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一项评估可植入式微型望远镜安全性和有效性的前瞻性多中心临床试验。

A prospective multicenter clinical trial to evaluate the safety and effectiveness of the implantable miniature telescope.

作者信息

Lane S S, Kuppermann B D, Fine I H, Hamill M B, Gordon J F, Chuck R S, Hoffman R S, Packer M, Koch D D

机构信息

Associated Eye Care, Stillwater, Minnesota, USA.

出版信息

Am J Ophthalmol. 2004 Jun;137(6):993-1001. doi: 10.1016/j.ajo.2004.01.030.

Abstract

PURPOSE

To evaluate the safety and preliminary efficacy of a novel visual prosthetic device, the Implantable Miniature Telescope, IMT (by Dr Isaac Lipshitz) (IMT), in a phase I trial in patients with significant bilateral central vision impairment from late-stage age-related macular degeneration (AMD). The IMT is designed to reduce the relative size of the scotoma by rendering enlarged (threefold) central visual field images over the central and peripheral retina.

DESIGN

Prospective, multicenter, open-label clinical trial.

METHODS

In this prospective, multicenter phase I trial, 14 patients aged 60 or older with bilateral geographic atrophy or disciform scar AMD, cataract, and best-corrected visual acuity (BCVA) between 20/80 and 20/400 had an IMT implanted in one eye. Distance and near BCVA, endothelial cell density, and quality of life, measured as activities of daily life (ADL), were evaluated preoperatively and postoperatively.

RESULTS

At 12 months, 10 (77%) of 13 patients gained 2 more lines of either distance or near BCVA, and eight (62%) of 13 patients gained 3 or more lines in either distance or near BCVA. Mean endothelial cell density decreased by 13%. All adverse events resolved without sequelae. ADL scores improved in the majority of patients.

CONCLUSION

The results of this phase I trial support further evaluation of the IMT in a larger study population with late-stage AMD. A phase II/III trial is in progress.

摘要

目的

在一项I期试验中,评估一种新型视觉假体装置——可植入式微型望远镜(IMT,由艾萨克·利普希茨博士研发),用于治疗晚期年龄相关性黄斑变性(AMD)导致的严重双侧中心视力损害患者的安全性和初步疗效。IMT旨在通过在中央和周边视网膜上呈现放大(三倍)的中心视野图像来缩小暗点的相对大小。

设计

前瞻性、多中心、开放标签临床试验。

方法

在这项前瞻性多中心I期试验中,14名年龄在60岁及以上、患有双侧地图样萎缩或盘状瘢痕性AMD、白内障且最佳矫正视力(BCVA)在20/80至20/400之间的患者,一只眼睛植入了IMT。术前和术后评估了远视力和近视力BCVA、内皮细胞密度以及以日常生活活动(ADL)衡量的生活质量。

结果

在12个月时,13名患者中有10名(77%)在远视力或近视力BCVA方面提高了2行或更多,13名患者中有8名(62%)在远视力或近视力BCVA方面提高了3行或更多。平均内皮细胞密度下降了13%。所有不良事件均无后遗症地得到解决。大多数患者的ADL评分有所改善。

结论

这项I期试验的结果支持在更大的晚期AMD研究人群中对IMT进行进一步评估。一项II/III期试验正在进行中。

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