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Can deep phenotyping using retinal images predict response to intravitreal aflibercept therapy in patients with neovascular age-related macular degeneration?

Not Applicable
Completed
Conditions
Eye Diseases
Wet age-related macular degeneration
Registration Number
ISRCTN28276860
Lead Sponsor
Moorfields Eye Hospital
Brief Summary

2023 Results article in https://pubmed.ncbi.nlm.nih.gov/37109349/ (added 17/07/2023)

Detailed Description

Not available

Recruitment & Eligibility

Status
Completed
Sex
All
Target Recruitment
3000
Inclusion Criteria

Inclusion criteria for both retrospective and prospective parts:
1. Adults who are = 50 years and = 100 years
2. Treatment naïve neovascular AMD at baseline
3. Media clarity, pupillary dilation and patient cooperation for adequate imaging
4. Ability to give informed consent

Inclusion criteria for retrospective part only in addition to the above:
1. Have received 3 loading injections of intravitreal aflibercept therapy at monthly intervals as per standard care
2. Review up to 10 weeks after the 3rd loading dose with or without injection at this visit
3. Had Heidelberg OCT at least at baseline and after the loading phase but ideally 4 Heidelberg OCTs for the 4 visits
4. Heidelberg OCTA images if available for baseline and any visit thereafter (2nd, 3rd or 4th visit) provided there is a baseline OCTA (optional criteria)

Exclusion Criteria

1. Co-existent ocular disease: any other ocular condition that, in the opinion of the investigator, might affect or alter visual acuity during the course of the study
2. Any patient who has opted out of their information being used for research nationally or locally at any site

Study & Design

Study Type
Observational
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Diagnostic accuracy of artificial intelligence over human graders in assessing the response of loading phase of intravitreal aflibercept injections for wet age-related macular degeneration
Secondary Outcome Measures
NameTimeMethod
1. The analyses will be repeated excluding patients who appeared in the training set and the primary validation set2. Performance of the AI will be evaluated using higher-quality images with no media opacity (eg, cataracts) as noted by professional graders 3. AUC subgroups will be computed stratified by age and sex, smoking or medical history4. The analysis will be repeated by calculating the AUC, sensitivity, and specificity of the AI and the proportion of concordant and discordant eyes on the external validation datasets, compared with the reference standards
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