study. 7. Participant must have normal renal function and liver function, or have mild abnormalities no greater than grade 1 as defined by the Common Terminology Criteria for Adverse Events v4.0 (CTCAE). 8. Participant has a diagnosis of diabetic mellitus (type 1 or type 2). Any one of the following will be considered to be sufficient evidence that diabetes is present: * Current regular use of insulin for the treatment of diabetes; * Current regular use of oral anti-hyperglycemia agents for the treatment of diabetes; * Documented diabetes by American Diabetes Association (ADA) and/or World Health Organization (WHO) criteria. 9. Participant has documented hemoglobin A1C 12% or less within one month of baseline. * Participants with elevated hemoglobin A1C but within the 12% or less cutoff will undergo appropriate evaluation, and unstable patients will be excluded according to the investigator's best medical judgment. * Participant agrees to refrain from consuming grapefruit juice, grapefruits and Seville oranges at any time while s/he is enrolled in this study. 10. Participant has at least one eye that meets the study eye criteria listed below.
Exclusion criteria
1. Participant is in another investigational study and actively receiving another study medication for diabetic macular edema (DME). 2. Participant is unable to comply with study procedures or follow-up visits. 3. Participant has a known hypersensitivity to sodium fluorescein dye. 4. Participant has a condition that, in the opinion of the investigator, would preclude participation in the study (e.g., unstable medical status including blood pressure and glycemic control). • Patients in poor glycemic control who, within the last four months, initiated intensive insulin treatment (a pump or multiple daily injections) or plan to do so in the next four months should not be enrolled. 5. Participant has a history of chronic renal failure requiring dialysis or kidney transplant. 6. Participant has a history of hepatitis or liver failure. 7. Participant has an allergy or hypersensitivity to dextromethorphan or levorphanol. 8. Participant is taking or has taken within the last 14 days any medication that could adversely interact with dextromethorphan such as selective serotonin reuptake inhibitors (SSRIs) or monoamine oxidase inhibitors (MAOIs) including but not limited to the following: almotriptan; amitriptyline; amoxapine; bromocriptine; buspirone; cabergoline; citalopram; clomipramine; desipramine; desvenlafaxine; dihydroergotamine; doxepin; duloxetine; eletriptan; ergoloid mesylates; ergotamine; escitalopram; fluoxetine; fluvoxamine; frovatriptan; imipramine; isocarboxazid; linezolid; lithium; maprotiline; meperidine; methylergonovine; milnacipran; mirtazapine; moclobemide; naratriptan; nefazodone; nortriptyline; paroxetine; phenelzine; procarbazine; promethazine; protriptyline; rasagiline; rizatriptan; SAMe (S-adenosylmethionine); selegiline; sertraline; sibutramine; St. Johns wort; sumatriptan; tapentadol; tramadol; tranylcypromine; trazodone; trimipramine; tryptophan; venlafaxine; vilazodone; zolmitriptan. 9. Participant has a blood pressure of \> 180/110 (systolic above 180 OR diastolic above 110). • If blood pressure is brought below 180/110 by anti-hypertensive treatment, a patient can become eligible. 10. Participant has a history of treatment with systemic anti-vascular endothelial growth factor (VEGF) agents or steroids within three months prior to study entry. Study Eye Inclusion Criteria 1. Best-corrected visual acuity (BCVA) Early Treatment Diabetic Retinopathy Study (ETDRS) score of 34 letters or better (i.e., 20/200 or better). 2. Definite retinal thickening due to diabetic macular edema, based on clinical examination, that is not refractory to further therapy as based on the investigator's clinical judgment. 3. Retinal thickening due to DME within 3000 μm of the center of the macula, as measured by Spectral optical coherence tomography (OCT). 4. Media clarity, pupillary dilation and patient cooperation sufficient for adequate fundus photographs. Study Eye
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage Change in Retinal Thickness in the Study Eye at 6 Months Compared to Baseline | Baseline and 6 months | Retinal thickness was assessed by spectral-domain optical coherence tomography (Cirrus HD-OCT; Carl Zeiss Meditec, Dublin, CA), a non-invasive imaging technique that uses long-wavelength light to capture micrometer-resolution cross-sectional images from biological tissue. The participant's eye that met the study eye eligibility criteria was selected as the study eye. For cases in which both eyes met the study eye eligibility criteria, the study eye was selected according to the choice of study eye in cases of bilateral disease selection criteria outlined in the eligibility criteria. The eye not chosen as the study eye is referred to as the fellow eye. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage Change in Retinal Thickness in the Study Eye at 18 Months Compared to Baseline | Baseline and 18 Months | Retinal thickness was assessed by spectral-domain optical coherence tomography (Cirrus HD-OCT; Carl Zeiss Meditec, Dublin, CA), a non-invasive imaging technique that uses long-wavelength light to capture micrometer-resolution cross-sectional images from biological tissue. Changes in OCT will be calculated using the ETDRS grid. Attention will be directed to changes in retinal thickness as measured by OCT in each of the 9 subfields of the grid. |
| Percentage Change in Retinal Thickness in the Study Eye at 24 Months Compared to Baseline | Baseline and 24 Months | Retinal thickness was assessed by spectral-domain optical coherence tomography (Cirrus HD-OCT; Carl Zeiss Meditec, Dublin, CA), a non-invasive imaging technique that uses long-wavelength light to capture micrometer-resolution cross-sectional images from biological tissue. Changes in OCT will be calculated using the ETDRS grid. Attention will be directed to changes in retinal thickness as measured by OCT in each of the 9 subfields of the grid. |
| Change in Best-corrected Visual Acuity (BCVA) in the Study Eye at 6 Months Compared to Baseline | Baseline and 6 Months | Visual acuity was measured using the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol. Acuity is measured as letters read on an ETDRS eye chart and the letters read equate to Snellen measurements. For example, if a participant reads between 84 and 88 letters, the equivalent Snellen measurement is 20/20. |
| Change in Best-corrected Visual Acuity (BCVA) in the Study Eye at 12 Months Compared to Baseline | Baseline and 12 Months | Visual acuity was measured using the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol. Acuity is measured as letters read on an ETDRS eye chart and the letters read equate to Snellen measurements. For example, if a participant reads between 84 and 88 letters, the equivalent Snellen measurement is 20/20. |
| Change in Best-corrected Visual Acuity (BCVA) in the Study Eye at 18 Months Compared to Baseline | Baseline and 18 Months | Visual acuity was measured using the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol. Acuity is measured as letters read on an ETDRS eye chart and the letters read equate to Snellen measurements. For example, if a participant reads between 84 and 88 letters, the equivalent Snellen measurement is 20/20. |
| Change in Best-corrected Visual Acuity (BCVA) in the Study Eye at 24 Months Compared to Baseline | Baseline and 24 Months | Visual acuity was measured using the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol. Acuity is measured as letters read on an ETDRS eye chart and the letters read equate to Snellen measurements. For example, if a participant reads between 84 and 88 letters, the equivalent Snellen measurement is 20/20. |
| Number of Study Eyes Demonstrating a Decrease in the Area of Late Leakage, as Measured by Fluorescein Angiography (FA), at 6 Months Compared to Baseline | Baseline and 6 Months | Fluorescein angiography (FA) images were obtained via a standard digital imaging system (OIS, Sacramento, CA) at baseline and at Month 6, Month 12, Month 18, and Month 24. Three retinal specialists independently graded the area of late fluorescein leakage (at approximately 10 minutes) using a region-of-interest tool in an image analysis software package (NIH ImageJ, Bethesda, MD). |
| Percentage Change in Retinal Thickness in the Study Eye at 12 Months Compared to Baseline | Baseline and 12 Months | Retinal thickness was assessed by spectral-domain optical coherence tomography (Cirrus HD-OCT; Carl Zeiss Meditec, Dublin, CA), a non-invasive imaging technique that uses long-wavelength light to capture micrometer-resolution cross-sectional images from biological tissue. Changes in OCT will be calculated using the ETDRS grid. Attention will be directed to changes in retinal thickness as measured by OCT in each of the 9 subfields of the grid. |
| Number of Study Eyes Demonstrating a Decrease in the Area of Late Leakage, as Measured by Fluorescein Angiography (FA), at 18 Months Compared to Baseline | Baseline and 18 Months | Fluorescein angiography (FA) images were obtained via a standard digital imaging system (OIS, Sacramento, CA) at baseline and at Month 6, Month 12, Month 18, and Month 24. Three retinal specialists independently graded the area of late fluorescein leakage (at approximately 10 minutes) using a region-of-interest tool in an image analysis software package (NIH ImageJ, Bethesda, MD). |
| Number of Study Eyes Demonstrating a Decrease in the Area of Late Leakage, as Measured by Fluorescein Angiography (FA), at 24 Months Compared to Baseline | Baseline and 24 Months | Fluorescein angiography (FA) images were obtained via a standard digital imaging system (OIS, Sacramento, CA) at baseline and at Month 6, Month 12, Month 18, and Month 24. Three retinal specialists independently graded the area of late fluorescein leakage (at approximately 10 minutes) using a region-of-interest tool in an image analysis software package (NIH ImageJ, Bethesda, MD). |
| Changes in Mean Macular Sensitivity in the Study Eye at 6 Months Compared to Baseline | Baseline and 6 Months | Microperimetry was used to assess macular sensitivity. |
| Changes in Mean Macular Sensitivity in the Study Eye at 12 Months Compared to Baseline | Baseline and 12 Months | Microperimetry was used to assess macular sensitivity. |
| Changes in Mean Macular Sensitivity in the Study Eye at 18 Months Compared to Baseline | Baseline and 18 Months | Microperimetry was used to assess macular sensitivity. |
| Changes in Mean Macular Sensitivity in the Study Eye at 24 Months Compared to Baseline | Baseline and 24 Months | Microperimetry was used to assess macular sensitivity. |
| Number of Participants Withdrawn From the Study Therapy Due to Vision Loss or Adverse Events | Duration of the study, up to 24 months | — |
| Number of Study Eyes Demonstrating a Decrease in the Area of Late Leakage, as Measured by Fluorescein Angiography (FA), at 12 Months Compared to Baseline | Baseline and 12 Months | Fluorescein angiography (FA) images were obtained via a standard digital imaging system (OIS, Sacramento, CA) at baseline and at Month 6, Month 12, Month 18, and Month 24. Three retinal specialists independently graded the area of late fluorescein leakage (at approximately 10 minutes) using a region-of-interest tool in an image analysis software package (NIH ImageJ, Bethesda, MD). |
Countries
United States
Participant flow
Recruitment details
Five participant study; however, up to an additional three participants may be enrolled to account for participants who withdraw from the study prior to receipt of six months of study treatment.
Participants by arm
| Arm | Count |
|---|---|
| Dextromethorphan Hydrobromide Dextromethorphan hydrobromide: Participants instructed to take 60 mg dextromethorphan capsules orally two times a day for 24 months. | 7 |
| Total | 7 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Adverse Event | 1 |
| Overall Study | Withdrawal by Subject | 2 |
Baseline characteristics
| Characteristic | Dextromethorphan Hydrobromide |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 1 Participants |
| Age, Categorical Between 18 and 65 years | 6 Participants |
| Age, Continuous | 58.57 years |
| Sex: Female, Male Female | 2 Participants |
| Sex: Female, Male Male | 5 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 6 / 7 |
| serious Total, serious adverse events | 1 / 7 |
Outcome results
Primary
Percentage Change in Retinal Thickness in the Study Eye at 6 Months Compared to Baseline
Retinal thickness was assessed by spectral-domain optical coherence tomography (Cirrus HD-OCT; Carl Zeiss Meditec, Dublin, CA), a non-invasive imaging technique that uses long-wavelength light to capture micrometer-resolution cross-sectional images from biological tissue. The participant's eye that met the study eye eligibility criteria was selected as the study eye. For cases in which both eyes met the study eye eligibility criteria, the study eye was selected according to the choice of study eye in cases of bilateral disease selection criteria outlined in the eligibility criteria. The eye not chosen as the study eye is referred to as the fellow eye.
Time frame: Baseline and 6 months
Population: Two participants withdrew from the study prior to the 6-month visit.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dextromethorphan Hydrobromide | Percentage Change in Retinal Thickness in the Study Eye at 6 Months Compared to Baseline | -7.89 percentage change in retinal thickness | Standard Deviation 15.18 |
Secondary
Change in Best-corrected Visual Acuity (BCVA) in the Study Eye at 12 Months Compared to Baseline
Visual acuity was measured using the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol. Acuity is measured as letters read on an ETDRS eye chart and the letters read equate to Snellen measurements. For example, if a participant reads between 84 and 88 letters, the equivalent Snellen measurement is 20/20.
Time frame: Baseline and 12 Months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dextromethorphan Hydrobromide | Change in Best-corrected Visual Acuity (BCVA) in the Study Eye at 12 Months Compared to Baseline | 1.50 ETDRS letters | Standard Deviation 15.02 |
Secondary
Change in Best-corrected Visual Acuity (BCVA) in the Study Eye at 18 Months Compared to Baseline
Visual acuity was measured using the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol. Acuity is measured as letters read on an ETDRS eye chart and the letters read equate to Snellen measurements. For example, if a participant reads between 84 and 88 letters, the equivalent Snellen measurement is 20/20.
Time frame: Baseline and 18 Months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dextromethorphan Hydrobromide | Change in Best-corrected Visual Acuity (BCVA) in the Study Eye at 18 Months Compared to Baseline | 4.00 ETDRS letters | Standard Deviation 10.74 |
Secondary
Change in Best-corrected Visual Acuity (BCVA) in the Study Eye at 24 Months Compared to Baseline
Visual acuity was measured using the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol. Acuity is measured as letters read on an ETDRS eye chart and the letters read equate to Snellen measurements. For example, if a participant reads between 84 and 88 letters, the equivalent Snellen measurement is 20/20.
Time frame: Baseline and 24 Months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dextromethorphan Hydrobromide | Change in Best-corrected Visual Acuity (BCVA) in the Study Eye at 24 Months Compared to Baseline | 5.50 ETDRS letters | Standard Deviation 12.58 |
Secondary
Change in Best-corrected Visual Acuity (BCVA) in the Study Eye at 6 Months Compared to Baseline
Visual acuity was measured using the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol. Acuity is measured as letters read on an ETDRS eye chart and the letters read equate to Snellen measurements. For example, if a participant reads between 84 and 88 letters, the equivalent Snellen measurement is 20/20.
Time frame: Baseline and 6 Months
Population: Two participants withdrew from the study prior to the 6-month visit.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dextromethorphan Hydrobromide | Change in Best-corrected Visual Acuity (BCVA) in the Study Eye at 6 Months Compared to Baseline | 0.60 ETDRS letters | Standard Deviation 11.44 |
Secondary
Changes in Mean Macular Sensitivity in the Study Eye at 12 Months Compared to Baseline
Microperimetry was used to assess macular sensitivity.
Time frame: Baseline and 12 Months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dextromethorphan Hydrobromide | Changes in Mean Macular Sensitivity in the Study Eye at 12 Months Compared to Baseline | -3.7 dB | Standard Deviation 3.44 |
Secondary
Changes in Mean Macular Sensitivity in the Study Eye at 18 Months Compared to Baseline
Microperimetry was used to assess macular sensitivity.
Time frame: Baseline and 18 Months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dextromethorphan Hydrobromide | Changes in Mean Macular Sensitivity in the Study Eye at 18 Months Compared to Baseline | -4.9 dB | Standard Deviation 3.97 |
Secondary
Changes in Mean Macular Sensitivity in the Study Eye at 24 Months Compared to Baseline
Microperimetry was used to assess macular sensitivity.
Time frame: Baseline and 24 Months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dextromethorphan Hydrobromide | Changes in Mean Macular Sensitivity in the Study Eye at 24 Months Compared to Baseline | -3.9 dB | Standard Deviation 3.54 |
Secondary
Changes in Mean Macular Sensitivity in the Study Eye at 6 Months Compared to Baseline
Microperimetry was used to assess macular sensitivity.
Time frame: Baseline and 6 Months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dextromethorphan Hydrobromide | Changes in Mean Macular Sensitivity in the Study Eye at 6 Months Compared to Baseline | -2.1 dB | Standard Deviation 3.1 |
Secondary
Number of Participants Withdrawn From the Study Therapy Due to Vision Loss or Adverse Events
Time frame: Duration of the study, up to 24 months
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Dextromethorphan Hydrobromide | Number of Participants Withdrawn From the Study Therapy Due to Vision Loss or Adverse Events | 1 participants |
Secondary
Number of Study Eyes Demonstrating a Decrease in the Area of Late Leakage, as Measured by Fluorescein Angiography (FA), at 12 Months Compared to Baseline
Fluorescein angiography (FA) images were obtained via a standard digital imaging system (OIS, Sacramento, CA) at baseline and at Month 6, Month 12, Month 18, and Month 24. Three retinal specialists independently graded the area of late fluorescein leakage (at approximately 10 minutes) using a region-of-interest tool in an image analysis software package (NIH ImageJ, Bethesda, MD).
Time frame: Baseline and 12 Months
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Dextromethorphan Hydrobromide | Number of Study Eyes Demonstrating a Decrease in the Area of Late Leakage, as Measured by Fluorescein Angiography (FA), at 12 Months Compared to Baseline | 3 eyes |
Secondary
Number of Study Eyes Demonstrating a Decrease in the Area of Late Leakage, as Measured by Fluorescein Angiography (FA), at 18 Months Compared to Baseline
Fluorescein angiography (FA) images were obtained via a standard digital imaging system (OIS, Sacramento, CA) at baseline and at Month 6, Month 12, Month 18, and Month 24. Three retinal specialists independently graded the area of late fluorescein leakage (at approximately 10 minutes) using a region-of-interest tool in an image analysis software package (NIH ImageJ, Bethesda, MD).
Time frame: Baseline and 18 Months
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Dextromethorphan Hydrobromide | Number of Study Eyes Demonstrating a Decrease in the Area of Late Leakage, as Measured by Fluorescein Angiography (FA), at 18 Months Compared to Baseline | 2 eyes |
Secondary
Number of Study Eyes Demonstrating a Decrease in the Area of Late Leakage, as Measured by Fluorescein Angiography (FA), at 24 Months Compared to Baseline
Fluorescein angiography (FA) images were obtained via a standard digital imaging system (OIS, Sacramento, CA) at baseline and at Month 6, Month 12, Month 18, and Month 24. Three retinal specialists independently graded the area of late fluorescein leakage (at approximately 10 minutes) using a region-of-interest tool in an image analysis software package (NIH ImageJ, Bethesda, MD).
Time frame: Baseline and 24 Months
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Dextromethorphan Hydrobromide | Number of Study Eyes Demonstrating a Decrease in the Area of Late Leakage, as Measured by Fluorescein Angiography (FA), at 24 Months Compared to Baseline | 4 eyes |
Secondary
Number of Study Eyes Demonstrating a Decrease in the Area of Late Leakage, as Measured by Fluorescein Angiography (FA), at 6 Months Compared to Baseline
Fluorescein angiography (FA) images were obtained via a standard digital imaging system (OIS, Sacramento, CA) at baseline and at Month 6, Month 12, Month 18, and Month 24. Three retinal specialists independently graded the area of late fluorescein leakage (at approximately 10 minutes) using a region-of-interest tool in an image analysis software package (NIH ImageJ, Bethesda, MD).
Time frame: Baseline and 6 Months
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Dextromethorphan Hydrobromide | Number of Study Eyes Demonstrating a Decrease in the Area of Late Leakage, as Measured by Fluorescein Angiography (FA), at 6 Months Compared to Baseline | 4 eyes |
Secondary
Percentage Change in Retinal Thickness in the Study Eye at 12 Months Compared to Baseline
Retinal thickness was assessed by spectral-domain optical coherence tomography (Cirrus HD-OCT; Carl Zeiss Meditec, Dublin, CA), a non-invasive imaging technique that uses long-wavelength light to capture micrometer-resolution cross-sectional images from biological tissue. Changes in OCT will be calculated using the ETDRS grid. Attention will be directed to changes in retinal thickness as measured by OCT in each of the 9 subfields of the grid.
Time frame: Baseline and 12 Months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dextromethorphan Hydrobromide | Percentage Change in Retinal Thickness in the Study Eye at 12 Months Compared to Baseline | 6.54 percentage change in retinal thickness | Standard Deviation 26.96 |
Secondary
Percentage Change in Retinal Thickness in the Study Eye at 18 Months Compared to Baseline
Retinal thickness was assessed by spectral-domain optical coherence tomography (Cirrus HD-OCT; Carl Zeiss Meditec, Dublin, CA), a non-invasive imaging technique that uses long-wavelength light to capture micrometer-resolution cross-sectional images from biological tissue. Changes in OCT will be calculated using the ETDRS grid. Attention will be directed to changes in retinal thickness as measured by OCT in each of the 9 subfields of the grid.
Time frame: Baseline and 18 Months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dextromethorphan Hydrobromide | Percentage Change in Retinal Thickness in the Study Eye at 18 Months Compared to Baseline | -0.99 percentage change in retinal thickness | Standard Deviation 19.11 |
Secondary
Percentage Change in Retinal Thickness in the Study Eye at 24 Months Compared to Baseline
Retinal thickness was assessed by spectral-domain optical coherence tomography (Cirrus HD-OCT; Carl Zeiss Meditec, Dublin, CA), a non-invasive imaging technique that uses long-wavelength light to capture micrometer-resolution cross-sectional images from biological tissue. Changes in OCT will be calculated using the ETDRS grid. Attention will be directed to changes in retinal thickness as measured by OCT in each of the 9 subfields of the grid.
Time frame: Baseline and 24 Months
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dextromethorphan Hydrobromide | Percentage Change in Retinal Thickness in the Study Eye at 24 Months Compared to Baseline | -7.44 percentage change in retinal thickness | Standard Deviation 18.33 |