Optic Neuropathy, IschemicPhase 1NCT01607671
Treatment Study for Ischemic Optic Neuropathy With Opthalmic Timolol Maleate 0.5%
A Phase 1 study testing Timolol maleate in people with Optic Neuropathy, Ischemic and Anterior Ischemic Optic Neuropathy, run by Fraser Health at 1 site in Canada.
Trial summary
The purpose of this study is to evaluate the feasibility of rapid evaluation and administration of ophthalmic Timolol maleate in the treatment of non-arteritic anterior ischemic optic neuropathy. Read more about this study
- Who is it for?
- Ages 41 years and older
- Conditions the study is for
- Optic Neuropathy, Ischemic, Anterior Ischemic Optic Neuropathy, Ischemic Optic Neuropathy
- What is being tested?
- Timolol maleate
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 0 participants
- Where
- 1 siteCanada
- Study dates
- Jun 2012to Nov 2013
- Phase
- Phase 1
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 41 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age >40
- Sudden, painless monocular vision loss with edema of the optic disc
- Clinical diagnosis is Non-Arteritic Anterior Ischemic Optic Neuropathy
- Relative Afferent Pupil Defect (RAPD) at first study visit
Who cannot join
- Onset of vision loss >48 hours from time of enrollment
- History of Asthma or COPD
- History of Heart Block or Sinus Bradycardia
- Allergy to any beta blocker
- History of Multiple Sclerosis or optic neuropathy
- Active Ocular Inflammation on examination
Show all 14Show fewer
- Currently being treated for Cancer or systemic vasculitis
- History of Glaucoma or use of medications that lower IOP
- Symptomatic cataract, retinopathy, macular disease or amblyopia in the symptomatic eye
- IOP of <10 at baseline
- Ocular surgery in past three months
- Women who are pregnant, breast-feeding or may become pregnant
- Inability to provide informed consent or follow up at three months
- Currently enrolled in any other study drug trial or previously enrolled in this study
Trial locations and contacts
1 site in 1 country.
Canada1 site
Jim Pattison Outpatient Care and Surgery Centre, 3C Neurology
Surrey, British Columbia, V3T 0G9
About this study
Official title: Can Urgent Reduction of Intraocular Pressure With Ophthalmic Timolol Improve Recovery From Non-arteritic Anterior Ischemic Optic Neuropathy (NAION): a Randomized Study.
The purpose of this study is to evaluate the feasibility of rapid evaluation and administration of ophthalmic Timolol maleate in the treatment of non-arteritic anterior ischemic optic neuropathy. Secondary goals are to evaluate if such treatment reduces the progression or improves recovery of patients who are randomly assigned to treatment versus standard of care.
Read the detailed description
Non-arteritic anterior ischemic optic neuropathy (NAION) currently has no widely accepted acute treatment to improve recovery or prevent progression in the first month. It causes monocular vision loss with potential second eye involvement in 15% at 5 years. This leads to significant disability. It is the most common acute optic neuropathy in patients over 55 years of age. The final mechanism of injury is believed to be ischemic. Increasing perfusion of the optic nerve may reduce damage and prevent progression. Reduction in intraocular pressure has been shown to increase optic disc perfusion in animal models. Timolol maleate is a widely used medication for Glaucoma that reduces intraocular pressure. Treatment with Timolol maleate may improve optic disc perfusion in NAION and reduce ischemic damage from this condition. This study aims to enroll and treat patients with Timolol maleate 0.5% within 48 hours of symptom onset to assess feasibility of the study design and potential benefit of rapid intraocular pressure reduction.
- Conditions
- Optic Neuropathy, Ischemic, Anterior Ischemic Optic Neuropathy, Ischemic Optic Neuropathy, Optic Neuropathy, Anterior Ischemic
- Being tested
- Timolol maleate
- Keywords
- Ischemic, Optic Neuropathy, Non-Arteritic Anterior Ischemic Optic Neuropathy, NAION, Ischemic Optic Neuropathy, Intraocular Pressure
- Medical subject headings
- Optic Neuropathy, Ischemic, Ischemia, Optic Nerve Diseases
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Timolol maleateDrug
Also called Timoptic., Timolol., Timolol maleate.
Timolol 0.5% 1 drop twice daily to the effected eye for 4 weeks.
| Study group | Role | What they receive |
|---|---|---|
| Timolol | Experimental | This group will receive ophthalmic Timolol maleate 0.5%, 1 drop to the effected eye twice daily for 4 weeks. Receives: Drug: Timolol maleate |
| Standard Care | No intervention | This group will be treated with current standard care. This does not include Timolol or other medications to reduce intraocular pressure. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Recruitment Rate of patients during the one year study to assess feasibility of a larger study
This is to define the feasabilty of the study design for a larger study.
Measured: 12 months
Number of patients with adverse events
Measured: 12 months
Secondary outcomes (4)
Change in visual acuity at enrollment and three month follow up using a logMAR scale.
This will evaluate the change in visual acuity as a measure of visual function.
Measured: Enrolment, Within 48 hours of enrollment , 1 month, 3 months.
Change in the mean deviation of actual versus predicted sensitivity of the visual field.
Using a a Haag-Streit Octopus 900 with white on white TOP 30-2 visual field program, the mean deviation will be compared at various time points to assess for improving visual function as it relates to the field of vision.
Measured: 48 hours after enrollment, 1 month, 3 months
Change in Colour vision as measured by HRR colour plates.
The total number of colour plates seen will be counted and compared to baseline as a measure of visual recovery as it effects colour vision.
Measured: Within 48 hours of enrollment, 1 month, 3 months
Change in contrast sensitivity will be measured using the Pelli-Robson contrast sensitivity chart.
The Pelli-Robson contrast sensitivity chart is another method to assess visual function. The change in total number of plates seen will be compared at the various time points.
Measured: 48 hours from enrollment, 1 month, 3 months.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted30 May 2012 (estimated)
- Study startJun 2012
- Primary completionNov 2013
- Study completionNov 2013
Why it stopped: Unable to recruit participants from recruiting sites.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for Optic Neuropathy, IschemicStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 1
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 0 participants (actual)
Sponsor and investigators
- Lead sponsor
- Fraser Health
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Martin A SuttonBrown, MD, Principal investigator, Fraser Health Region
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01607671
- Sponsor's protocol ID
- NAION-001
- Status last verified
- May 2012
- First submitted
- 25 May 2012
- Last updated
- 25 May 2015
- Results posted
- No
- Data monitoring committee
- No
Publications
Atkins EJ, Bruce BB, Newman NJ, Biousse V. Treatment of nonarteritic anterior ischemic optic neuropathy. Surv Ophthalmol. 2010 Jan-Feb;55(1):47-63. doi: 10.1016/j.survophthal.2009.06.008.
PubMed 20006051Glucksberg MR, Dunn R. Direct measurement of retinal microvascular pressures in the live, anesthetized cat. Microvasc Res. 1993 Mar;45(2):158-65. doi: 10.1006/mvre.1993.1015.
PubMed 8361399Maepea O. Pressures in the anterior ciliary arteries, choroidal veins and choriocapillaris. Exp Eye Res. 1992 May;54(5):731-6. doi: 10.1016/0014-4835(92)90028-q.
PubMed 1623958Wilhelm B, Ludtke H, Wilhelm H; BRAION Study Group. Efficacy and tolerability of 0.2% brimonidine tartrate for the treatment of acute non-arteritic anterior ischemic optic neuropathy (NAION): a 3-month, double-masked, randomised, placebo-controlled trial. Graefes Arch Clin Exp Ophthalmol. 2006 May;244(5):551-8. doi: 10.1007/s00417-005-0102-8. Epub 2005 Sep 8.
PubMed 16151785Optic nerve decompression surgery for nonarteritic anterior ischemic optic neuropathy (NAION) is not effective and may be harmful. The Ischemic Optic Neuropathy Decompression Trial Research Group. JAMA. 1995 Feb 22;273(8):625-32.
PubMed 7844872
Study at a glance
From the registry record, last updated by the sponsor on 25 May 2015. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Can Urgent Reduction of Intraocular Pressure With Ophthalmic Timolol Improve Recovery From Non-arteritic Anterior Ischemic Optic Neuropathy (NAION): a Randomized Study.
- ClinicalTrials.gov ID
- NCT01607671
- Acronym / sponsor ID
- NAION-001
- Conditions
- Optic Neuropathy, Ischemic, Anterior Ischemic Optic Neuropathy, Ischemic Optic Neuropathy, Optic Neuropathy, Anterior Ischemic
- Keywords
- Ischemic, Optic Neuropathy, Non-Arteritic Anterior Ischemic Optic Neuropathy, NAION, Ischemic Optic Neuropathy, Intraocular Pressure
- Phase
- Phase 1
- Study type
- Interventional
- Recruitment status
- WithdrawnReason stopped: Unable to recruit participants from recruiting sites.
- Enrolment
- 0 participants (actual)
- Lead sponsor
- Fraser HealthUniversity, hospital or other
- Study start
- Jun 2012
- Primary completion
- Nov 2013 (actual)
- Study completion
- Nov 2013 (actual)
- First posted
- 30 May 2012 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to evaluate the feasibility of rapid evaluation and administration of ophthalmic Timolol maleate in the treatment of non-arteritic anterior ischemic optic neuropathy. Secondary goals are to evaluate if such treatment reduces the progression or improves recovery of patients who are randomly assigned to treatment versus standard of care.
Detailed description
Non-arteritic anterior ischemic optic neuropathy (NAION) currently has no widely accepted acute treatment to improve recovery or prevent progression in the first month. It causes monocular vision loss with potential second eye involvement in 15% at 5 years. This leads to significant disability. It is the most common acute optic neuropathy in patients over 55 years of age. The final mechanism of injury is believed to be ischemic. Increasing perfusion of the optic nerve may reduce damage and prevent progression. Reduction in intraocular pressure has been shown to increase optic disc perfusion in animal models. Timolol maleate is a widely used medication for Glaucoma that reduces intraocular pressure. Treatment with Timolol maleate may improve optic disc perfusion in NAION and reduce ischemic damage from this condition. This study aims to enroll and treat patients with Timolol maleate 0.5% within 48 hours of symptom onset to assess feasibility of the study design and potential benefit of rapid intraocular pressure reduction.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Timolol | Experimental | Drug: Timolol maleateThis group will receive ophthalmic Timolol maleate 0.5%, 1 drop to the effected eye twice daily for 4 weeks. |
| Standard Care | No intervention | –This group will be treated with current standard care. This does not include Timolol or other medications to reduce intraocular pressure. |
Who may qualify
- Ages
- 41 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Age >40
- Sudden, painless monocular vision loss with edema of the optic disc
- Clinical diagnosis is Non-Arteritic Anterior Ischemic Optic Neuropathy
- Relative Afferent Pupil Defect (RAPD) at first study visit
Key exclusion criteria (14 listed)
- Onset of vision loss >48 hours from time of enrollment
- History of Asthma or COPD
- History of Heart Block or Sinus Bradycardia
- Allergy to any beta blocker
- History of Multiple Sclerosis or optic neuropathy
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Timolol maleateAlso: Timoptic., Timolol., Timolol maleate.Timolol 0.5% 1 drop twice daily to the effected eye for 4 weeks. | Drug | Timolol |
Primary outcome
Recruitment Rate of patients during the one year study to assess feasibility of a larger study
Time frame: 12 months
This is to define the feasabilty of the study design for a larger study.
Number of patients with adverse events
Time frame: 12 months
4 secondary outcomes
Change in visual acuity at enrollment and three month follow up using a logMAR scale.
Time frame: Enrolment, Within 48 hours of enrollment , 1 month, 3 months.
Change in the mean deviation of actual versus predicted sensitivity of the visual field.
Time frame: 48 hours after enrollment, 1 month, 3 months
Change in Colour vision as measured by HRR colour plates.
Time frame: Within 48 hours of enrollment, 1 month, 3 months
Change in contrast sensitivity will be measured using the Pelli-Robson contrast sensitivity chart.
Time frame: 48 hours from enrollment, 1 month, 3 months.
Results and safety
The study was withdrawn before enrolling participants, so there are no results.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 25 May 2015.
- Background: PubMed 20006051Atkins EJ, Bruce BB, Newman NJ, Biousse V. Treatment of nonarteritic anterior ischemic optic neuropathy. Surv Ophthalmol. 2010 Jan-Feb;55(1):47-63. doi: 10.1016/j.survophthal.2009.06.008.
- Background: PubMed 8361399Glucksberg MR, Dunn R. Direct measurement of retinal microvascular pressures in the live, anesthetized cat. Microvasc Res. 1993 Mar;45(2):158-65. doi: 10.1006/mvre.1993.1015.
- Background: PubMed 1623958Maepea O. Pressures in the anterior ciliary arteries, choroidal veins and choriocapillaris. Exp Eye Res. 1992 May;54(5):731-6. doi: 10.1016/0014-4835(92)90028-q.
- Background: PubMed 16151785Wilhelm B, Ludtke H, Wilhelm H; BRAION Study Group. Efficacy and tolerability of 0.2% brimonidine tartrate for the treatment of acute non-arteritic anterior ischemic optic neuropathy (NAION): a 3-month, double-masked, randomised, placebo-controlled trial. Graefes Arch Clin Exp Ophthalmol. 2006 May;244(5):551-8. doi: 10.1007/s00417-005-0102-8. Epub 2005 Sep 8.
- Background: PubMed 7844872Optic nerve decompression surgery for nonarteritic anterior ischemic optic neuropathy (NAION) is not effective and may be harmful. The Ischemic Optic Neuropathy Decompression Trial Research Group. JAMA. 1995 Feb 22;273(8):625-32.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Martin A SuttonBrown, MD principal investigator
Fraser Health Region
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1 study testing Timolol maleate in people with Optic Neuropathy, Ischemic and Anterior Ischemic Optic Neuropathy, run by Fraser Health at 1 site in Canada.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: withdrawn, as of the sponsor's last update on 25 May 2015. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study was withdrawn before enrolling participants, so there are no results.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Recruitment Rate of patients during the one year study to assess feasibility of a larger study (time frame: 12 months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01607671, which also lists 5 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 25 May 2015.