Wagner Siegfried K, Jolly Jasleen K, Pefkianaki Maria, Gekeler Florian, Webster Andrew R, Downes Susan M, Maclaren Robert E
Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
Oxford Eye Hospital, John Radcliffe Hospital, Oxford, UK.
BMJ Open Ophthalmol. 2017 Dec 14;2(1):e000096. doi: 10.1136/bmjophth-2017-000096. eCollection 2017.
To explore the impact of weekly transcorneal electrical stimulation (TES) over a 6-month period as a treatment for retinitis pigmentosa (RP).
A prospective open-label observational trial was carried out assessing weekly TES in participants with RP for a period of 6 months followed by observation for a further 6 months. Clinical examination and investigations were carried out at 3 monthly intervals for a total of 12 months. The primary outcome measure explored safety through a descriptive analysis of adverse effects with secondary outcome measures evaluating structural and functional efficacy.
Seven male and seven female participants with RP aged 18-80 years were recruited. TES was well tolerated with no serious adverse events reported. Two participants reported transient foreign body sensation and one participant had discomfort underneath the skin electrode. Following 6 months of TES, best-corrected visual acuity increased by 1.1±1.4 letters in the control arm and 0.93±1.4 letters in the treated arm. Central microperimetry threshold sensitivity rose by 0.02±0.5 decibels (dB) and 0.37±0.4 dB and Goldmann visual field volume by 0.16±0.09 steradians (sr) vs 0.22±0.12 sr for the control and treated eye, respectively. There was no statistical significance seen between eyes following the treatment or observation period.
This small open-label clinical trial showed that TES was safe and well tolerated in patients with RP. Visual function measurements at 6 months demonstrated no significant difference between the control and treated eyes. The results justify a larger clinical trial over a longer period of time in order to identify any treatment effect.
探讨为期6个月的每周经角膜电刺激(TES)治疗视网膜色素变性(RP)的效果。
开展一项前瞻性开放标签观察性试验,对RP患者进行为期6个月的每周一次TES治疗,随后再观察6个月。每3个月进行一次临床检查和调查,共持续12个月。主要结局指标通过对不良反应的描述性分析来探索安全性,次要结局指标评估结构和功能疗效。
招募了7名年龄在18 - 80岁之间的RP男性患者和7名女性患者。TES耐受性良好,未报告严重不良事件。两名患者报告有短暂的异物感,一名患者在皮肤电极下方有不适感。经过6个月的TES治疗,对照组最佳矫正视力提高了1.1±1.4行,治疗组提高了0.93±1.4行。中心微视野阈值敏感度分别提高了0.02±0.5分贝(dB)和0.37±0.4 dB,Goldmann视野体积分别增加了0.16±0.09球面度(sr)和0.22±0.12 sr,分别为对照眼和治疗眼。治疗期或观察期后两眼之间未见统计学意义。
这项小型开放标签临床试验表明,TES在RP患者中是安全且耐受性良好的。6个月时的视觉功能测量显示,对照眼和治疗眼之间无显著差异。这些结果证明有必要进行更长时间的更大规模临床试验,以确定任何治疗效果。