Neural Conduction Along the Visual Pathways After Oral Treatment With Citicoline in Patients With Optic Nerve Diseases

This study has been completed.
Sponsor:
Information provided by:
Fondazione G.B. Bietti, IRCCS
ClinicalTrials.gov Identifier:
NCT00404729
First received: November 28, 2006
Last updated: NA
Last verified: November 2006
History: No changes posted
  Purpose

In the management of glaucoma, as for as in other optic nerve diseases, an important goal of ophthalmologists is represented by the possibility of influencing visual function.

In this regard, Parisi et al [Ophthalmology 1999; 106:1126-1134.] suggested the intramuscular treatment with Cytidine-5-diphosphocholine (CDP-Choline or citicoline) to improve glaucomatous visual defects. In particular, recent studies reported the effects of citicoline on glaucomatous retinal and postretinal visual structures evaluated by electrophysiological examinations (PERG and VEP). It was observed that a 2-month period of treatment with citicoline may induce improvement in both ganglion cell function (PERGs with increase in amplitudes and shortening in times-to-peak) and in neural conduction along postretinal visual pathways (VEPs with increase in amplitudes and shortening in times-to-peak). The effects of citicoline on glaucomatous retinal and postretinal structures were not present 8 months after the end of treatment. However, performing several 2-month period of treatment with citicoline during a total period of 8 years, it was found a additional improvement of the glaucomatous retinal and postretinal impairment [Parisi V. Doc Ophthalmol. 2005 Jan;110:91-102). In this work, we aimed to assess whether there similar visual function outcomes can be reached by the oral treatment with citicoline in patients affected by glaucomatous optic nerve disease as of as in other optic nerve diseases (i.e. non-arteritic ischemic optic neuropathy)


Condition Intervention Phase
Glaucoma
Optic Neuropathy, Ischemic
Visual Pathways,
Optic Nerve
Neural Conduction
Drug: Cytidine-5’-diphosphocholine (Citicoline)
Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Phase 4 Study of Evaluation of Neural Conduction Along the Visual Pathways Before and After Oral Treatment With Citicoline in Patients With Optic Nerve Diseases

Resource links provided by NLM:


Further study details as provided by Fondazione G.B. Bietti, IRCCS:

Primary Outcome Measures:
  • VEPs responses (P100 Implicit time and N75-P100 Amplitude)

Secondary Outcome Measures:
  • Visual Field Defects (Humphrey 24/1: Mean Deviation and Corrected Pattern Standard Deviation)

Estimated Enrollment: 60
Study Start Date: February 2005
Estimated Study Completion Date: July 2006
Detailed Description:

Participants: 30 patients with open-angle glaucoma (OAG) and 15 patients (mean age 64.6±3.3ys) with non-arteritic ischemic optic neuropathy (NION) were enrolled enrolled.

Ten OAG patients will be untreated (NT-AOG, 10 eyes), while 20 OAG patients (T-AOG, 20 eyes) and 15 NION patients (T-NION, 14 eyes) were treated with Citicoline (oral treatment:1600 mg/die per 60 days) (Cebrolux®, Tubilux, Italy).

Methods: In T-OAG, NT-OAG and T-NION patients, Visual Evoked Potentials (VEPs)were recorded in response to 15’ checkerboard pattern stimuli.

VEPs were assessed 5 times during a total period of 360 days: at baseline conditions (0 day), after two different cycles of 60 days of treatment (days 0-60 and days 180-240), and after two different cycles of 120 days of wash out (days 60-180 and 240-360). In NT-AOG patients, VEPs were assessed at baseline conditions (0 day) and after 60, 180, 240 and 360 days.

  Eligibility

Ages Eligible for Study:   40 Years to 70 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

Glaucoma Patients:

  • IOP > 23 mmHg and < 28 mmHg (average of the two highest readings of the daily curve, from 8:00 a.m. to 6:00 p.m., six independent readings, one every two hours) without medical treatment;
  • HFA with MD < - 2 dB; CPSD > +2 dB; fixation losses, false positive rate and false negative rate each less than 20%;
  • best corrected visual acuity of 20/20 or better;
  • one or more papillary signs on conventional color stereo-slides: the presence of a localized loss of neuroretinal rim (notch), thinning of the neuroretinal rim, generalized loss of optic rim tissue, optic disc excavation, vertical or horizontal cup/disc ratio greater than 0.5, cup-disc asymmetry between the two eyes greater than 0.2, peripapillary splinter hemorrhages;
  • refractive error (when present) between -1.00 and +1.00 spherical equivalent;
  • no previous history or presence of any disease involving cornea, lens, macula or retina;
  • no previous history or presence of diabetes, optic neuritis, any disease involving the visual pathways;
  • pupil diameter > 3 mm without mydriatic or miotic drugs.

Patients with non-arteritic ischemic optic neuropathy:

  • IOP < 21 mmHg HFA with MD < - 2 dB; CPSD > +2 dB; fixation losses, false positive rate and false negative rate each less than 20%;
  • refractive error (when present) between -1.00 and +1.00 spherical equivalent;
  • no previous history or presence of any disease involving cornea, lens, macula or retina;
  • no previous history or presence of diabetes of any further disease involving the visual pathways;
  • pupil diameter > 3 mm without mydriatic or miotic drugs.

Exclusion Criteria:

All other condition that may influence Visual Evoked Potentials:

- previous history or presence of any disease involving cornea, lens, macula or retina or optic nerve (i.e inflammatory diseases)

  Contacts and Locations
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Please refer to this study by its ClinicalTrials.gov identifier: NCT00404729

Locations
Italy
Fondazione G.B. Bietti- IRCCS
Rome, Italy, 00199
Fondazione G.B. Bietti-IRCCS
Rome, Italy, 00199
Sponsors and Collaborators
Fondazione G.B. Bietti, IRCCS
Investigators
Study Director: Vincenzo Parisi, MD Fondazione G.B. Bietti-IRCCS, Rome, Italy
  More Information

Additional Information:
Publications:
ClinicalTrials.gov Identifier: NCT00404729     History of Changes
Other Study ID Numbers: 86216880, 85356727
Study First Received: November 28, 2006
Last Updated: November 28, 2006
Health Authority: Italy: Ministry of Health

Keywords provided by Fondazione G.B. Bietti, IRCCS:
Glaucoma
Optic Neuropathy, Ischemic
Visual Pathways,
Optic nerve
Neural conduction

Additional relevant MeSH terms:
Glaucoma
Ischemia
Nervous System Diseases
Optic Nerve Diseases
Optic Neuropathy, Ischemic
Ocular Hypertension
Eye Diseases
Pathologic Processes
Cranial Nerve Diseases
Vascular Diseases
Cardiovascular Diseases
Cytidine Diphosphate Choline
Nootropic Agents
Central Nervous System Agents
Therapeutic Uses
Pharmacologic Actions

ClinicalTrials.gov processed this record on July 23, 2014