330 Participants Needed

Rose Bengal + Light Therapy for Corneal Inflammation

(REAGIR Trial)

Recruiting at 3 trial locations
TL
JR
Overseen ByJennifer Rose-Nussbaumer, MD
Age: 18+
Sex: Any
Trial Phase: Phase 3
Sponsor: University of California, San Francisco
Pivotal Trial (Near Approval)This treatment is in the last trial phase before FDA approval
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests whether combining rose Bengal with light therapy can improve vision in individuals with specific eye infections. It compares standard antimicrobial treatments to those treatments plus the new therapy. Individuals with fungal or acanthamoeba keratitis (a type of corneal infection) or corneal ulcers of unclear cause, who have noticeable vision loss, might be suitable candidates. The research aims to determine if the new treatment enhances vision recovery more effectively than current methods. As a Phase 3 trial, this study represents the final step before FDA approval, offering participants an opportunity to contribute to a potentially groundbreaking treatment.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. However, it mentions specific treatments for the trial, so it's best to discuss your current medications with the trial team.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that Rose Bengal Photodynamic Therapy (RB-PDT), when combined with green light, holds promise for treating eye infections such as fungal keratitis. Studies have found RB-PDT to be generally safe, with most participants experiencing no serious side effects. Some mild side effects, like temporary eye irritation or redness, were noted but were uncommon.

The study is in an advanced phase, indicating that RB-PDT has already undergone safety testing in earlier stages. This suggests sufficient data exists to show that serious side effects are unlikely.

For those considering joining a trial with RB-PDT, current research supports its safety for human use.12345

Why do researchers think this study treatment might be promising?

Unlike the standard treatments for corneal inflammation, which typically involve antibiotics or antifungals like moxifloxacin or natamycin, the new approach using Rose Bengal with light therapy, or RB-PDT, offers a unique mechanism. Rose Bengal is activated by light to create a cross-linking effect, which can strengthen the corneal tissue and help reduce inflammation more effectively. This method has the potential to provide faster and more targeted relief, making it an exciting development for researchers looking to improve outcomes for patients with corneal issues.

What evidence suggests that Rose Bengal Electromagnetic Activation with Green light might be an effective treatment for corneal inflammation?

Research has shown that rose Bengal photodynamic therapy (RB-PDT) can help treat severe eye infections. In this trial, one group of participants will receive RB-PDT alongside standard treatments, which include topical chlorhexidine gluconate, moxifloxacin, or natamycin, depending on the type of keratitis. One study found that RB-PDT reduced the need for more invasive surgeries in patients with bacterial, fungal, and acanthamoeba keratitis, which are different types of eye infections. It also improved vision over six months when combined with standard treatments for infections. The treatment uses a special dye and light to kill harmful germs in the eye. Early findings suggest it may also help prevent complications like corneal perforation, where the outer layer of the eye gets damaged.12678

Who Is on the Research Team?

TL

Tom Lietman, MD

Principal Investigator

University of California, San Frnasco

JR

Jennifer Rose-Nussbaumer, MD

Principal Investigator

Stanford University

NV

Nicole Varnado, MPH

Principal Investigator

Stanford University

Are You a Good Fit for This Trial?

This trial is for adults over 18 with corneal infections like fungal or acanthamoeba keratitis, or negative smear/culture ulcers causing moderate to severe vision loss. Participants must understand the study and commit to follow-up visits. Those with other eye infections, recent eye surgery, very poor vision in the unaffected eye, or cognitive impairments cannot join.

Inclusion Criteria

Basic understanding of the study as determined by the physician
Commitment to return for follow up visits
I am over 18 years old.

Exclusion Criteria

I am at risk of or currently have a ruptured organ.
I have not had eye surgery in the last three months.
Pinhole visual acuity worse than 20/200 in the unaffected eye
See 6 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either standard antimicrobial treatment plus sham RB-PDT or antimicrobial treatment plus RB-PDT

6 months

Follow-up

Participants are monitored for safety and effectiveness after treatment

12 months

What Are the Treatments Tested in This Trial?

Interventions

  • Chlorhexidine Gluconate
  • Moxifloxacin Ophthalmic
  • Natamycin
  • Rose Bengal Electromagnetic Activation
Trial Overview The REAGIR trial tests if adding Rose Bengal Photodynamic Therapy (RB-PDT) to standard antimicrobial treatments improves visual acuity in patients with certain corneal infections. It's a randomized study where participants either receive RB-PDT or a sham treatment alongside their regular medication.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Placebo Group
Group I: Cross-Linking with rose Bengal (RB-PDT)Experimental Treatment4 Interventions
Group II: Standard TherapyPlacebo Group4 Interventions

Chlorhexidine Gluconate is already approved in United States, Canada, European Union for the following indications:

🇺🇸
Approved in United States as Chlorhexidine Gluconate for:
🇨🇦
Approved in Canada as Chlorhexidine Gluconate for:
🇪🇺
Approved in European Union as Chlorhexidine Gluconate for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of California, San Francisco

Lead Sponsor

Trials
2,636
Recruited
19,080,000+

Thomas M. Lietman

Lead Sponsor

Trials
4
Recruited
1,400+

Federal University of São Paulo

Collaborator

Trials
477
Recruited
109,000+

Aravind Eye Care System

Collaborator

Trials
13
Recruited
102,000+

National Eye Institute (NEI)

Collaborator

Trials
572
Recruited
1,320,000+

Stanford University

Collaborator

Trials
2,527
Recruited
17,430,000+

Published Research Related to This Trial

Chlorhexidine Gluconate (CHG) and its derivatives can cause severe eye and ear damage, even with minimal exposure during surgical preparations, leading to serious conditions like corneal injury and potential blindness.
In contrast, 10% Povidone-Iodine (PI) solutions show minimal toxicity to the eyes and ears while providing similar effectiveness in preventing surgical site infections, making them a safer alternative for preoperative skin preparation.
Review: Perspective on ocular toxicity of presurgical skin preparations utilizing Chlorhexidine Gluconate/Hibiclens/Chloraprep.Epstein, NE.[2022]
Accidental exposure to Hibiclens (chlorhexidine 4% and detergent) can lead to severe and permanent corneal opacification, as seen in two patients.
Experimental studies on rabbit eyes showed that exposure to Hibiclens for just 5 to 15 minutes caused severe, irreversible corneal damage in all cases, highlighting its high toxicity to corneal tissue.
Hibiclens keratitis.Hamed, LM., Ellis, FD., Boudreault, G., et al.[2019]
The review analyzed six randomized controlled trials to compare the antimicrobial efficacy and safety of various antiseptics for preoperative skin preparation, including combinations of chlorhexidine gluconate and isopropyl alcohol, and other antiseptics like povidone-iodine.
Results indicated that 2% chlorhexidine gluconate combined with 70% isopropyl alcohol (ChloraPrep) showed superior immediate and persistent antimicrobial efficacy compared to other antiseptics, suggesting it may be the best option for preventing nosocomial infections during surgery.
Analyses comparing the antimicrobial activity and safety of current antiseptic agents: a review.Hibbard, JS.[2019]

Citations

1.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/39192339/
A double-masked, sham-controlled trial of rose bengal ...In one published series, RB-PDT reduced the need for therapeutic penetrating keratoplasty in severe bacterial, fungal, and acanthamoeba ...
Rose Bengal Electromagnetic Activation with Green Light ...Objective. To determine the effect of adjunctive rose-bengal photodynamic therapy (RB-PDT) in the treatment of fungal, Acanthamoeba, and smear/ ...
Rose Bengal Electromagnetic Activation With Green Light ...The purpose of this study is to determine differences in 6-month visual acuity between medical antimicrobial treatments alone versus antimicrobial treatment ...
Rose Bengal Electromagnetic Activation With Green Light ...The purpose of this study is to determine differences in 6-month visual acuity between medical antimicrobial treatments alone versus antimicrobial treatment ...
5.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/39011096/
A double-masked, sham-controlled trial of rose bengal ...Discussion: We anticipate that RB-PDT will improve best spectacle corrected visual acuity and also reduce complications such as corneal perforation and the need ...
Rose Bengal Electromagnetic Activation with Green Light ...Rose Bengal Electromagnetic Activation with Green Light for Infection Reduction (REAGIR) Study: A randomized, double-masked, sham-controlled ...
Rose Bengal Electromagnetic Activation With Green Light ...The purpose of this study is to determine differences in 6-month visual acuity between medical antimicrobial treatments alone versus antimicrobial treatment ...
Rose Bengal-Assisted Photodynamic Antimicrobial ...The results of this study are anticipated to have favorable outcomes in microbial keratitis and improve the best spectacle-corrected visual ...
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