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NCT Number: NCT04847635

Subthreshold Laser Treatment for Reticular Pseudodrusen Secondary to Age-related Macular Degeneration

Prospective, randomized, controlled, longitudinal, interventional multicentric study involving patients with reticular pseudodrusen secondary to AMD.

The objective of this study is to establish the effectiveness of subthreshold laser treatment in increase/prevent the decrease of the retinal sensibility in patients with reticular pseudodrusen, and to reduce the progression of RPD to atrophy.

Approximately 50 naïve patients with reticular pseudodrusen who underwent subthreshold laser treatment in perifoveal area. These patients should be randomized in the 2 study arms of the study. Patients will be evaluated at Screening/Baseline and then revaluated and retreated at month 3, 6 and 9. At month 12, all patients will be evaluated with a full ocular examination, visual acuity measurement (VA), optical coherence tomography (OCT) with autofluorescence, OCT-angiography and microperimetry.

The rationale of the study is to prevent the evolution of reticular pseudodrusen to atrophic degeneration.

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Key information

Age range

55 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Massimo Nicolò, Genova, Italy

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 50 years or older
  • Presence of RPD secondary to AMD
  • Best-corrected visual acuity (BCVA) between 20/20 and 20/400 inclusive
  • Clear ocular media
  • Ability to provide informed consent and attend all study visits

Exclusion criteria

  • Presence of Geographic Atrophy (GA)
  • Evidence of choroidal neovascularization in either eye
  • Any prior treatment for AMD, aside from antioxidants
  • Any corneal opacity, cataract formation and hemorrhage in the vitreous body, which may interfere with viewing by the laser surgeon of the target structures
  • Aphakic eye with vitreous in the anterior chamber
  • Neovascular Glaucoma
  • Glaucoma caused by congenital angle anomalies
  • Open angle of less than 90º or extensive peripheral anterior and low synechia, present circumferentially around the corner
  • Significant corneal edema or reduced water clarity that obscures the view angle in detail
  • Glaucoma secondary to active uveitis
  • Any other ocular condition that would progress in the study period and confound visual acuity assessment
  • Any ocular or systemic medication known to be toxic to the lens, retina or optic nerve Presence of idiopathic or autoimmune-associated uveitis
  • Any intraocular surgery 3 months of entry
  • Any prior thermal laser in the macula
  • History of vitrectomy, filtering surgery, corneal transplant or retinal detachment surgery
  • Previous therapeutic radiation in the ocular region in either eye
  • Any treatment with an investigational agent in the previous 60 days before study entry
  • Women of child-bearing potential, defined as all women less than 1 year postmenopausal or less than 6 weeks since sterilization (further definition can be found in Section 12.7) at Baseline, unless they are using highly effective methods of contraception during dosing of study treatment.
  • Participation in an investigational drug, biologic, or device study within 6 Months prior to Baseline [Note: observational clinical studies solely involving over-the-counter vitamins, supplements, or diets are not exclusionary

Treatment and study plan

Pascal Synthesis 577 sub-threshold laser (Topcon Corporation, Tokyo, Japan)

Device

The subthreshold laser treatment will be performed using subthreshold laser Pascal Synthesis 577 on a customized macular area.

Pascal Synthesis 577 sham (Topcon Corporation, Tokyo, Japan)

Device

The laser treatment will be performed without any power (only the light beam) using subthreshold laser Pascal Synthesis 577 on a customized macular area.

Primary outcomes

  1. Changes in the retinal sensitivity - 12 months

    Time frame: 12 months

    Functional changes in the retinal sensitivity on customized microperimetry from day 0 to month 12 (unit of measure: dB)

  2. Anatomical changes using structural optical coherence tomography (OCT)

    Time frame: 12 months

    Anatomical changes will be evaluated with retinal thickness (unit of measure: microns)

  3. Rate of Progression

    Time frame: 12 months

    Rate of progression to advance AMD (GA and/or neovascular AMD)

Secondary outcomes

  1. Changes in the retinal sensitivity - 6 months

    Time frame: 6 months

    Functional changes in the retinal sensitivity on customized microperimetry from day 0 to month 6 (unit of measure: dB)

  2. Anatomical changes using fundus autofluorescence (FAF)

    Time frame: 12 months

    Anatomical changes will be evaluated analyzing the development of geographic atrophy using FAF

  3. Genetic influence (% of AMD-associated single-nucleotide polymorphism (SNP) in treated patients)

    Time frame: 12 months

    The % of AMD-associated single-nucleotide polymorphism (SNP) will be evaluated analyzing the % of patients with an AMD-associated SNP in patients showing no progression vs progression to advance AMD (main outcome 3).

  4. Anatomical changes using OCT-angiography (OCT-A)

    Time frame: 12 months

    Anatomical changes will be evaluated analyzing the perfusion density by means of OCT-A

Study contacts

Contact information is provided by the study sponsor or research team.

Giuseppe Querques, MD, PhD

CONTACT

[email protected]

+390226434004

Sponsors and collaborators

Lead sponsor

Ospedale San Raffaele

Other

Collaborators

  • Fondazione G.B. Bietti, IRCCS
  • University of Genova
  • University of Rome Tor Vergata

Registry information

Acronym: PASCAL-RPD

Important dates

Study start
2021
Primary completion
2026
Study completion
2026
First posted
Apr 19, 2021
Registry last updated
Mar 12, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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