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Central Serous ChorioretinopathyPhase 2NCT01971190

Efficacy and Safety of Intravitreal Aflibercept Injection for Subacute Central Serous Chorioretinopathy

A Phase 2 study testing Intravitreal Aflibercept injection and Half-fluence photodynamic therapy in people with Central Serous Chorioretinopathy, run by Asan Medical Center at 6 sites in South Korea.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Central serous chorioretinopathy (CSC) is a self-limiting disease that usually associated with good visual prognosis. In some cases, however, CSC may persist and result in permanent retinal or retinal pigment epithelium (RPE) damage. Read more about this study

Who is it for?
Ages 18 to 60 years
Conditions the study is for
Central Serous Chorioretinopathy
What is being tested?
Intravitreal Aflibercept injection and Half-fluence photodynamic therapy
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
43 participants
Where
6 sitesSouth Korea
Study dates
Oct 2013to May 2015
Phase
Phase 2
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 18 to 60 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Clinical diagnosis of idiopathic CSC.
  • 18 to 60 years old, woman and man.
  • Subretinal fluid is found at OCT.
  • Symptom duration is from 6 weeks to 4 months.
  • Patient who agree to participate in the study.

Who cannot join

  • Patient who was treated previously for CSC
  • Patient who has choroidal neovascularization or other macular disease
  • Patient who has other ophthalmologic disease that may affect patient's vision.
  • History of any intraocular surgery, except cataract extraction prior to 3 months
  • Patient who has active intraocular inflammation or infection
  • Patient who has uncontrolled glaucoma IOP was more than 25 mmHg in spite of anti-glaucoma medication Visual field defect which affect best corrected visual acuity
Show all 13Show fewer
  • Patient who has been used systemic or topical carbonic anhydrase inhibitor within 1 month
  • Cushing syndrome
  • History of intravitreal steroid injection to study eye
  • Patient who has been used or plan to use systemic drug which is toxic to crystalline lens, retina or optic nerve.
  • Patient who has a known allergy to fluorescein or ICG
  • Pregnant or breast-feeding woman
  • Patient with contraindication to aflibercept Ocular or periocular infection Active severe intraocular inflammation Known hypersensitivity to aflibercept or to any of the excipients

Trial locations and contacts

6 sites in 1 country.

6 sites in 1 country

South Korea6 sites
  • Chungbuk national hospital

    Chungju

  • Gangneung asan hospital

    Gangneung

  • Seoul national university Bundang Hospital

    Ilsan

  • Asan medical center

    Seoul, 138736

  • Kim's Eye Hospital

    Seoul, 150-034

  • Samsung seoul hospital

    Seoul

Other trials in South Korea

About this study

Central serous chorioretinopathy (CSC) is a self-limiting disease that usually associated with good visual prognosis. In some cases, however, CSC may persist and result in permanent retinal or retinal pigment epithelium (RPE) damage. Therefore, if the disease is persistent beyond the acute phase, an active treatment should be considered to prevent an irreversible damage to retinal function.

The pathophysiology of CSC is associated with abnormal choroidal circulation. Indocyanine green angiography (ICGA) has revealed dilated and congested choroidal vessel and leakage into the extracellular space that appears as area of hyperfluorescence seen in middle and late phase in eyes with CSC.

Read more

A goal of treatment has been focused on reducing choroidal hyperpermeability. Currently, photodynamic therapy with verteporfin (PDT) and intravitreal anti-VEGF (vascular endothelial growth factor)antibody injection are being tried in order to treat chronic CSC. PDT reduces choroidal hyperpermeability by inducing hypoperfusion of the choriocapillaris in the short term and choroidal vascular remodeling over time. Intravitreal anti-VEGF injection for the treatment of CSC also effectively reduces choroidal hyperpermeability by blocking vascular leakage. Both methods have shown to be effective with good functional outcome for treating chronic CSC in many reports, but until now there is no established standard treatment protocol for chronic CSC.

Bevacizumab (Avastin) and ranibizumab (Lucentis) have been used widely as anti-VEGF therapeutic agent for the treatment of age related macular generation (AMD) and macular edema of various reasons. A newly developed anti-VEGF drug, aflibercept (Eylea○R), shows higher affinity to VEGF and has a longer duration of effect in the vitreous.FDA approved aflibercept to treat wet type AMD and macular edema due to central retinal vein occlusion.

Until now, no study has been reported on the efficacy and safety of aflibercept for treating CSC. The aim of this study is to evaluate the efficacy and safety of intravitreal aflibercept injection for the treatment of idiopathic CSC

Read the detailed description

Single-center Double blind randomized Phase 2 interventional parallel study.

Group A : 2mg intravitreal Aflibercept(Eylea) injection at baseline, at 1 month, and at 2 month Group B : Sham injection at baseline, at 1 month, and at 2 month

At 3 month, 4 month, 5 month, and 6 month, PRN treatment of aflibercept injection or half-fluence photodynamic therapy may be done, if one of following conditions is fulfilled.

The PRN treatment method was decided by investigator's discretion.

Of patient who had persistent intra- or subretina fluid on SD-OCT

  1. Central subfield thickness is not decreased to more than 50 micrometer compared with baseline central subfield thickness
  2. Best-corrected ETDRS letter score dose not increased more than 5 letters than baseline (because of the persistent CSC).
  3. Central subfield thickness is thicker than the previous exam
  4. BCVA letter score is worse than the previous exam (because of the persistent CSC)
Being tested
Intravitreal Aflibercept injection, Sham injection, Half-fluence photodynamic therapy
Medical subject headings
Central Serous Chorioretinopathy

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Intravitreal Aflibercept injectionDrug

    2mg intravitreal Aflibercept(Eylea) injection at baseline, at 1 month, and at 2 month.

    At 3 month, 4 month, 5 month, and 6 month, PRN treatment of aflibercept injection or half-fluence photodynamic therapy may be done, if one of following conditions is fulfilled.

    The PRN treatment method was decided by investigator's discretion.

    Of patient who had persistent intra- or subretina fluid on SD-OCT

    1. Central subfield thickness is not decreased to more than 50 micrometer compared with baseline central subfield thickness
    2. Best-corrected ETDRS letter score dose not increased more than 5 letters than baseline (because of the persistent CSC).
    3. Central subfield thickness is thicker than the previous exam
    4. BCVA letter score is worse than the previous exam (because of the persistent CSC)
  • Sham injectionDrug

    Sham injection at baseline, at 1 month, and at 2 month.

    At 3 month, 4 month, 5 month, and 6 month, PRN treatment of aflibercept injection or half-fluence photodynamic therapy may be done, if one of following conditions is fulfilled.

    The PRN treatment method was decided by investigator's discretion.

    Of patient who had persistent intra- or subretina fluid on SD-OCT

    1. Central subfield thickness is not decreased to more than 50 micrometer compared with baseline central subfield thickness
    2. Best-corrected ETDRS letter score dose not increased more than 5 letters than baseline (because of the persistent CSC).
    3. Central subfield thickness is thicker than the previous exam
    4. BCVA letter score is worse than the previous exam (because of the persistent CSC)
  • Half-fluence photodynamic therapyProcedure or surgery

    At 3 month, 4 month, 5 month, and 6 month, PRN treatment of aflibercept injection or half-fluence photodynamic therapy may be done, if one of following conditions is fulfilled.

    The PRN treatment method was decided by investigator's discretion.

    Of patient who had persistent intra- or subretina fluid on SD-OCT

    1. Central subfield thickness is not decreased to more than 50 micrometer compared with baseline central subfield thickness
    2. Best-corrected ETDRS letter score dose not increased more than 5 letters than baseline (because of the persistent CSC).
    3. Central subfield thickness is thicker than the previous exam
    4. BCVA letter score is worse than the previous exam (because of the persistent CSC)
Study groups in NCT01971190
Study groupRoleWhat they receive
Sham injectionSham comparatorSham injection at baseline, at 1 month, and at 2 month
Receives: Drug: Sham injection; Procedure: Half-fluence photodynamic therapy
Intravitreal Aflibercept injectionActive comparator2mg intravitreal Aflibercept(Eylea) injection at baseline, at 1 month, and at 2 month
Receives: Drug: Intravitreal Aflibercept injection; Procedure: Half-fluence photodynamic therapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Changes of central subfield thickness from baseline with time

    Measured: at 1,2,3,4,5,6 month

Secondary outcomes (5)
  1. Percentage of eyes achieving complete resolution of subretinal fluid

    Measured: at 6 month

  2. Percentage of eyes achieving 20/20 vision

    Measured: at 6 month

  3. Number of aflibercept injection to achieve a complete resolution

    Measured: at 6 month

  4. Change in subfoveal choroidal thickness from baseline using EDI-OCT

    Measured: at 1,2,3,4,5,6 month

  5. Adverse effect of intravitreal aflibercept (Eylea) injection

    Measured: upto 6 month

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Oct 2013 (estimated)
  2. Study startOct 2013
  3. Primary completionApr 2015
  4. Study completionMay 2015

Resources

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
43 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01971190
Sponsor's protocol ID
AFECT_001
Status last verified
Jun 2015
First submitted
21 Oct 2013
Last updated
25 Jun 2015
Results posted
No
Data monitoring committee
No

Publications

  • Dohrmann J, Lommatzsch A, Spital G, Pauleikhoff D. [Pathogenesis of central serous chorioretinopathy: angiographic and electrophysiological studies]. Ophthalmologe. 2001 Nov;98(11):1069-73. doi: 10.1007/s003470170027. German.

    PubMed 11729739
  • Wong R, Chopdar A, Brown M. Five to 15 year follow-up of resolved idiopathic central serous chorioretinopathy. Eye (Lond). 2004 Mar;18(3):262-8. doi: 10.1038/sj.eye.6700637.

    PubMed 15004575
  • Spaide RF, Hall L, Haas A, Campeas L, Yannuzzi LA, Fisher YL, Guyer DR, Slakter JS, Sorenson JA, Orlock DA. Indocyanine green videoangiography of older patients with central serous chorioretinopathy. Retina. 1996;16(3):203-13. doi: 10.1097/00006982-199616030-00004.

    PubMed 8789858
  • Bae SH, Heo JW, Kim C, Kim TW, Lee JY, Song SJ, Park TK, Moon SW, Chung H. A randomized pilot study of low-fluence photodynamic therapy versus intravitreal ranibizumab for chronic central serous chorioretinopathy. Am J Ophthalmol. 2011 Nov;152(5):784-92.e2. doi: 10.1016/j.ajo.2011.04.008. Epub 2011 Jul 13.

    PubMed 21742303
  • Lee JY, Chae JB, Yang SJ, Kim JG, Yoon YH. Intravitreal bevacizumab versus the conventional protocol of photodynamic therapy for treatment of chronic central serous chorioretinopathy. Acta Ophthalmol. 2011 May;89(3):e293-4. doi: 10.1111/j.1755-3768.2009.01835.x. No abstract available.

    PubMed 20346078
  • Lim JW, Kim MU. The efficacy of intravitreal bevacizumab for idiopathic central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol. 2011 Jul;249(7):969-74. doi: 10.1007/s00417-010-1581-9. Epub 2010 Dec 8.

    PubMed 21140161
  • Semeraro F, Romano MR, Danzi P, Morescalchi F, Costagliola C. Intravitreal bevacizumab versus low-fluence photodynamic therapy for treatment of chronic central serous chorioretinopathy. Jpn J Ophthalmol. 2012 Nov;56(6):608-12. doi: 10.1007/s10384-012-0162-3. Epub 2012 Aug 23.

    PubMed 22915299
  • Browning DJ, Kaiser PK, Rosenfeld PJ, Stewart MW. Aflibercept for age-related macular degeneration: a game-changer or quiet addition? Am J Ophthalmol. 2012 Aug;154(2):222-6. doi: 10.1016/j.ajo.2012.04.020.

    PubMed 22813448
  • Frampton JE. Aflibercept for intravitreal injection: in neovascular age-related macular degeneration. Drugs Aging. 2012 Oct;29(10):839-46. doi: 10.1007/s40266-012-0015-2.

    PubMed 23038609
  • Holash J, Davis S, Papadopoulos N, Croll SD, Ho L, Russell M, Boland P, Leidich R, Hylton D, Burova E, Ioffe E, Huang T, Radziejewski C, Bailey K, Fandl JP, Daly T, Wiegand SJ, Yancopoulos GD, Rudge JS. VEGF-Trap: a VEGF blocker with potent antitumor effects. Proc Natl Acad Sci U S A. 2002 Aug 20;99(17):11393-8. doi: 10.1073/pnas.172398299. Epub 2002 Aug 12.

    PubMed 12177445
  • Brown DM, Heier JS, Clark WL, Boyer DS, Vitti R, Berliner AJ, Zeitz O, Sandbrink R, Zhu X, Haller JA. Intravitreal aflibercept injection for macular edema secondary to central retinal vein occlusion: 1-year results from the phase 3 COPERNICUS study. Am J Ophthalmol. 2013 Mar;155(3):429-437.e7. doi: 10.1016/j.ajo.2012.09.026. Epub 2012 Dec 4.

    PubMed 23218699
  • Heier JS, Brown DM, Chong V, Korobelnik JF, Kaiser PK, Nguyen QD, Kirchhof B, Ho A, Ogura Y, Yancopoulos GD, Stahl N, Vitti R, Berliner AJ, Soo Y, Anderesi M, Groetzbach G, Sommerauer B, Sandbrink R, Simader C, Schmidt-Erfurth U; VIEW 1 and VIEW 2 Study Groups. Intravitreal aflibercept (VEGF trap-eye) in wet age-related macular degeneration. Ophthalmology. 2012 Dec;119(12):2537-48. doi: 10.1016/j.ophtha.2012.09.006. Epub 2012 Oct 17.

    PubMed 23084240
  • Boyer D, Heier J, Brown DM, Clark WL, Vitti R, Berliner AJ, Groetzbach G, Zeitz O, Sandbrink R, Zhu X, Beckmann K, Haller JA. Vascular endothelial growth factor Trap-Eye for macular edema secondary to central retinal vein occlusion: six-month results of the phase 3 COPERNICUS study. Ophthalmology. 2012 May;119(5):1024-32. doi: 10.1016/j.ophtha.2012.01.042. Epub 2012 Mar 21.

    PubMed 22440275
  • Do DV, Nguyen QD, Boyer D, Schmidt-Erfurth U, Brown DM, Vitti R, Berliner AJ, Gao B, Zeitz O, Ruckert R, Schmelter T, Sandbrink R, Heier JS; da Vinci Study Group. One-year outcomes of the da Vinci Study of VEGF Trap-Eye in eyes with diabetic macular edema. Ophthalmology. 2012 Aug;119(8):1658-65. doi: 10.1016/j.ophtha.2012.02.010. Epub 2012 Apr 24.

    PubMed 22537617
  • Lange CA, Qureshi R, Pauleikhoff L. Interventions for central serous chorioretinopathy: a network meta-analysis. Cochrane Database Syst Rev. 2025 Jun 16;6(6):CD011841. doi: 10.1002/14651858.CD011841.pub3.

    PubMed 40522203

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Intravitreal Aflibercept injection and Half-fluence photodynamic therapy in people with Central Serous Chorioretinopathy, run by Asan Medical Center at 6 sites in South Korea.

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 5 inclusion and 13 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: finished, as of the sponsor's last update on 25 Jun 2015. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 6 sites in South Korea. 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. Some participants in this study may receive a placebo. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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 is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Changes of central subfield thickness from baseline with time (time frame: at 1,2,3,4,5,6 month). 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 NCT01971190, which also lists 15 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 Jun 2015.

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