<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03763227</url>
  </required_header>
  <id_info>
    <org_study_id>MREC 883</org_study_id>
    <nct_id>NCT03763227</nct_id>
  </id_info>
  <brief_title>Intravitreal Ranibizumab (Lucentis®) in the Treatment of Non-leaking Macular Cysts in Retinal Dystrophy</brief_title>
  <official_title>Efficacy and Safety of Intravitreal Ranibizumab (Lucentis®) Injection in the Treatment of Non-leaking Macular Cysts in Patients With Retinal Dystrophy.</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Sultan Qaboos University</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Sultan Qaboos University</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
    <is_fda_regulated_drug>Yes</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
    <is_us_export>Yes</is_us_export>
  </oversight_info>
  <brief_summary>
    <textblock>
      To evaluate the efficacy and safety of intravitreal ranibizumab (IVR) injection in the&#xD;
      treatment of non-leaking macular cysts in patients with retinal dystrophy.&#xD;
&#xD;
      Material and Methods:&#xD;
&#xD;
      Design - Prospective, nonrandomized, nonblinded, clinical trial. Participants - Patients &gt;18&#xD;
      years diagnosed with retinal dystrophies and non-leaking macular cysts between Jan 2015 and&#xD;
      July 2018 in 1 center.&#xD;
&#xD;
      Methods - Phase 1: Patients with best corrected visual acuity (BCVA) &lt; 0.5 will receive&#xD;
      carbonic anhydrase inhibitors (CAI) [oral acetazolamide 500mg/day or topical brinzolamide&#xD;
      twice daily] and followed up for three months. Phase 2: Patients who do not show an adequate&#xD;
      response with CAI will receive three 0.5mg IVR injection at monthly intervals.&#xD;
&#xD;
      Outcome - 1) Significant reduction (&gt; 10%) of the central macular thickness (CMT), 2)&#xD;
      Improvement (&gt; 1 line) in BCVA 3) Presence of any complication.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      The treatment of cystoid macular edema (CME) in retinitis pigmentosa (RP) is well established&#xD;
      in medical literature. These treatments include topical and oral carbonic anhydrase&#xD;
      inhibitors (CAI), intravitreal triamcinolone acetonide, and laser photocoagulation. Oral&#xD;
      acetazolamide, a carbonic anhydrase inhibitor (CAI), was found to be effective in the&#xD;
      treatment of RP related CME with improvement in both visual acuity and fundus fluorescein&#xD;
      angiography (FFA). However, some patients may not benefit from the treatment, or do not&#xD;
      tolerate it, while others may develop rebound CME with prolonged use of at least 8 to 12&#xD;
      weeks.&#xD;
&#xD;
      An emerging treatment modality for CME in RP is the use of intravitreal injections of&#xD;
      anti-vascular endothelial growth factors (anti-VEGF) such as bevacizumab (Avastin®) and&#xD;
      ranibizumab (Lucentis®). Anti-VEGF has been used successfully for treating diabetic macular&#xD;
      edema, and macular edema secondary to retinal vein occlusion and choroidal&#xD;
      neovascularization, with limited side effects.&#xD;
&#xD;
      A subset of patients with retinal dystrophy develop non-leaking macular cysts that can be&#xD;
      confused with CME on ophthalmoscopy and optical coherence tomography (OCT). FFA establishes&#xD;
      the cavitary nature of the maculopathy, with no hyperfluorescence seen on angiography&#xD;
      compared with leakage seen in patients with CME and retinal dystrophy.&#xD;
&#xD;
      CAI may promote resolution of the non-leaking macular cysts. There are limited studies that&#xD;
      explore the effect of anti-VEGF specifically on non-leaking macular cysts in retinal&#xD;
      dystrophies.&#xD;
&#xD;
      Aims:&#xD;
&#xD;
      - Assess the efficacy of intravitreal ranibizumab (IVR) injection in the treatment of&#xD;
      non-leaking macular cystic lesions in patients with retinal dystrophy that have not responded&#xD;
      to therapy with oral or topical CAI.&#xD;
&#xD;
      Objectives:&#xD;
&#xD;
        -  Delineate the entity of non-leaking macular cysts by OCT and FFA.&#xD;
&#xD;
        -  Assess the efficacy of short-term oral and topical CAI treatment on non-leaking macular&#xD;
           cysts in retinal dystrophies.&#xD;
&#xD;
        -  Study the visual response and structural resolution of non-leaking macular cysts in&#xD;
           response to IVR.&#xD;
&#xD;
      Design: Two-phase prospective, non-randomized, open-label, comparative interventional,&#xD;
      clinical trial.&#xD;
&#xD;
      Inclusion criteria:&#xD;
&#xD;
        1. Omani patients over 18 years old&#xD;
&#xD;
        2. Retinal dystrophy and non-leaking macular cysts confirmed by fundus examination,&#xD;
           electroretinography (ERG), OCT, FFA and genetic testing.&#xD;
&#xD;
        3. Capacity and cooperation to undergo visual function assessment (i.e. best-corrected&#xD;
           visual acuity (BCVA), as well as the above-mentioned investigations.&#xD;
&#xD;
        4. Written, informed consent to participate in the study&#xD;
&#xD;
      Exclusion Criteria:&#xD;
&#xD;
        1. Patients with pseudo-RP&#xD;
&#xD;
        2. Patients with cystic macular lesions or progressive retinal disease due to any cause&#xD;
           other than retinal dystrophy&#xD;
&#xD;
        3. Patients with reduced visual acuity due to media opacities (e.g. cataract).&#xD;
&#xD;
        4. Patients with any contraindication or known allergy to CAI or anti-VEGF agents&#xD;
&#xD;
        5. Patients who have undergone vitreo-retinal surgery or intravitreal injection.&#xD;
&#xD;
      Methods:&#xD;
&#xD;
      Phase 1: Patients with best corrected visual acuity (BCVA) &lt; 0.5 will receive carbonic&#xD;
      anhydrase inhibitors (CAI) [oral acetazolamide 500mg/day or topical brinzolamide twice daily]&#xD;
      and followed up for three months. Baseline urea and electrolyte (U&amp;E) will be tested prior to&#xD;
      receiving CAI, and monitored every month while on the treatment. Upon completion of the&#xD;
      treatment course, the patients will be assessed for response with visual function assessment&#xD;
      and central macular thickness (CMT) on OCT. Patients who show an adequate response (defined&#xD;
      as &gt; 10% reduction of CMT) and/or improvement of BCVA by two lines or more) will continue in&#xD;
      the CAI arm.&#xD;
&#xD;
      Phase 2: Patients who do not show an adequate response with CAI or develop significant side&#xD;
      effects from CAI treatment will stop receiving CAI and will move to Phase 2 of the study and&#xD;
      receive three 0.5mg IVR injection at monthly intervals. Upon completion of the treatment&#xD;
      course, the patients will be assessed for response with visual function assessment and CMT on&#xD;
      OCT.&#xD;
&#xD;
      The purpose of the proposed procedures/treatment, as well as potential complications, will be&#xD;
      clearly explained to participants. It will be made clear to the patient that IVR treatment is&#xD;
      experimental and may or may not lead to improvement of vision. The patient will also be&#xD;
      informed that the treatment will be withheld in case of allergy or complications. It will be&#xD;
      emphasized that he/she may withdraw from the study at any stage.&#xD;
&#xD;
      Patients will be under regular and close follow-up. They will be monitored for the&#xD;
      development of any complications during the study. Any complication will be logged and&#xD;
      treated appropriately. Patients' personal information, clinical history, examination,&#xD;
      investigation results and progress with treatment, will be treated confidentially.&#xD;
&#xD;
      Institutional research ethics board approval will be obtained prior to the start of the&#xD;
      study.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date type="Actual">July 24, 2015</start_date>
  <completion_date type="Actual">August 29, 2019</completion_date>
  <primary_completion_date type="Actual">August 29, 2019</primary_completion_date>
  <phase>Phase 2</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Non-Randomized</allocation>
    <intervention_model>Sequential Assignment</intervention_model>
    <intervention_model_description>Phase 1: Patients with best corrected visual acuity (BCVA) &lt; 0.5 will receive carbonic anhydrase inhibitors (CAI) [oral acetazolamide 500mg/day or topical brinzolamide twice daily] and followed up for three months. Phase 2: Patients who do not show an adequate response with CAI will receive three 0.5mg IVR injection at monthly intervals.</intervention_model_description>
    <primary_purpose>Treatment</primary_purpose>
    <masking>None (Open Label)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Macular Cyst</measure>
    <time_frame>3 months</time_frame>
    <description>Reduction in central macular thickness by 10%</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Macula</measure>
    <time_frame>3 months</time_frame>
    <description>Improvement in visual acuity by over one line</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Complications</measure>
    <time_frame>3 months</time_frame>
    <description>Presence of any complications from treatment</description>
  </primary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Actual">13</enrollment>
  <condition>Retinal Dystrophies</condition>
  <arm_group>
    <arm_group_label>Carbonic Anhydrase Inhibitor (CAI) Arm</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>Patients who have received carbonic anhydrase inhibitor (CAI) therapy namely oral acetazolamide or topical brinzolamide</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Intravitreal ranibizumab (IVR) arm</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>Intravitreal ranibizumab (IVR) injection administered to patients who have not shown adequate response or who have not tolerated CAI therapy&#xD;
IVR therapy = Three 0.5mg IVR injection at monthly intervals</description>
  </arm_group>
  <intervention>
    <intervention_type>Drug</intervention_type>
    <intervention_name>Intravitreal ranibizumab (IVR) injection</intervention_name>
    <description>Intravitreal ranibizumab (IVR) injection in patients with retinal dystrophy and macular cysts who have not responded to treatment with carbonic anhydrase inhibitors</description>
    <arm_group_label>Intravitreal ranibizumab (IVR) arm</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Drug</intervention_type>
    <intervention_name>Carbonic Anhydrase Inhibitor (CAI) therapy</intervention_name>
    <description>Carbonic anhydrase therapy (Oral or Topical) in patients with retinal dystrophy and macular cysts</description>
    <arm_group_label>Carbonic Anhydrase Inhibitor (CAI) Arm</arm_group_label>
    <other_name>CAI</other_name>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
        Omani patients over 18 year old, with retinal dystrophy and non-leaking macular cysts&#xD;
        confirmed by fundus examination, electroretinography (ERG), optical coherence tomography&#xD;
        (OCT), fundus fluorescein angiography (FFA) and genetic testing.&#xD;
&#xD;
        Included patients should also have the capacity and cooperation to undergo visual function&#xD;
        assessment (i.e. best-corrected visual acuity (BCVA), color vision as well as the&#xD;
        above-mentioned investigations.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
        Patients with pseudo-retinitis pigmentosa, those with cystic macular lesions or progressive&#xD;
        retinal disease due to any cause other than retinal dystrophy, and patients with reduced&#xD;
        visual acuity due to media opacities (e.g. cataract). Patients with any contraindication or&#xD;
        known allergy to brinzolamide, acetazolamide or anti-VEGF agents will not receive the&#xD;
        respective drug, nor those who underwent intraocular surgery or injection within the last 1&#xD;
        month.&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Anuradha Ganesh, MD</last_name>
    <role>Study Chair</role>
    <affiliation>Sultan Qaboos University Hospital</affiliation>
  </overall_official>
  <reference>
    <citation>Moustafa GA, Moschos MM. Intravitreal aflibercept (Eylea) injection for cystoid macular edema secondary to retinitis pigmentosa - a first case report and short review of the literature. BMC Ophthalmol. 2015 Apr 30;15:44. doi: 10.1186/s12886-015-0033-z.</citation>
    <PMID>25925748</PMID>
  </reference>
  <reference>
    <citation>Artunay O, Yuzbasioglu E, Rasier R, Sengul A, Bahcecioglu H. Intravitreal ranibizumab in the treatment of cystoid macular edema associated with retinitis pigmentosa. J Ocul Pharmacol Ther. 2009 Dec;25(6):545-50. doi: 10.1089/jop.2009.0089.</citation>
    <PMID>20028262</PMID>
  </reference>
  <reference>
    <citation>Yuzbasioglu E, Artunay O, Rasier R, Sengul A, Bahcecioglu H. Intravitreal bevacizumab (Avastin) injection in retinitis pigmentosa. Curr Eye Res. 2009 Mar;34(3):231-7. doi: 10.1080/02713680802710692.</citation>
    <PMID>19274531</PMID>
  </reference>
  <reference>
    <citation>Miyata M, Oishi A, Oishi M, Hasegawa T, Ikeda HO, Tsujikawa A. Long-term efficacy and safety of anti-VEGF therapy in retinitis pigmentosa: a case report. BMC Ophthalmol. 2018 Sep 14;18(1):248. doi: 10.1186/s12886-018-0914-z.</citation>
    <PMID>30217183</PMID>
  </reference>
  <verification_date>September 2019</verification_date>
  <study_first_submitted>December 1, 2018</study_first_submitted>
  <study_first_submitted_qc>December 1, 2018</study_first_submitted_qc>
  <study_first_posted type="Actual">December 4, 2018</study_first_posted>
  <last_update_submitted>September 20, 2019</last_update_submitted>
  <last_update_submitted_qc>September 20, 2019</last_update_submitted_qc>
  <last_update_posted type="Actual">September 23, 2019</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Retinal Dystrophies</mesh_term>
  </condition_browse>
  <intervention_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Ranibizumab</mesh_term>
    <mesh_term>Carbonic Anhydrase Inhibitors</mesh_term>
  </intervention_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03763227
org study id: MREC 883
nct id: NCT03763227
lead sponsor: 
has dmc: Yes
is fda regulated drug: Yes
is fda regulated device: No
is us export: Yes
To evaluate the efficacy and safety of intravitreal ranibizumab (IVR) injection in the
      treatment of non-leaking macular cysts in patients with retinal dystrophy.

      Material and Methods:

      Design - Prospective, nonrandomized, nonblinded, clinical trial. Participants - Patients >18
      years diagnosed with retinal dystrophies and non-leaking macular cysts between Jan 2015 and
      July 2018 in 1 center.

      Methods - Phase 1: Patients with best corrected visual acuity (BCVA) < 0.5 will receive
      carbonic anhydrase inhibitors (CAI) [oral acetazolamide 500mg/day or topical brinzolamide
      twice daily] and followed up for three months. Phase 2: Patients who do not show an adequate
      response with CAI will receive three 0.5mg IVR injection at monthly intervals.

      Outcome - 1) Significant reduction (> 10%) of the central macular thickness (CMT), 2)
      Improvement (> 1 line) in BCVA 3) Presence of any complication.
The treatment of cystoid macular edema (CME) in retinitis pigmentosa (RP) is well established
      in medical literature. These treatments include topical and oral carbonic anhydrase
      inhibitors (CAI), intravitreal triamcinolone acetonide, and laser photocoagulation. Oral
      acetazolamide, a carbonic anhydrase inhibitor (CAI), was found to be effective in the
      treatment of RP related CME with improvement in both visual acuity and fundus fluorescein
      angiography (FFA). However, some patients may not benefit from the treatment, or do not
      tolerate it, while others may develop rebound CME with prolonged use of at least 8 to 12
      weeks.

      An emerging treatment modality for CME in RP is the use of intravitreal injections of
      anti-vascular endothelial growth factors (anti-VEGF) such as bevacizumab (Avastin®) and
      ranibizumab (Lucentis®). Anti-VEGF has been used successfully for treating diabetic macular
      edema, and macular edema secondary to retinal vein occlusion and choroidal
      neovascularization, with limited side effects.

      A subset of patients with retinal dystrophy develop non-leaking macular cysts that can be
      confused with CME on ophthalmoscopy and optical coherence tomography (OCT). FFA establishes
      the cavitary nature of the maculopathy, with no hyperfluorescence seen on angiography
      compared with leakage seen in patients with CME and retinal dystrophy.

      CAI may promote resolution of the non-leaking macular cysts. There are limited studies that
      explore the effect of anti-VEGF specifically on non-leaking macular cysts in retinal
      dystrophies.

      Aims:

      - Assess the efficacy of intravitreal ranibizumab (IVR) injection in the treatment of
      non-leaking macular cystic lesions in patients with retinal dystrophy that have not responded
      to therapy with oral or topical CAI.

      Objectives:

        -  Delineate the entity of non-leaking macular cysts by OCT and FFA.

        -  Assess the efficacy of short-term oral and topical CAI treatment on non-leaking macular
           cysts in retinal dystrophies.

        -  Study the visual response and structural resolution of non-leaking macular cysts in
           response to IVR.

      Design: Two-phase prospective, non-randomized, open-label, comparative interventional,
      clinical trial.

      Inclusion criteria:

        1. Omani patients over 18 years old

        2. Retinal dystrophy and non-leaking macular cysts confirmed by fundus examination,
           electroretinography (ERG), OCT, FFA and genetic testing.

        3. Capacity and cooperation to undergo visual function assessment (i.e. best-corrected
           visual acuity (BCVA), as well as the above-mentioned investigations.

        4. Written, informed consent to participate in the study

      Exclusion Criteria:

        1. Patients with pseudo-RP

        2. Patients with cystic macular lesions or progressive retinal disease due to any cause
           other than retinal dystrophy

        3. Patients with reduced visual acuity due to media opacities (e.g. cataract).

        4. Patients with any contraindication or known allergy to CAI or anti-VEGF agents

        5. Patients who have undergone vitreo-retinal surgery or intravitreal injection.

      Methods:

      Phase 1: Patients with best corrected visual acuity (BCVA) < 0.5 will receive carbonic
      anhydrase inhibitors (CAI) [oral acetazolamide 500mg/day or topical brinzolamide twice daily]
      and followed up for three months. Baseline urea and electrolyte (U&E) will be tested prior to
      receiving CAI, and monitored every month while on the treatment. Upon completion of the
      treatment course, the patients will be assessed for response with visual function assessment
      and central macular thickness (CMT) on OCT. Patients who show an adequate response (defined
      as > 10% reduction of CMT) and/or improvement of BCVA by two lines or more) will continue in
      the CAI arm.

      Phase 2: Patients who do not show an adequate response with CAI or develop significant side
      effects from CAI treatment will stop receiving CAI and will move to Phase 2 of the study and
      receive three 0.5mg IVR injection at monthly intervals. Upon completion of the treatment
      course, the patients will be assessed for response with visual function assessment and CMT on
      OCT.

      The purpose of the proposed procedures/treatment, as well as potential complications, will be
      clearly explained to participants. It will be made clear to the patient that IVR treatment is
      experimental and may or may not lead to improvement of vision. The patient will also be
      informed that the treatment will be withheld in case of allergy or complications. It will be
      emphasized that he/she may withdraw from the study at any stage.

      Patients will be under regular and close follow-up. They will be monitored for the
      development of any complications during the study. Any complication will be logged and
      treated appropriately. Patients' personal information, clinical history, examination,
      investigation results and progress with treatment, will be treated confidentially.

      Institutional research ethics board approval will be obtained prior to the start of the
      study.
allocation: Non-Randomized
intervention model: Sequential Assignment
intervention model description: Phase 1: Patients with best corrected visual acuity (BCVA) < 0.5 will receive carbonic anhydrase inhibitors (CAI) [oral acetazolamide 500mg/day or topical brinzolamide twice daily] and followed up for three months. Phase 2: Patients who do not show an adequate response with CAI will receive three 0.5mg IVR injection at monthly intervals.
primary purpose: Treatment
masking: None (Open Label)
measure: Macular Cyst
time frame: 3 months
description: Reduction in central macular thickness by 10%
measure: Macula
time frame: 3 months
description: Improvement in visual acuity by over one line
measure: Complications
time frame: 3 months
description: Presence of any complications from treatment
arm group label: Carbonic Anhydrase Inhibitor (CAI) Arm
arm group type: Active Comparator
description: Patients who have received carbonic anhydrase inhibitor (CAI) therapy namely oral acetazolamide or topical brinzolamide
arm group label: Intravitreal ranibizumab (IVR) arm
arm group type: Experimental
description: Intravitreal ranibizumab (IVR) injection administered to patients who have not shown adequate response or who have not tolerated CAI therapy
IVR therapy = Three 0.5mg IVR injection at monthly intervals
intervention type: Drug
intervention name: Intravitreal ranibizumab (IVR) injection
description: Intravitreal ranibizumab (IVR) injection in patients with retinal dystrophy and macular cysts who have not responded to treatment with carbonic anhydrase inhibitors
arm group label: Intravitreal ranibizumab (IVR) arm
intervention type: Drug
intervention name: Carbonic Anhydrase Inhibitor (CAI) therapy
description: Carbonic anhydrase therapy (Oral or Topical) in patients with retinal dystrophy and macular cysts
arm group label: Carbonic Anhydrase Inhibitor (CAI) Arm
other name: CAI
criteria: 
gender: All
minimum age: 18 Years
maximum age: N/A
healthy volunteers: No
last name: Anuradha Ganesh, MD
role: Study Chair
affiliation: Sultan Qaboos University Hospital
citation: Moustafa GA, Moschos MM. Intravitreal aflibercept (Eylea) injection for cystoid macular edema secondary to retinitis pigmentosa - a first case report and short review of the literature. BMC Ophthalmol. 2015 Apr 30;15:44. doi: 10.1186/s12886-015-0033-z.
PMID: 25925748
citation: Artunay O, Yuzbasioglu E, Rasier R, Sengul A, Bahcecioglu H. Intravitreal ranibizumab in the treatment of cystoid macular edema associated with retinitis pigmentosa. J Ocul Pharmacol Ther. 2009 Dec;25(6):545-50. doi: 10.1089/jop.2009.0089.
PMID: 20028262
citation: Yuzbasioglu E, Artunay O, Rasier R, Sengul A, Bahcecioglu H. Intravitreal bevacizumab (Avastin) injection in retinitis pigmentosa. Curr Eye Res. 2009 Mar;34(3):231-7. doi: 10.1080/02713680802710692.
PMID: 19274531
citation: Miyata M, Oishi A, Oishi M, Hasegawa T, Ikeda HO, Tsujikawa A. Long-term efficacy and safety of anti-VEGF therapy in retinitis pigmentosa: a case report. BMC Ophthalmol. 2018 Sep 14;18(1):248. doi: 10.1186/s12886-018-0914-z.
PMID: 30217183
responsible party type: Sponsor
mesh term: Retinal Dystrophies
mesh term: Ranibizumab
mesh term: Carbonic Anhydrase Inhibitors
sharing ipd: No