The Effects of Disulfiram (Antabuse®) on Visual Acuity in Patients With Retinal Degeneration

Official title

The Effects of Disulfiram on Visual Acuity in Patients With Retinal Degeneration

Overview

Oral disulfiram (Antabuse®) has been shown to improve image-forming vision in animal models with retinal degeneration due to its ability to decrease Retinoic Acid synthesis and consequently reduce hyperactivity in the inner retina. The investigator will aim to evaluate the impact of oral disulfiram on the vision of patients with retinal degeneration who are being treated with the drug in the management of their concurrent alcohol use disorder.

Interventions

• Drug Oral disulfiram
  250 mg/day

Primary outcome measures

• mean change in Best Corrected Visual Acuity (BCVA) score assessed by ETDRS [Time frame: baseline to day 180]

Secondary outcome measures (12)

• mean change in total contrast sensitivity score using Pelli-Robson charts [Time frame: baseline to day 180]
• mean change in light-adapted microperimetry sensitivity assessed using standard MAIA microperimetry equipment [Time frame: baseline to day 180]
• mean change in outer retinal thickness assessed using Spectral Domain Optical Coherence Tomography (SD-OCT) [Time frame: baseline to day 180]
• mean change in fundus autofluorescence (FAF) [Time frame: baseline to day 180]
• number of participants with retinal anatomy changes assessed using fundus photos [Time frame: baseline to day 180]
• mean change in visual field perimetry using full-field stimulus test [Time frame: baseline to day 180]
• mean change in isopter constriction using Goldmann visual field [Time frame: baseline to day 180]
• mean change in size of scotomas using Goldmann visual field [Time frame: baseline to day 180]
• mean change in cone and rod latency assessed using Full field electroretinogram (ffERG) [Time frame: baseline to day 180]
• mean change in cone and rod amplitude assessed using Full field electroretinogram (ffERG) [Time frame: baseline to day 180]
• mean change in cone and rod latency assessed using multifocal electroretinogram (mfERG) [Time frame: baseline to day 180]
• mean change in cone and rod amplitude assessed using multifocal electroretinogram (mfERG) [Time frame: baseline to day 180]

Eligibility criteria

Inclusion criteria

• All sexes, 18 years and older.
• Participants must speak English, understand, and sign the informed consent document.
• Stated willingness to comply with all study procedures and availability for the duration of the study.
• In good general health as evidenced by medical history and with a clinical diagnosis of inherited retinal dystrophy or dry-AMD.
• Best Corrected Visual Acuity (BCVA) of 20/20 (with constriction or other defects of Goldmann visual field) to Light Perception in the better eye.
• Intact inner nuclear layer, inner plexiform, and ganglion cell layer on macular SD-OCT.
• Ability to take oral medication and be willing to adhere to the disulfiram regimen.
• Patients must have the diagnosis of alcohol use disorder provided by an addiction specialist and be a candidate for therapeutic use of disulfiram for that condition.
• Patients must agree to refrain from all alcohol consumption for 180 days.
• Any female participant of childbearing potential must have a negative urine pregnancy test at screening.
• Any female participant of childbearing potential must have (or have a partner who has) had a surgical sterilization (vasectomy, hysterectomy, or tubal ligation), be completely abstinent from intercourse or must agree to practice two acceptable methods of contraception throughout the course of the study and for at least one week after disulfiram discontinuation. Acceptable methods of contraception include hormonal contraception (i.e., birth control pills, injected hormones, dermal patch, or vaginal ring); intrauterine device; barrier methods (diaphragm, condom) with spermicide.

Exclusion criteria

• A condition that, in the opinion of the investigator, would preclude participation in the study, e.g., cardiovascular disease, hepatitis.
• Individuals with a history of diabetes mellitus.
• Individuals with a history of psychosis.
• Individuals with hypothyroidism.
• Individuals with hypersensitivity to thiuram derivatives causing rubber contact dermatitis.
• Those on anticoagulant therapy or other medications that may be affected by disulfiram.
• Ophthalmic conditions with independent effect upon visual function (e.g. diabetic retinopathy, glaucoma, cataract, vitreous hemorrhage, retinal detachment, active intraocular inflammation or active infectious ocular diseases, choroidal neovascularization).
• Patients with No Light Perception (NLP) in both eyes.
• History of major ocular surgery within the prior 6 months or major ocular surgery anticipated within the next 6 months following randomization.
• Exam evidence of severe external ocular infection, including conjunctivitis, chalazion, or substantial blepharitis
• Participation in an investigational trial that involves treatment with any drug within 30 days of randomization that has not received regulatory approval at the time of study entry. Note: study participants cannot receive another investigational drug while participating in this study.
• Known allergy or hypersensitivity to any component of the study drug.
• For women of child-bearing potential: pregnant or lactating or intending to become pregnant within the next 12 months.
• Participants who expect to move out of the area of the clinical center during the 8 months of the study

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

N/A

Model

Sequential

Masking

Open label

Primary purpose

Treatment

Study locations

United States · 1 center

• Flaum Eye Institute, University of Rochester Medical Center — Rochester

Identifiers

NCT: NCT06319872 · STUDY00009118

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗