Skip to content

Use of Intravitreal Aflibercept Injection for Neovascular Glaucoma

Use of Intravitreal Aflibercept Injection for Neovascular Glaucoma

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01711879
Enrollment
7
Registered
2012-10-22
Start date
2013-01-31
Completion date
2015-10-31
Last updated
2022-03-18

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Neovascular Glaucoma

Brief summary

This 52 week study will assess the use of intravitreal aflibercept injections in patients with neovascular glaucoma (NVG) compared to standard of care panretinal photocoagulation. The investigators hypothesize that the neovascularization of the iris and angle present in neovascular glaucoma will resolve more quickly in eye treated with intravitreal aflibercept injection alone and result in increased comfort and preservation of visual field as compared to current standard of care utilizing pan-retinal photocoagulation. The advantages to intravitreal aflibercept injection use could include resolution of NVI/NVA (neovascularization of the iris/neovascularization of the angle) leading to quicker pain relief and quicker lowering of IOP (intraocular pressure).

Detailed description

The two arms of this study will compare current common practice (initial intravitreal anti-VEGF (vascular endothelial growth factor) to study treatment (VEGF) injection only) for 52 weeks. This single center study will consist of 20 patients with NVG. Patients will be randomized to: * Group A: A single injection of 2mg (0.05ml) intravitreal aflibercept injection at baseline followed by standard of care laser with observation for a total of 52 weeks. or * Group B: 2mg (0.05ml) intravitreal aflibercept injection at baseline followed by two additional injections at 4 weeks and 8 weeks, then every 8 weeks for a total of 52 weeks. Clinical assessment will include pain assessment (Universal Pain Scale), best corrected visual acuity (ETDRS), ophthalmic examination, anterior segment assessment including number of clock-hours of NVI/NVA, gonioscopy, anterior segment photography, visual field test (Humphrey SITA- Standard 24-2), optic nerve OCT (Zeiss Cirrus Optic Disc Cube 200x200), macular OCT (Cube scan 512 x 128 and 5 Line Raster), fluorescein angiography (initial iris phase followed by standard retinal angiography), and concurrent medical/ocular medications. Qualitative assessment of neovascularization will be made by the investigator based on comparison to baseline angiography.

Interventions

DRUGAflibercept

Details covered in arm description

Sponsors

University of Colorado, Denver
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
21 Years to 90 Years
Healthy volunteers
No

Inclusion criteria

* Patients with a diagnosis of neovascular glaucoma (Stage I-II) * Individuals who are ages 21-90 years old; male or female of any race * Presence of neovascularization of the iris and/or angle * At least 90 degrees of unzipped anterior chamber angle as noted by gonioscopy. (a zipped angle is the term used for a drainage angle that is slowly closing due to scar tissue from the neovascularization process) * Visual acuity of light perception or better in the study eye * Willing and able to comply with clinic visits and study-related procedures * Provide signed informed consent

Exclusion criteria

* Use of intravitreal anti-VEGF agents in the study eye in the past 3 months. * Full PRP in the study eye * Prior vitrectomy in the study eye * Prior trabeculectomy or other filtration surgery in the study eye * Active ocular or periocular infection in the study eye * Ocular conditions (Cataract or vitreous hemorrhage) that might require surgery in next 12 months * Allergy to fluorescein dye * Any past use of systemic anti-VEGF medication * Myocardial infarction within 6 months prior to study enrollment * Stroke within 6 months prior to study enrollment * Pregnant or breast-feeding women * Sexually active men or women of childbearing potential who are unwilling to practice adequate contraception during the study

Design outcomes

Primary

MeasureTime frameDescription
Incidence of Adverse Events2 yearAssess the safety profile of repeated intravitreal aflibercept injections in patients with NVG by evaluating the incidence of adverse events
Severity of Adverse Events2 yearAssess the safety profile of repeated intravitreal aflibercept injections in patients with NVG by evaluating the severity of adverse events

Secondary

MeasureTime frameDescription
Intraocular Pressure (mmHg) at Week 52Week 52Mean intraocular pressure(mmHg) as measured by Goldmann applanation tonometry between groups A and B
Number of Patients Losing > 5 Letters on Visual Acuity in Each Group A and Group BBaseline to Week 52Comparison between patients, groups A and B, that lost \> 5 letters on visual acuity
Number of Patients in Each, Group A and Group B, Gaining > 5 Letters on Visual AcuityBaseline to Week 52Comparison of patients in each, group A and group B, that gained \> 5 letters on visual acuity
Visual Acuity at BaselineBaselineComparison of visual acuity between groups A and B
Visual Acuity at Week 52Week 52Comparison of visual acuity at Week 52 between groups A and B
Rate and Extent of Resolution of Neovascularization1 yearCompare between Groups A and B the Rate and extent of resolution of neovascularization in patients with NVG Stages 1 & 2.
Measure of the Optical Coherence Tomography(OCT) OutcomesBaseline to Week 52Evaluation of the Optical Coherence Tomography(OCT) outcomes (average retinal nerve fiber layer(RNFL) and central macular thickness), Compared between groups A and B.
Number of Patients With Need for Surgical Intervention1 yearComparison between groups A and B and the need for surgical intervention in both arms during the follow-up period
Number of Participants With Need for Additional IOP Lowering Medications1 yearComparison between groups A and B for the need of additional IOP lowering medications
Extent of Resolution of Neovascularization Between Groups1 yearComparison of groups A and B and the extent of resolution of neovascularization in patients with NVG Stages 1 & 2
Evaluation of the Average Retinal Nerve Fiber Layer (RNFL)1 yearComparison between groups A and B of the average retinal nerve fiber layer (RNFL) as measured by Optical Coherence Tomography (OCT)
Comparison of the Visual Field Between Groups1 yearComparison of the Visual field s measured by HVF 24-2 SITA Standards between groups A and B
Intraocular Pressure (mmHg) at BaselineBaselineIntraocular pressure(mmHg) as measured by Goldmann applanation tonometry between groups A and B

Countries

United States

Participant flow

Participants by arm

ArmCount
Aflibercept With Laser
A single injection of 2mg (0.05ml) intravitreal aflibercept injection at baseline followed by standard of care laser with observation for a total of 52 weeks Aflibercept: Details covered in arm description
3
Aflibercept
2mg (0.05ml) intravitreal aflibercept injection at baseline followed by two additional injections at 4 weeks and 8 weeks, then every 8 weeks for a total of 52 weeks. Aflibercept: Details covered in arm description
4
Total7

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyDeath10

Baseline characteristics

CharacteristicAflibercept With LaserAfliberceptTotal
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
0 Participants2 Participants2 Participants
Age, Categorical
Between 18 and 65 years
3 Participants2 Participants5 Participants
Age, Continuous56.33 years
STANDARD_DEVIATION 5.69
61.5 years
STANDARD_DEVIATION 15.63
59.29 years
STANDARD_DEVIATION 11.86
Ethnicity (NIH/OMB)
Hispanic or Latino
3 Participants3 Participants6 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
0 Participants1 Participants1 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Sex: Female, Male
Female
3 Participants3 Participants6 Participants
Sex: Female, Male
Male
0 Participants1 Participants1 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
1 / 30 / 4
other
Total, other adverse events
3 / 34 / 4
serious
Total, serious adverse events
1 / 30 / 4

Outcome results

Primary

Incidence of Adverse Events

Assess the safety profile of repeated intravitreal aflibercept injections in patients with NVG by evaluating the incidence of adverse events

Time frame: 2 year

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Aflibercept With LaserIncidence of Adverse Events3 Participants
AfliberceptIncidence of Adverse Events4 Participants
Primary

Severity of Adverse Events

Assess the safety profile of repeated intravitreal aflibercept injections in patients with NVG by evaluating the severity of adverse events

Time frame: 2 year

ArmMeasureGroupCategoryValue (COUNT_OF_PARTICIPANTS)
Aflibercept With LaserSeverity of Adverse EventsVitreous hemorrhageMild2 Participants
Aflibercept With LaserSeverity of Adverse EventsRecurrent BCCMild0 Participants
Aflibercept With LaserSeverity of Adverse EventsWorsening cataract non-study eyeNone3 Participants
Aflibercept With LaserSeverity of Adverse EventsRecurrent BCCModerate0 Participants
Aflibercept With LaserSeverity of Adverse EventsAsthmaNone3 Participants
Aflibercept With LaserSeverity of Adverse EventsRecurrent BCCSevere0 Participants
Aflibercept With LaserSeverity of Adverse Eventsprogression of gall bladder cancerMild0 Participants
Aflibercept With LaserSeverity of Adverse EventsWorsening Cataract Study eyeMild1 Participants
Aflibercept With LaserSeverity of Adverse Eventsprogression of gall bladder cancerModerate0 Participants
Aflibercept With LaserSeverity of Adverse EventsVitreous hemorrhageModerate0 Participants
Aflibercept With LaserSeverity of Adverse Eventsprogression of gall bladder cancerSevere1 Participants
Aflibercept With LaserSeverity of Adverse EventsWorsening Cataract Study eyeModerate1 Participants
Aflibercept With LaserSeverity of Adverse Eventsprogression of gall bladder cancerNone2 Participants
Aflibercept With LaserSeverity of Adverse EventsRecurrent BCCNone3 Participants
Aflibercept With LaserSeverity of Adverse Eventsworsening of arthritis Right kneeMild0 Participants
Aflibercept With LaserSeverity of Adverse EventsWorsening Cataract Study eyeSevere0 Participants
Aflibercept With LaserSeverity of Adverse Eventsworsening of arthritis Right kneeModerate0 Participants
Aflibercept With LaserSeverity of Adverse EventsVitreous hemorrhageSevere0 Participants
Aflibercept With LaserSeverity of Adverse Eventsworsening of arthritis Right kneeSevere0 Participants
Aflibercept With LaserSeverity of Adverse EventsWorsening Cataract Study eyeNone1 Participants
Aflibercept With LaserSeverity of Adverse Eventsworsening of arthritis Right kneeNone3 Participants
Aflibercept With LaserSeverity of Adverse EventsPneumoniaMild0 Participants
Aflibercept With LaserSeverity of Adverse Eventsmatastatic cancer of liverMild0 Participants
Aflibercept With LaserSeverity of Adverse EventsDiabetes MellitusMild0 Participants
Aflibercept With LaserSeverity of Adverse Eventsmatastatic cancer of liverModerate0 Participants
Aflibercept With LaserSeverity of Adverse EventsVitreous hemorrhageNone1 Participants
Aflibercept With LaserSeverity of Adverse Eventsmatastatic cancer of liverSevere1 Participants
Aflibercept With LaserSeverity of Adverse EventsDiabetes MellitusModerate0 Participants
Aflibercept With LaserSeverity of Adverse Eventsmatastatic cancer of liverNone2 Participants
Aflibercept With LaserSeverity of Adverse EventsPneumoniaNone3 Participants
Aflibercept With LaserSeverity of Adverse Eventsshortness of breathMild0 Participants
Aflibercept With LaserSeverity of Adverse EventsDiabetes MellitusSevere0 Participants
Aflibercept With LaserSeverity of Adverse Eventsshortness of breathModerate0 Participants
Aflibercept With LaserSeverity of Adverse EventsWorsening cataract non-study eyeMild0 Participants
Aflibercept With LaserSeverity of Adverse Eventsshortness of breathSevere0 Participants
Aflibercept With LaserSeverity of Adverse EventsDiabetes MellitusNone3 Participants
Aflibercept With LaserSeverity of Adverse Eventsshortness of breathNone3 Participants
Aflibercept With LaserSeverity of Adverse EventsPneumoniaModerate0 Participants
Aflibercept With LaserSeverity of Adverse EventsAbcess left thighMild0 Participants
Aflibercept With LaserSeverity of Adverse EventsWorsening NVG - non-study eyeMild0 Participants
Aflibercept With LaserSeverity of Adverse EventsAbcess left thighModerate0 Participants
Aflibercept With LaserSeverity of Adverse EventsWorsening cataract non-study eyeModerate0 Participants
Aflibercept With LaserSeverity of Adverse EventsAbcess left thighSevere0 Participants
Aflibercept With LaserSeverity of Adverse EventsWorsening NVG - non-study eyeModerate0 Participants
Aflibercept With LaserSeverity of Adverse EventsAbcess left thighNone3 Participants
Aflibercept With LaserSeverity of Adverse EventsPneumoniaSevere0 Participants
Aflibercept With LaserSeverity of Adverse EventsAsthmaMild0 Participants
Aflibercept With LaserSeverity of Adverse EventsWorsening NVG - non-study eyeSevere0 Participants
Aflibercept With LaserSeverity of Adverse EventsAsthmaModerate0 Participants
Aflibercept With LaserSeverity of Adverse EventsWorsening cataract non-study eyeSevere0 Participants
Aflibercept With LaserSeverity of Adverse EventsAsthmaSevere0 Participants
Aflibercept With LaserSeverity of Adverse EventsWorsening NVG - non-study eyeNone3 Participants
AfliberceptSeverity of Adverse EventsAsthmaSevere0 Participants
AfliberceptSeverity of Adverse EventsRecurrent BCCNone3 Participants
AfliberceptSeverity of Adverse EventsPneumoniaSevere0 Participants
AfliberceptSeverity of Adverse EventsPneumoniaNone3 Participants
AfliberceptSeverity of Adverse EventsAsthmaNone3 Participants
AfliberceptSeverity of Adverse EventsPneumoniaMild1 Participants
AfliberceptSeverity of Adverse EventsPneumoniaModerate0 Participants
AfliberceptSeverity of Adverse EventsVitreous hemorrhageMild0 Participants
AfliberceptSeverity of Adverse EventsVitreous hemorrhageModerate0 Participants
AfliberceptSeverity of Adverse EventsVitreous hemorrhageSevere0 Participants
AfliberceptSeverity of Adverse EventsVitreous hemorrhageNone4 Participants
AfliberceptSeverity of Adverse EventsWorsening cataract non-study eyeMild1 Participants
AfliberceptSeverity of Adverse EventsWorsening cataract non-study eyeModerate0 Participants
AfliberceptSeverity of Adverse EventsWorsening cataract non-study eyeSevere0 Participants
AfliberceptSeverity of Adverse EventsWorsening cataract non-study eyeNone3 Participants
AfliberceptSeverity of Adverse EventsWorsening Cataract Study eyeMild1 Participants
AfliberceptSeverity of Adverse EventsWorsening Cataract Study eyeModerate0 Participants
AfliberceptSeverity of Adverse EventsWorsening Cataract Study eyeSevere0 Participants
AfliberceptSeverity of Adverse EventsWorsening Cataract Study eyeNone3 Participants
AfliberceptSeverity of Adverse EventsDiabetes MellitusMild1 Participants
AfliberceptSeverity of Adverse EventsDiabetes MellitusModerate0 Participants
AfliberceptSeverity of Adverse EventsDiabetes MellitusSevere0 Participants
AfliberceptSeverity of Adverse EventsDiabetes MellitusNone3 Participants
AfliberceptSeverity of Adverse EventsWorsening NVG - non-study eyeMild1 Participants
AfliberceptSeverity of Adverse EventsWorsening NVG - non-study eyeModerate0 Participants
AfliberceptSeverity of Adverse EventsWorsening NVG - non-study eyeSevere0 Participants
AfliberceptSeverity of Adverse EventsWorsening NVG - non-study eyeNone3 Participants
AfliberceptSeverity of Adverse EventsRecurrent BCCMild1 Participants
AfliberceptSeverity of Adverse EventsRecurrent BCCModerate0 Participants
AfliberceptSeverity of Adverse Eventsprogression of gall bladder cancerMild0 Participants
AfliberceptSeverity of Adverse Eventsprogression of gall bladder cancerModerate0 Participants
AfliberceptSeverity of Adverse Eventsprogression of gall bladder cancerSevere0 Participants
AfliberceptSeverity of Adverse Eventsprogression of gall bladder cancerNone4 Participants
AfliberceptSeverity of Adverse Eventsworsening of arthritis Right kneeMild1 Participants
AfliberceptSeverity of Adverse Eventsworsening of arthritis Right kneeModerate0 Participants
AfliberceptSeverity of Adverse Eventsworsening of arthritis Right kneeSevere0 Participants
AfliberceptSeverity of Adverse Eventsworsening of arthritis Right kneeNone3 Participants
AfliberceptSeverity of Adverse Eventsmatastatic cancer of liverMild0 Participants
AfliberceptSeverity of Adverse Eventsmatastatic cancer of liverModerate0 Participants
AfliberceptSeverity of Adverse Eventsmatastatic cancer of liverSevere0 Participants
AfliberceptSeverity of Adverse Eventsmatastatic cancer of liverNone4 Participants
AfliberceptSeverity of Adverse Eventsshortness of breathMild1 Participants
AfliberceptSeverity of Adverse Eventsshortness of breathModerate0 Participants
AfliberceptSeverity of Adverse Eventsshortness of breathSevere0 Participants
AfliberceptSeverity of Adverse Eventsshortness of breathNone3 Participants
AfliberceptSeverity of Adverse EventsAbcess left thighMild1 Participants
AfliberceptSeverity of Adverse EventsAbcess left thighModerate0 Participants
AfliberceptSeverity of Adverse EventsAbcess left thighSevere0 Participants
AfliberceptSeverity of Adverse EventsAbcess left thighNone3 Participants
AfliberceptSeverity of Adverse EventsAsthmaMild1 Participants
AfliberceptSeverity of Adverse EventsAsthmaModerate0 Participants
AfliberceptSeverity of Adverse EventsRecurrent BCCSevere0 Participants
Secondary

Comparison of the Visual Field Between Groups

Comparison of the Visual field s measured by HVF 24-2 SITA Standards between groups A and B

Time frame: 1 year

Population: No data was collected or analyzed for this Outcome Measure during the clinical trial.

Secondary

Evaluation of the Average Retinal Nerve Fiber Layer (RNFL)

Comparison between groups A and B of the average retinal nerve fiber layer (RNFL) as measured by Optical Coherence Tomography (OCT)

Time frame: 1 year

Population: The OCT database was corrupted and the data was lost

Secondary

Extent of Resolution of Neovascularization Between Groups

Comparison of groups A and B and the extent of resolution of neovascularization in patients with NVG Stages 1 & 2

Time frame: 1 year

Population: NVG Staging not recorded

Secondary

Intraocular Pressure (mmHg) at Baseline

Intraocular pressure(mmHg) as measured by Goldmann applanation tonometry between groups A and B

Time frame: Baseline

Population: One participant from group Aflibercept with Laser did not complete analysis due to death. Analysis is limited due to small sample size.

ArmMeasureGroupValue (MEAN)
Aflibercept With LaserIntraocular Pressure (mmHg) at BaselineStudy Eye Mean IOP(mmHg) at Baseline10 mmHg
Aflibercept With LaserIntraocular Pressure (mmHg) at BaselineFellow Eye Mean IOP(mmHg) at Baseline11 mmHg
AfliberceptIntraocular Pressure (mmHg) at BaselineStudy Eye Mean IOP(mmHg) at Baseline23.5 mmHg
AfliberceptIntraocular Pressure (mmHg) at BaselineFellow Eye Mean IOP(mmHg) at Baseline22.75 mmHg
Secondary

Intraocular Pressure (mmHg) at Week 52

Mean intraocular pressure(mmHg) as measured by Goldmann applanation tonometry between groups A and B

Time frame: Week 52

Population: One participant from group Aflibercept with Laser did not complete analysis due to death. Analysis is limited due to small sample size.

ArmMeasureGroupValue (MEAN)
Aflibercept With LaserIntraocular Pressure (mmHg) at Week 52Study Eye Mean IOP(mmHg) at W5210 mmHg
Aflibercept With LaserIntraocular Pressure (mmHg) at Week 52Fellow Eye Mean IOP(mmHg) at W5210 mmHg
AfliberceptIntraocular Pressure (mmHg) at Week 52Study Eye Mean IOP(mmHg) at W5215.25 mmHg
AfliberceptIntraocular Pressure (mmHg) at Week 52Fellow Eye Mean IOP(mmHg) at W5214 mmHg
Secondary

Measure of the Optical Coherence Tomography(OCT) Outcomes

Evaluation of the Optical Coherence Tomography(OCT) outcomes (average retinal nerve fiber layer(RNFL) and central macular thickness), Compared between groups A and B.

Time frame: Baseline to Week 52

Population: The database in OCT was corrupted and the data was lost

Secondary

Number of Participants With Need for Additional IOP Lowering Medications

Comparison between groups A and B for the need of additional IOP lowering medications

Time frame: 1 year

ArmMeasureValue (NUMBER)
Aflibercept With LaserNumber of Participants With Need for Additional IOP Lowering Medications0 participants
AfliberceptNumber of Participants With Need for Additional IOP Lowering Medications0 participants
Secondary

Number of Patients in Each, Group A and Group B, Gaining > 5 Letters on Visual Acuity

Comparison of patients in each, group A and group B, that gained \> 5 letters on visual acuity

Time frame: Baseline to Week 52

Population: One participant from group Aflibercept with Laser did not complete analysis due to death. Analysis is limited due to small sample size.

ArmMeasureValue (NUMBER)
Aflibercept With LaserNumber of Patients in Each, Group A and Group B, Gaining > 5 Letters on Visual Acuity2 participants
AfliberceptNumber of Patients in Each, Group A and Group B, Gaining > 5 Letters on Visual Acuity0 participants
Secondary

Number of Patients Losing > 5 Letters on Visual Acuity in Each Group A and Group B

Comparison between patients, groups A and B, that lost \> 5 letters on visual acuity

Time frame: Baseline to Week 52

Population: One participant from group Aflibercept with Laser did not complete analysis due to death. Analysis is limited due to small sample size.

ArmMeasureValue (NUMBER)
Aflibercept With LaserNumber of Patients Losing > 5 Letters on Visual Acuity in Each Group A and Group B0 participants
AfliberceptNumber of Patients Losing > 5 Letters on Visual Acuity in Each Group A and Group B0 participants
Secondary

Number of Patients With Need for Surgical Intervention

Comparison between groups A and B and the need for surgical intervention in both arms during the follow-up period

Time frame: 1 year

Population: One participant from group Aflibercept with Laser did not complete analysis due to death. Analysis is limited due to small sample size.

ArmMeasureValue (NUMBER)
Aflibercept With LaserNumber of Patients With Need for Surgical Intervention0 participants
AfliberceptNumber of Patients With Need for Surgical Intervention0 participants
Secondary

Rate and Extent of Resolution of Neovascularization

Compare between Groups A and B the Rate and extent of resolution of neovascularization in patients with NVG Stages 1 & 2.

Time frame: 1 year

Population: No data was collected or analyzed for this Outcome Measure

Secondary

Visual Acuity at Baseline

Comparison of visual acuity between groups A and B

Time frame: Baseline

Population: One participant from group Aflibercept with Laser did not complete analysis due to death. Analysis is limited due to small sample size.

ArmMeasureValue (MEAN)
Aflibercept With LaserVisual Acuity at Baseline64 Letters
AfliberceptVisual Acuity at Baseline37.5 Letters
Secondary

Visual Acuity at Week 52

Comparison of visual acuity at Week 52 between groups A and B

Time frame: Week 52

Population: One participant from group Aflibercept with Laser did not complete analysis due to death. Analysis is limited due to small sample size.

ArmMeasureGroupValue (MEAN)
Aflibercept With LaserVisual Acuity at Week 52Study Eye Mean W52 Number of ETDRS Letters33.5 Letters
Aflibercept With LaserVisual Acuity at Week 52Fellow Eye Mean W52 Number of ETDRS Letters32 Letters
AfliberceptVisual Acuity at Week 52Study Eye Mean W52 Number of ETDRS Letters62 Letters
AfliberceptVisual Acuity at Week 52Fellow Eye Mean W52 Number of ETDRS Letters46.75 Letters

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026