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CTRI Number  CTRI/2019/11/022048 [Registered on: 18/11/2019] Trial Registered Prospectively
Last Modified On: 20/11/2019
Post Graduate Thesis  No 
Type of Trial  Interventional 
Type of Study   Medical Device
Diagnostic 
Study Design  Randomized, Parallel Group Trial 
Public Title of Study   A comparative clinical study to determine equivalence and precision of measurement parameters in ophthalmic images obtained from PRIMUS 300 and CIRRUS 5000 HD OCT imaging devices. 
Scientific Title of Study   Comparison of macular thickness, ganglion cell analysis (GCA), retinal nerve fiber layer (RNFL) thickness and optic nerve head (ONH) measurements of PRIMUS 300 and CIRRUS HD-OCT, Model 5000 
Trial Acronym   
Secondary IDs if Any  
Secondary ID  Identifier 
CARIn-02-2019  Protocol Number 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Dr Sribhargava Natesh 
Designation  Consultant Vitreoretinal and Director  
Affiliation  Nethra Eye Hospital 
Address  Vitreous and Retina Division, Retina Dept., No. 8, Poojary Layout, 80 Ft Road, RMV II Stage, Bangalore

Bangalore
KARNATAKA
560094
India 
Phone  080-23512666   
Fax    
Email  sribhargava.natesh@gmail.com  
 
Details of Contact Person
Scientific Query
 
Name  Dr T C Ganesh Babu 
Designation  Head of Clinical & Regulatory Affairs 
Affiliation  Carl Zeiss India (Bangalore) Pvt Ltd  
Address  Plot no. 3, Jigani Link Road, Bommasandra Industrial Area, Bangalore

Bangalore
KARNATAKA
560099
India 
Phone  9880225622  
Fax    
Email  ganesh.babu@zeiss.com  
 
Details of Contact Person
Public Query
 
Name  Dr T C Ganesh Babu 
Designation  Head of Clinical & Regulatory Affairs 
Affiliation  Carl Zeiss India (Bangalore) Pvt Ltd  
Address  Plot no. 3, Jigani Link Road, Bommasandra Industrial Area, Bangalore

Bangalore
KARNATAKA
560099
India 
Phone  9880225622  
Fax    
Email  ganesh.babu@zeiss.com  
 
Source of Monetary or Material Support  
CARIn Division. Carl Zeiss India Pvt Ltd., Plot No 3 Jigani Link Road Bommasandra Industrial Area, Bangalore - 560099 
 
Primary Sponsor  
Name  Carl Zeiss India Pvt Ltd 
Address  Plot No 3 Jigani Link Road Bommasandra Industrial Area Bangalore 560099 
Type of Sponsor  Other [Medical Device Industry - Global] 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Sribhargava Natesh  Nethra Eye Hospital   Vitreous and Retina Division, Retina Dept., Room No. 8, Poojary Layout, 80 Ft Road, RMV II Stage, Bangalore - 560 094
Bangalore
KARNATAKA 
080-23512666

sribhargava.natesh@gmail.com 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
ACE Independent Ethics Committee  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Healthy Human Volunteers  Normal subjects, Subjects with known retinal disease and Subjects with glaucoma of any type 
 
Intervention / Comparator Agent  
Type  Name  Details 
Comparator Agent  CIRRUS HD-OCT Model 5000   The CIRRUS HD-OCT Model 5000 is a non-contact, high resolution tomographic and biomicroscopic device for imaging the anterior and posterior segments of the eye. It is a Class II medical device that has received 510(k) clearance from the United States FDA (K111157, K083291, K063378 K150977; K181534) and is commercially released. 
Intervention  PRIMUS 300 HD OCT   The PRIMUS 300 is an ophthalmologic instrument, a class II medical device that provides functionality similar to CIRRUS 400, but with a separate manual patient interface. The high resolution of retinal cross-sectional image is acquired by utilizing spectral domain optical coherence tomography, a non-invasive, non-contact low-coherence interferometry technique.  
 
Inclusion Criteria  
Age From  18.00 Year(s)
Age To  80.00 Year(s)
Gender  Both 
Details  For inclusion, as normal subject, both eyes (OD & OS) must fulfill all of the following
criteria
1.Males or females 18 years of age or older
2. No history and evidence of retinal pathology or glaucoma

Inclusion criteria: Retinal disease subjects (any eye OD or OS must meet any of the
criteria)
1.Males or females 50 years of age or older with diagnosis of active or recurrent neovascular age-related macular degeneration with presence of either drusen, pigment epithelial detachment or choroidal neovascularisation
2.Males or females 18 years of age or older with diagnosis of persistent diabetic macular
edema or cystoid macular edema or proliferative diabetic retinopathy
3.Males or females 18 years of age or older, with diagnosis of macular hole or vitreomacular
traction
4. Males or females 18 years of age or older with diagnosis of either sub-retinal fluid
(neurosensory detachment), subretinal hemorrhage, intraretinal atrophy, RPE disruption and tear, lamellar holes, exudates, fibrotic disciform scar, ischemic tissue, intra-retinal hemorrhage, vitreous hemorrhage, vascular occlusive disease, central serous retinopathy, epiretinal membranes, or other retinal disease

Inclusion criteria: Glaucoma Subjects (any eye, OD or OS)
1.Males or females 18 years of age or older, with a diagnosis of glaucoma of any type,
ranging from early to advanced stage  
 
ExclusionCriteria 
Details  Exclusion criteria
1. Best spectacle corrected visual acuity worse than 20/40 in either eye (normal subjects
only)
2.Inability to clinically view the optic discs due to media opacity or poorly dilating pupil
3.Unable to understand and follow the instructions on study procedures
4. Unable to cooperate for study procedures, specifically in terms of fixation
5.Unable to sit upright in front of the device
6.Presence of tremor, pathological rotational nystagmus and dyspnea
7. Any active infection of anterior or posterior segments
8.Unable to return for the required study visits  
 
Method of Generating Random Sequence   Random Number Table 
Method of Concealment   Not Applicable 
Blinding/Masking   Not Applicable 
Primary Outcome  
Outcome  TimePoints 
To evaluate the equivalence of the means of 26 measurement parameters: macular thickness (9 parameters), ganglion cell analysis (7 parameters), RNFL thickness (5 parameters), ONH measurements (5 parameters), between PRIMUS 300 and CIRRUS 5000 for the purpose of reusing CIRRUS reference database  4 Months 
 
Secondary Outcome  
Outcome  TimePoints 
To determine the repeatability and reproducibility of PRIMUS 300 macular thickness,
ganglion cell analysis, RNFL thickness & ONH measurements 
4 Months 
 
Target Sample Size   Total Sample Size="165"
Sample Size from India="165" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   N/A 
Date of First Enrollment (India)   25/11/2019 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="0"
Months="4"
Days="0" 
Recruitment Status of Trial (Global)
Modification(s)  
Not Applicable 
Recruitment Status of Trial (India)  Not Yet Recruiting 
Publication Details   Not Applicable. This study has not been submitted for publication and hence mentioned as "Not Applicable" in publication section. 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Brief Summary   OBJECTIVES:
1. To evaluate the equivalence of the means of 26 measurement parameters: macular thickness (9 parameters), ganglion cell analysis (7 parameters), RNFL thickness (5 parameters), ONH measurements (5 parameters), between PRIMUS 300 and CIRRUS 5000 for the purpose of reusing CIRRUS reference database
2. To determine the repeatability and reproducibility of PRIMUS 300 macular thickness, ganglion cell analysis, RNFL thickness & ONH measurements

Study Design & Overview
This is a prospective single centre, comparative study and will undergo approval process by study independent ethics committee, prior to study initiation.

Informed consent will be obtained after explaining the nature and purpose of study. Any further study related procedures will be undertaken after obtaining informed consent from the subjects.

The study will include a total of 165 eligible subjects. Both normal subjects & subjects with ocular disease will be enrolled in this study. A previous diagnosis of retinal disease or glaucoma will be noted as part of the study procedures. Subjects may undergo the study site’s standard practice of clinical and eye examination procedures on the same date as their study visit, but is not a requirement. The subjects will be evaluated for eligibility and study enrollment within 3 study groups, normal, retinal disease & glaucoma.

For a subject with no known retinal disease or glaucoma, both the eyes (OD & OS) will be scanned. The assignment of scan type for the eyes (OD/OS), either macular cube scans or RNFL/ONH scans and acquisitions on the study devices will be as per the randomization table. For a subject with known retinal disease, the study eye (OD/OS) will be assigned by the Investigator based on the disease findings and macular cube scans will be acquired only on the study eye. Scan acquisitions using the study devices will be as per the randomization table. For a subject with known glaucoma, the study eye (OD/OS) will be assigned by the Investigator based on the disease findings and GCA & RNFL/ONH scans will be acquired only on the study eye. Scan acquisitions using the study devices will be as per the randomization table.

Data collected in the study will be used to evaluate the equivalence of the means of 26 measurements, for the purpose of reusing the CIRRUS reference database. Three (3) PRIMUS 300 devices, one (1) CIRRUS 400 device and three (3) OCT operators with varied expertise will be involved in the study. All study activities will be performed in a single visit but scanning may be performed on an optional 2nd visit if necessary.

All the enrolled subjects with retinal disease and glaucoma will be managed for the condition as per the study site’s standard practice. The specific study procedures will have no influence on the decision making and disease management process practiced at the site.

Target population
Normal male and female subjects and subjects with known retinal disease and glaucoma of any type ranging from early to advanced stage, aged ≥ 18 years.

Statistical Methods

Agreement Analyses: For each macular thickness, ganglion cell analysis and RNFL/ONH parameter, the mean across different devices and operators will be calculated for the first measurement from each study eye for PRIMUS 300 and CIRRUS 5000

Transferring CIRRUS 5000 Reference Database: After comparing individual study eye groups for agreement, the normal eye group and retinal disease eye group will undergo a combined regression analysis to determine the appropriate conversion of CIRRUS 5000 reference data to apply to PRIMUS 300 data for macular thickness measurements. The normal eye group and glaucoma eye group will undergo a combined regression analysis to determine the appropriate conversion of CIRRUS 5000 reference data to apply to PRIMUS 300 data for MTA, GCA, RNFL and ONH measurements.

Repeatability and Reproducibility: An analysis of variance (ANOVA) model will be used to estimate the repeatability and
reproducibility of the parameters for PRIMUS 300.
 
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