High Myopia: Extended and Longterm Observation of Pathologic Myopia Patients With the Risk for Developing a Myopic Choroidal Neovascularization (CNV) (HELP)

• ClinicalTrials.gov Identifier: NCT03070717
• Recruitment Status: Completed
• First Posted: March 3, 2017
• Last Update Posted: July 19, 2019
• Sponsor: Novartis Pharmaceuticals
• Information provided by (Responsible Party): Novartis ( Novartis Pharmaceuticals )

Study Description

Brief Summary:

This research project intends to observe patients with high myopia who show pathological retinal changes, in order to evaluate more data on the risk factors for developing mCNV within this research project population in Germany.

Condition or disease	Intervention/treatment
Pathologic Myopia	Procedure: Observation & Diagnosis

Study Design

• Study Type: Observational
• Actual Enrollment: 153 participants
• Observational Model: Cohort
• Time Perspective: Prospective
• Official Title: High Myopia: Extended and Longterm Observation of Pathologic Myopia Patients With the Risk for Developing a Myopic Choroidal Neovascularization (CNV)
• Actual Study Start Date: June 12, 2014
• Actual Primary Completion Date: May 23, 2019
• Actual Study Completion Date: May 23, 2019

Groups and Cohorts

Group/Cohort	Intervention/treatment
All patients; Patients with diagnosis of high myopia secondary to an anterior-posterior elongation of the bulbus confirmed by ocular examination in either eye using specific criteria.	Procedure: Observation & Diagnosis; SD-OCT, fundus autofluorescence, fundus photography, optional microperimetry, ophthalmic exams (BCVA, optical biometry), blood sampling.

Outcome Measures

Primary Outcome Measures :

1. Change in retinal morphology by SD-OCT [ Time Frame: Baseline, first year, 2nd year, 3rd year ]

   To exploratively determine the pathogenesis within the project population by assessing and evaluating the risk factors of myopic CNV by measuring the change in retinal morphology with spectral domain optical coherence tomography (SD-OCT).

   Risk factors are defined as choroidal thinning < 50μm, choroidal curvature length > 6300 μm (nasal temporal), lacquer cracks, patchy atrophy > 5mm² and preexisting myopic CNV in second eye.

Secondary Outcome Measures :

1. Change in retinal morphology by fundus autofluorescence [ Time Frame: Baseline, first year, 2nd year, 3rd year ]

   To exploratively determine the pathogenesis within the project population by assessing and evaluating the risk factors of myopic CNV within the project population by measuring the change in retinal morphology with fundus autofluorescence.

   Risk factors are defined as choroidal thinning < 50μm, choroidal curvature length > 6300 μm (nasal temporal), lacquer cracks, patchy atrophy > 5mm² and preexisting myopic CNV in second eye.

2. Change in retinal morphology by fundus photography [ Time Frame: Baseline, first year, 2nd year, 3rd year ]

   To exploratively determine the pathogenesis within the project population by assessing and evaluating the risk factors of myopic CNV within the project population by measuring the change in retinal morphology with fundus photography.

   Risk factors are defined as choroidal thinning < 50μm, choroidal curvature length > 6300 μm (nasal temporal), lacquer cracks, patchy atrophy > 5mm² and preexisting myopic CNV in second eye.

3. Change in Best Corrected Visual Acuity (BCVA) by vision testing (Landolt chart or equivalent) [ Time Frame: Baseline, 3rd year ]
   To exploratively determine the pathogenesis within the project population and within the individual patient by change of BCVA from baseline to 3rd year.
4. Change in refraction error by autorefractometer [ Time Frame: Baseline, 3rd year ]
   To exploratively determine the pathogenesis within the project population and within the individual patient by change of refraction error from baseline to 3rd year.

Other Outcome Measures:

1. Occurence of myopic CNV at the investigator's discretion [ Time Frame: From baseline until the date of occurence of myopic CNV at the investigator's discretion (if any), assessed up to 3 years. ]
   To assess if myopic CNV in study eye and/or fellow eye occured from baseline to 3rd year.
2. Change in health related quality of life (QoL) by NEI-VFQ-25 questionnaire [ Time Frame: Baseline and 3rd year (or at the date of occurence of myopic CNV at the investigator's discretion, if any, whichever comes first, assessed up to 3 years). ]
   To assess the change in health related QoL by patient reported outcome with the VFQ-25 questionnaire.
3. Assessment of biomarkers by analyzing blood samples [ Time Frame: Baseline and at the date of occurence of myopic CNV at the investigator's discretion, if any, assessed up to 3 years. ]
   To assess biomarkers which are possibly related to mCNV development. Blood samples will be taken at baseline from all patients who gave separate informed consents. A second sample will only be taken at CNV occurence (if any), assessed up to 3 years. Inflammatory and angiogenic markers will be measured and checked for the potential association to CNV formation.
4. Assessment of genetic factors by analyzing blood samples [ Time Frame: Baseline and at the date of occurence of myopic CNV at the investigator's discretion, if any, assessed up to 3 years. ]
   To assess genetic factors which are possibly related to mCNV development. Blood samples will be taken at baseline from all patients who gave separate informed consents. A second sample will only be taken at CNV occurence (if any), assessed up to 3 years. Inflammatory and angiogenic markers will be measured and checked for the potential association to CNV formation.
5. Change in axial length of the bulbus by optical biometry [ Time Frame: Baseline, first year, 2nd year, 3rd year ]
   To assess the change in axial length of the bulbus in both eyes by optical biometry.

Biospecimen Retention:   Samples With DNA

Whole blood, Serum

Eligibility Criteria

• Ages Eligible for Study: 18 Years and older (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No
• Sampling Method: Non-Probability Sample

Study Population

Caucasian adults with high myopia in Germany, recruited on an outpatient basis.

Criteria

Inclusion Criteria:

• Male or female caucasian patients ≥ 18 years of age

• Diagnosis of high myopia secondary to an anterior-posterior elongation of the bulbus confirmed by ocular examination in either eye using the following criteria:

  • Ocular ultrasonography or biometry demonstrating anterior-posterior elongation measurement ≥ 26 mm
  • abnormal change in retinal tissue by SD-OCT that are attributed to be caused by high myopia as shown in Table 4-2 of the protocol in the investigator's discretion confirmed by the reading centre

Exclusion Criteria:

• Patients with Diabetes mellitus of any grade
• Patients showing signs of Age-Related Macular Degeneration (AMD), e.g. drusen, characteristic changes in fundus (with shaping or extension of hemorrhages, fibrosis, exudative areas) in either eye
• Acute neovascularization (CNV or iris neovascularization) and intra- or subretinal fluid in either eye at the time of enrolment.
• History of inactive CNV in study eye. Inactive CNV of fellow eye is allowed if treatment was performed more than 12 months before enrolment.
• Any anti vascular endothelial growth factor' (anti-VEGF) or Verteporfin treatment in study eye and anti-VEGF or Verteporfin treatment less than 12 months before enrolment in fellow eye
• History of systemic anti vascular endothelial growth factor' (anti-VEGF) therapy
• Cataract that would prevent an accurate measurement of the axial length of the study eye

Other protocol-defined inclusion/exclusion criteria may apply

Contacts and Locations

Locations

Germany

Novartis Investigative Site

Regensburg, Bavaria, Germany, 93053

Novartis Investigative Site

Ansbach, Germany, 91522

Novartis Investigative Site

Bad Rothenfelde, Germany, 49214

Novartis Investigative Site

Berlin, Germany, 10713

Novartis Investigative Site

Berlin, Germany, 13353

Novartis Investigative Site

Bochum, Germany, 44892

Novartis Investigative Site

Bonn, Germany, 53105

Novartis Investigative Site

Chemnitz, Germany, 09113

Novartis Investigative Site

Duesseldorf, Germany, 40225

Novartis Investigative Site

Essen, Germany, 45147

Novartis Investigative Site

Frankfurt, Germany, 60590

Novartis Investigative Site

Freiburg, Germany, 79106

Novartis Investigative Site

Gottingen, Germany, 37075

Novartis Investigative Site

Hamburg, Germany, 20246

Novartis Investigative Site

Hösbach, Germany, 63768

Novartis Investigative Site

Karlsruhe, Germany, 76133

Novartis Investigative Site

Koeln, Germany, 50924

Novartis Investigative Site

Leipzig, Germany, 04103

Novartis Investigative Site

Mainz, Germany, 55131

Novartis Investigative Site

Muenchen, Germany, 81377

Novartis Investigative Site

Muenchen, Germany, 81675

Novartis Investigative Site

Muenster, Germany, 48145

Novartis Investigative Site

Muenster, Germany, 48149

Novartis Investigative Site

München, Germany, 80637

Novartis Investigative Site

Tuebingen, Germany, 72076

Novartis Investigative Site

Wuerzburg, Germany, 97080

Sponsors and Collaborators

Novartis Pharmaceuticals

More Information

• Responsible Party: Novartis Pharmaceuticals
• ClinicalTrials.gov Identifier: NCT03070717
• Other Study ID Numbers: CRFB002FDE01
• First Posted: March 3, 2017
• Last Update Posted: July 19, 2019
• Last Verified: July 2019

Keywords provided by Novartis ( Novartis Pharmaceuticals ):

High myopia, shortsightedness, retinal changes

Additional relevant MeSH terms:

Myopia; Choroidal Neovascularization; Neovascularization, Pathologic; Refractive Errors; Eye Diseases; Metaplasia; Pathologic Processes; Choroid Diseases; Uveal Diseases