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RETeval Study for Diabetic Retinopathy

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT01950663
Recruitment Status : Completed
First Posted : September 25, 2013
Results First Posted : May 9, 2017
Last Update Posted : June 12, 2017
Sponsor:
Collaborators:
LKC Technologies, Inc.
National Eye Institute (NEI)
Information provided by (Responsible Party):
Stephen R Fransen, MD, Inoveon Corporation

Brief Summary:
RETeval is a new handheld device intended to detect vision threatening diabetic retinopathy. The purpose of this study is to calibrate RETeval, and then measure its ability to detect vision threatening diabetic retinopathy. Early Treatment Diabetic Retinopathy Study (ETDRS) 7-field, dilated, stereo, color fundus photography, read according to the ETDRS protocol, will be used as the gold standard.

Condition or disease Intervention/treatment Phase
Diabetic Retinopathy Device: RETeval Not Applicable

Detailed Description:

Diabetic retinopathy is the leading cause of preventable blindness in working age Americans. The associated loss of quality of life, and the economic loss from health care costs and lost productivity, are staggering. This burden is increasing rapidly as the epidemic of diabetes continues. In the developing world, diabetic retinopathy is expected to become the leading cause of preventable blindness since the prevalence of diabetes correlates closely with the dietary changes, obesity, and sedentary lifestyles that accompany economic development.

Half of all people with proliferative diabetic retinopathy will be blind within five years. With proven laser and intravitreal drug therapy this risk is reduced to less than 5%, a ten-fold decrease in risk. One third of all people with diabetic macular edema will suffer moderate visual loss in three years. With proven therapy this risk is reduced to less than 10%, a three-fold decrease in risk. Nonetheless, diabetic retinopathy remains the leading cause of preventable blindness in working age Americans.

Excellent diabetes control prevents or significantly reduces the development and progression of diabetic retinopathy but this approach requires difficult lifestyle changes. Therefore, timely identification of patients at risk for blindness, and assuring they receive proven care, are essential to eliminate blindness from diabetic retinopathy. Unfortunately, despite decades of public health awareness campaigns and programs, only 56.9% of US patients with diabetes received universally recommended eye evaluations in 2011.

One reason for this failure is the complexity of existing methods for diabetic retinopathy testing. To be effective, accurate testing should be available in the primary care physician's office since the need for an additional visit to an ophthalmologist is another reason universal testing has failed. To succeed in the primary care physician's office, existing personnel, with minimal training, must be able to accurately and easily test patients. The testing method must take little time and require no additional space since efficient time and space utilization are critical in primary care settings. It must meet quality measures used by Medicare and other payors to award financial incentives. Finally, it must be reimbursed at a favorable level.

RETeval is LKC Technologies' new, handheld, non-invasive, device that measures full-field electroretinogram (ERG) cone b-wave photopic flicker implicit times quickly and easily in a primary care setting. RETeval is simple to use and takes less than five minutes for most patients. It is a handheld device that requires no additional space. Based on published literature, the implicit time is significantly delayed in eyes with severe non proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR) relative to eyes with milder forms of DR. These findings suggest that the photopic ERG implicit time can be a good indicator for the objective evaluation of the severity of DR ranging from mild NPDR to PDR.

This study will measure the accuracy of the RETeval device. ETDRS 7-field, dilated, stereo, color fundus photography, read according to the ETDRS protocol, will be used as the gold standard. Cone b-wave photopic flicker implicit time, measured by the RETeval device, and ETDRS photography, will be performed during a single visit. A random sample of the results, the calibration set, will be used to calibrate the referral threshold for the RETeval device. The remaining results, the validation set, will be used as an independent validation to assess accuracy. If RETeval is accurate, and is accepted as a quality measure meeting performance standards, it will be an ideal method to test for retinopathy in patients with diabetes.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 468 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Diagnostic
Official Title: RETeval Calibration / Validation Study - Diabetic Retinopathy
Study Start Date : September 2013
Actual Primary Completion Date : April 2014
Actual Study Completion Date : April 2014

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: RETeval
RETeval is a new handheld device intended to detect vision threatening diabetic retinopathy by measuring the response of the retina to a flash of light.
Device: RETeval
RETeval is a new handheld device intended to detect vision threatening diabetic retinopathy by measuring the response of the retina to a flash of light.




Primary Outcome Measures :
  1. Per Patient Referral Accuracy [ Time Frame: During a single visit, implicit time, measured by the RETeval device, and ETDRS photography, will be performed to support the analysis of the accuracy of the RETeval device. ]
    Accuracy will be reported as count of participants with referral status correctly identified, sensitivity, and specificity, with ETDRS photography and reading as the gold standard.



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients diagnosed with diabetes and treated with at least one oral hypoglycemic medication or insulin
  • Eighteen years or older

Exclusion Criteria:

  • History of photosensitive epilepsy
  • Previous laser or drug treatment for diabetic retinopathy or macular edema
  • Eye diseases other than diabetic retinopathy or macular edema that, in the opinion of the recruiting ophthalmologist, may affect the electroretinogram or result in ungradable Early Treatment Diabetic Retinopathy Study Protocol images.
  • Inability or unwillingness of the subject or legal guardian/representative to give written informed consent

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01950663


Locations
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United States, Georgia
Atlanta VA Medical Center
Decatur, Georgia, United States, 30033
United States, Oklahoma
Oklahoma City VA Medical Center
Oklahoma City, Oklahoma, United States, 73104
Sponsors and Collaborators
Inoveon Corporation
LKC Technologies, Inc.
National Eye Institute (NEI)
Investigators
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Principal Investigator: Stephen R Fransen, MD Inoveon Corporation

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Responsible Party: Stephen R Fransen, MD, Chief Medical Officer, Inoveon Corporation
ClinicalTrials.gov Identifier: NCT01950663    
Other Study ID Numbers: 3032
R44EY021121 ( U.S. NIH Grant/Contract )
First Posted: September 25, 2013    Key Record Dates
Results First Posted: May 9, 2017
Last Update Posted: June 12, 2017
Last Verified: May 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Keywords provided by Stephen R Fransen, MD, Inoveon Corporation:
Diagnostic Equipment
Validation Studies
Additional relevant MeSH terms:
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Retinal Diseases
Diabetic Retinopathy
Eye Diseases
Diabetic Angiopathies
Vascular Diseases
Cardiovascular Diseases
Diabetes Complications
Diabetes Mellitus
Endocrine System Diseases