A Study to Learn How Well a Higher Amount of Aflibercept Given as an Injection Into the Eye Works and How Safe it is in People With Reduced Vision Due to Swelling in the Macula, Central Part of the Retina Caused by a Blocked Vein in the Retina (Macula Edema Secondary to Retinal Vein Occlusion)
- Conditions
- Macular Edema Secondary to Retinal Vein Occlusion
- Interventions
- Drug: Aflibercept, VEGF Trap-Eye(Eylea, BAY86-5321)_higher doseDrug: Aflibercept, VEGF Trap-Eye(Eylea, BAY86-5321)_2 mgDrug: ShamDiagnostic Test: Fluorescein
- Registration Number
- NCT05850520
- Lead Sponsor
- Bayer
- Brief Summary
Researchers are looking for a better way to treat people who have macular edema secondary to retinal vein occlusion (RVO).
In people with RVO, a blood vessel that carries blood away from the retina (vein) becomes blocked. The retina is the very back part of the eye. The blocked vein causes fluid and blood to leak into the retina and thereby causes a swelling of the macula (the center of the retina responsible for fine vision). This swelling is called macular edema.
When a vein in the retina is blocked, the levels of a protein called vascular endothelial growth factor (VEGF) rises. VEGF helps the growth of new blood vessels. This can lead to macular edema and may cause the vision to become blurry.
The study treatment intravitreal (IVT) aflibercept is given as an injection into the eye. It works by blocking VEGF and this can help repair vision problems related to RVO. IVT aflibercept is already available and is prescribed by doctors as the standard of care treatment for macula edema secondary to RVO. Standard of care is a treatment that medical experts consider most appropriate for a disease.
Standard of care is given every 4 weeks in people with macula edema secondary to RVO. While repeated injections of aflibercept may prevent worsening of vision, it may place a burden on the patient. However, a higher amount (8 mg) compared to the standard of care (2 mg) of IVT aflibercept is being tested in studies. This higher amount could be given less often. The amount of IVT aflibercept given is measured in milligrams, also known as mg.
The main purpose of this study is to learn how well a higher amount of the study treatment aflibercept works in people with macular edema secondary to RVO. To answer this, researchers will measure changes in vision called best corrected visual acuity (BCVA) in the study participants between study start and after 36 weeks of treatment. Changes will then be compared between those participants who received the higher amount of IVT aflibercept and those that received standard of care.
To learn how safe the study treatment is in the participants, the researchers will count the number of participants from study start and up to 64 weeks later that have:
* adverse events
* serious adverse events
"Adverse events" are any medical problems that the participants have during a study. Doctors keep track of all adverse events that happen in studies, even if they do not think they might be related to the study treatments. An adverse event is considered "serious" when it leads to death, puts the participants' lives at risk, requires hospitalization, causes disability, causes a baby being born with medical problems or is otherwise medically important.
Dependent on the treatment group, the participants will either receive the higher amount of aflibercept or standard of care as an intravitreal injection for up to 60 weeks. The study will consist of a test (screening) phase, a treatment phase and an end of study phase. Each participant will be in the study for up to 64 weeks.
One visit to the study site is planned during the screening phase, followed by visits approximately every 4 weeks (16 in total) during treatment and one visit at the end of the study.
During the study, the study doctors and their team will:
* check patients' eye health using various eye examination techniques
* measure patients' eye vision (BCVA)
* take blood and urine samples
* do physical examinations
* check vital signs
* examine heart health using electrocardiogram (ECG)
* do pregnancy tests in women of childbearing age
In addition, participants will be asked to fill a questionnaire on vision-related quality of life.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 892
- Adult ≥18 years of age (or country's legal age of adulthood if the legal age is >18 years) at the time of signing the informed consent.
- Treatment-naïve macular edema involving the foveal center secondary to RVO (BRVO, HRVO, or CRVO) diagnosed within 16 weeks (112 days) before the screening visit in the study eye.
- Early Treatment Diabetic Retinopathy Study BCVA letter score of 73 to 24 (20/40 to 20/320) at screening and baseline visits in the study eye.
Decrease in BCVA determined to be primarily the result of RVO in the study eye.
- Mean CST ≥300 μm on optical coherence tomography (OCT) if excluding Bruch's membrane (e.g., Cirrus or Topcon) or ≥320 μm if including Bruch's membrane (e.g., Heidelberg Spectralis), confirmed by the reading center at the screening visit and by the site at baseline visit in the study eye.
- Capable of giving signed informed consent form (ICF) by study participant or legally acceptable representative, which includes compliance with the requirements and restrictions listed in the ICF and in this protocol.
- US participants will be required to have a Health Insurance Portability and Accountability Act (HIPAA) authorization; in other countries, as applicable according to national laws.
- Women of childbearing potential (WOCBP) or men who are sexually active with partners of childbearing potential must agree to use highly effective contraception prior to the initial dose/start of the first treatment, during the study, and for at least 4 months after the last administration of study intervention. Contraceptive use by men or women should be consistent with local regulations regarding the methods of contraception for participation in clinical studies and fulfil the conditions set on Section 10.4.2.
-
Concurrent disease that causes substantial decrease of BCVA, is expected to limit BCVA recovery or is likely to require medical or surgical intervention during the study in the study eye.
-
Presence or history of the following ocular conditions:
- Advanced age-related macular degeneration (neovascular AMD or geographic atrophy) in the study eye.
- Diabetic macular edema or diabetic retinopathy, defined in diabetic participants as diabetic retinopathy lesions outside the area of the vein occlusion in the study eye and anywhere in the retina in the fellow eye.
- Anterior segment neovascularization, vitreous hemorrhage, retinal detachment in the study eye.
- Vitreomacular traction, epiretinal membrane or structural damage to the macula that is considered by the Investigator to significantly affect central vision or preclude improvement in vision in the study eye.
- Macular hole of stage 2 and above in the study eye.
- Myopia of a spherical equivalent of at least 8 diopters prior to any refractive or cataract surgery in the study eye.
- Corneal transplant or corneal dystrophy in the study eye.
- Idiopathic or autoimmune uveitis in the study or in the fellow eye.
-
Presence of the following ocular conditions at screening or baseline visit:
- Significant media opacities, including cataract, that interfere with BCVA, or imaging assessments (e.g., fundus photography [FP], OCT) in the study eye.
- Aphakia, or pseudophakia with absence of posterior capsule (unless it occurred as a result of a yttrium-aluminum-garnet [YAG] posterior capsulotomy performed more than 30 days before the screening visit), in the study eye.
- Uncontrolled glaucoma (defined as IOP >25 mmHg despite treatment with anti-glaucoma medication); or history or likely future need of glaucoma surgery in the study eye.
- Intraocular inflammation/infection (including trace, or above, cells in the anterior chamber and/or vitreous) within 12 weeks (84 days) of the screening visit in the study or in the fellow eye.
- Extraocular or periocular infection or inflammation (including infectious blepharitis, keratitis, scleritis, or conjunctivitis) in the study or in the fellow eye.
-
Uncontrolled blood pressure (defined as systolic >160 mmHg or diastolic >95 mmHg) at the screening visit or baseline visit.
-
Uncontrolled diabetes mellitus, defined by hemoglobin A1c (HbA1c) >12% at the screening visit.
-
History of cerebrovascular accident or myocardial infarction within 24 weeks (168 days) before the screening visit or between screening and baseline visits.
-
Renal failure requiring dialysis, or renal transplant at screening or potentially during the study.
-
Any prior or concomitant ocular or systemic treatment (with an investigational or approved, anti-VEGF or other agent) or surgery for RVO in the study eye.
-
Previous administration of systemic anti-angiogenic medications for any condition.
-
Prior treatment of the study eye with any of the following drugs (any route of ophthalmic administration) or procedures:
- Anti-angiogenic drugs at any time including investigational therapy (e.g., with anti-angiopoietin/anti-VEGF bispecific monoclonal antibodies).
- Previous use topical steroids within 4 weeks (28 days) from the screening visit, or intraocular or periocular steroids within 16 weeks (112 days) from the screening visit, or steroid implants at any time.
- Previous treatment with intraocular or periocular implant, gene therapy, or cell therapy at any time.
- Treatment with ocriplasmin at any time.
- Vitreoretinal surgery (including scleral buckling) at any time.
- Any intraocular surgery, including cataract surgery, within 12 weeks (84 days) before the screening visit.
- Previous treatment with retinal laser photocoagulation.
-
Prior treatment of the fellow eye with any of the following:
a. Gene therapy, or cell therapy in the fellow eye at any time.
-
Participation in other clinical studies requiring administration of investigational treatments (other than vitamins and minerals) at the time of screening visit, or within 30 days or 5 half-lives of administration of the previous study intervention, whichever is longer.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Higher Dose Regimen 1 Aflibercept, VEGF Trap-Eye(Eylea, BAY86-5321)_higher dose Higher dose of aflibercept is administered with initial initiation doses intervals, followed by extension of treatment intervals and further adjustment of intervals according to treatment response. Higher Dose Regimen 1 Sham Higher dose of aflibercept is administered with initial initiation doses intervals, followed by extension of treatment intervals and further adjustment of intervals according to treatment response. Higher Dose Regimen 1 Fluorescein Higher dose of aflibercept is administered with initial initiation doses intervals, followed by extension of treatment intervals and further adjustment of intervals according to treatment response. Higher Dose Regimen 2 Aflibercept, VEGF Trap-Eye(Eylea, BAY86-5321)_higher dose Higher dose of aflibercept is administered with initial initiation doses intervals, followed by extension of treatment intervals and further adjustment of intervals according to treatment response. Higher Dose Regimen 2 Sham Higher dose of aflibercept is administered with initial initiation doses intervals, followed by extension of treatment intervals and further adjustment of intervals according to treatment response. Higher Dose Regimen 2 Fluorescein Higher dose of aflibercept is administered with initial initiation doses intervals, followed by extension of treatment intervals and further adjustment of intervals according to treatment response. Standard of care Aflibercept, VEGF Trap-Eye(Eylea, BAY86-5321)_2 mg Aflibercept 2 mg is administered by standard treatment intervals, followed by adjustment of treatment intervals according to treatment response. Standard of care Fluorescein Aflibercept 2 mg is administered by standard treatment intervals, followed by adjustment of treatment intervals according to treatment response.
- Primary Outcome Measures
Name Time Method Change from baseline in BCVA measured by the ETDRS letter score at Week 36 At Week 36 BCVA: Best-Corrected Visual Acuity; ETDRS: Early Treatment Diabetic Retinopathy Study; ETDRS letter score (ranging from 0 to 100 letters). A higher letter score means a better outcome (better visual acuity)
- Secondary Outcome Measures
Name Time Method Number of active injections from baseline to Week 64 From baseline to Week 64 Number of active injections from baseline to Week 36 From baseline to Week 36 Change from baseline in BCVA measured by the ETDRS letter score at Week 44 At baseline, week 44 ETDRS letter score (ranging from 0 to 100 letters). A higher letter score means a better outcome (better visual acuity)
Change from baseline in BCVA measured by the ETDRS letter score at Week 64 At baseline, week 64 ETDRS letter score (ranging from 0 to 100 letters). A higher letter score means a better outcome (better visual acuity)
Number of participants gaining at least 15 letters in BCVA from baseline at Weeks 36 and 64 From baseline at week 36 and week 64 Number of participant achieving an ETDRS letter score of at least 69 (approximate 20/40 Snellen equivalent) at Weeks 36 and 64 At week 36 and week 64 ETDRS letter score (ranging from 0 to 100 letters). A higher letter score means a better outcome (better visual acuity)
Participant having no IRF and no SRF in the center subfield at Weeks 36 and 64 (yes/no) At week 36 and week 64 Change from baseline in CST at Weeks 36 and 64 At baseline, week 36 and week 64 CST: Central Sub-field Thickness;
Change from baseline in NEI VFQ 25 total score at Weeks 36 and 64 At baseline, week 36 and week 64 NEI-VFQ-25: National Eye Institute Visual Functioning Questionnaire-25; The NEI VFQ-25 total score ranges from 0 to 100. A higher score means a better outcome (better patient-reported visual function).
Number of participant with TEAEs and SAEs through Weeks 36 and 64 Through weeks 36 and 64 Participants dosed only Q8W through Week 36 in the 8 mg Q8W group Through weeks 36 Participants having last treatment intervals ≥12 or of 16 weeks at Week 64 At week 64 Participants having next intended interval ≥12 or of 16 weeks at Week 64 At week 64 Systemic exposure to aflibercept as assessed by plasma concentrations of free, adjusted bound and total aflibercept from baseline through Weeks 36 and 64 From baseline through weeks 36 and 64
Trial Locations
- Locations (274)
Hacettepe Universitesi Tip Fakultesi
🇹🇷Ankara, Turkey
Adnan Menderes Universitesi Tip fakultesi
🇹🇷Aydin, Turkey
Ankara Bilkent Sehir Hastanesi
🇹🇷Bilkent Ankara, Turkey
Kocaeli Universitesi Tip Fakultesi
🇹🇷Kocaeli, Turkey
Debreceni Egyetem Klinikai Kozpont
🇭🇺Debrecen, Hungary
Espaco Medico de Coimbra
🇵🇹Coimbra, Portugal
SBU Gulhane Egitim ve Arastirma Hastanesi
🇹🇷Ankara, Turkey
Ankara Numune Egitim ve Arastirma Hastanesi
🇹🇷Ankara, Turkey
Strathfield Retina Clinic
🇦🇺Strathfield, New South Wales, Australia
Hanusch-Krankenhaus Wien
🇦🇹Wien, Austria
SEHAT Pentagram
🇧🇬Sofia, Bulgaria
Edith Wolfson Medical Center | Internal Medicine Department
🇮🇱Holon, Israel
Hadassah Hebrew University Hospital Ein Kerem
🇮🇱Jerusalem, Israel
Specjalistyczny Osrodek Okulistyczny Oculomedica
🇵🇱Bydgoszcz, Poland
Profesorskie Centrum Okulistyki
🇵🇱Gdansk, Poland
Gabinet Okulistyczny Prof. Edward Wylegala
🇵🇱Katowice, Poland
Centrum Medyczne Dietla 19 Sp. z o.o.
🇵🇱Krakow, Poland
Centrum Medyczne PROMED
🇵🇱Krakow, Poland
Centrum Diagnostyki i Mikrochirurgii Oka Lens
🇵🇱Olsztyn, Poland
Osrodek Chirurgii Oka prof. Zagorskiego Sp. z o.o.
🇵🇱Rzeszow, Poland
Centrum Medyczne Piasta 47
🇵🇱Walbrzych, Poland
AIBILI
🇵🇹Coimbra, Portugal
Japanese Red Cross Nagasaki Genbaku Hospital
🇯🇵Nagasaki, Japan
Rambam Health Corporation
🇮🇱Haifa, Israel
Lady Davis Carmel Medical Center
🇮🇱Haifa, Israel
Fakultní nemocnice Královské Vinohrady - Urologická klinikay
🇨🇿Praha 10, Czechia
Ganglion Medical Center
🇭🇺Pecs, Hungary
SZTE ÁOK Szent Györgyi Albert Klinikai Kozpont
🇭🇺Szeged, Hungary
Retina Consultants of Orange County
🇺🇸Fullerton, California, United States
South Coast Retina Center
🇺🇸Long Beach, California, United States
Northern California Retina Vitreous Associates - Mountain View Office
🇺🇸Mountain View, California, United States
Southern California Desert Retina Consultants - Palm Springs Office
🇺🇸Palm Springs, California, United States
Azul Vision Pasadena
🇺🇸Pasadena, California, United States
Retina Consultants of Southern California
🇺🇸Redlands, California, United States
Retina Consultants of Southern Colorado, PC
🇺🇸Colorado Springs, Colorado, United States
New England Retina Associates
🇺🇸New London, Connecticut, United States
Rand Eye Institute
🇺🇸Deerfield Beach, Florida, United States
Clalit Health | Soroka Medical Center - Internal Medicine Department
🇮🇱Beer Sheva, Israel
National Ophthalmic Research Institute - Fort Myers
🇺🇸Fort Myers, Florida, United States
The Eye Institute of West Florida
🇺🇸Largo, Florida, United States
Florida Eye Associates - Melbourne Main Office
🇺🇸Melbourne, Florida, United States
Florida Retina Institute - Orlando
🇺🇸Orlando, Florida, United States
Retina Specialists
🇺🇸Pensacola, Florida, United States
Fort Lauderdale Eye Institute
🇺🇸Plantation, Florida, United States
Retina Vitreous Associates of Florida - Saint Petersburg
🇺🇸Saint Petersburg, Florida, United States
East Florida Eye Institute
🇺🇸Stuart, Florida, United States
Center for Retina and Macular Disease - Winter Haven
🇺🇸Winter Haven, Florida, United States
Marietta Eye Clinic
🇺🇸Marietta, Georgia, United States
Retina Associates IL
🇺🇸Elmhurst, Illinois, United States
University Retina and Macula Associates
🇺🇸Oak Forest, Illinois, United States
Retina Associates, LLC
🇺🇸Lenexa, Kansas, United States
Retina Care Center
🇺🇸Baltimore, Maryland, United States
Cumberland Valley Retina Consultants | Hagerstown, MD
🇺🇸Hagerstown, Maryland, United States
Mid Atlantic Retina Specialists - Hagerstown
🇺🇸Hagerstown, Maryland, United States
Vitreo-Retinal Associates, PC
🇺🇸Grand Rapids, Michigan, United States
Retina Consultants of Minnesota
🇺🇸Saint Louis Park, Minnesota, United States
Retina Consultants of Nevada
🇺🇸Las Vegas, Nevada, United States
Retina Center of New Jersey
🇺🇸Bloomfield, New Jersey, United States
NJ Retina - New Brunswick
🇺🇸New Brunswick, New Jersey, United States
NJ Retina | Teaneck
🇺🇸Teaneck, New Jersey, United States
Eye Associates of New Mexico - Albuquerque - Retina Center
🇺🇸Albuquerque, New Mexico, United States
Long Island Vitreoretinal Consultants - Great Neck
🇺🇸Great Neck, New York, United States
Vitreoretinal Consultants of NY - Hauppauge
🇺🇸Hauppauge, New York, United States
Ophthalmic Consultants of Long Island
🇺🇸Lynbrook, New York, United States
Retina Associates of Western New York
🇺🇸Rochester, New York, United States
University of North Carolina at Chapel Hill (UNC) | Ophthalmology
🇺🇸Chapel Hill, North Carolina, United States
Cincinnati Eye Institute - Blue Ash
🇺🇸Blue Ash, Ohio, United States
Midwest Retina - Main Office
🇺🇸Dublin, Ohio, United States
Retina Consultants, LLC
🇺🇸Salem, Oregon, United States
Mid Atlantic Retina - Philadelphia / Wills Eye Hospital
🇺🇸Philadelphia, Pennsylvania, United States
Retina Consultants of Charleston
🇺🇸Charleston, South Carolina, United States
Palmetto Retina Center, LLC - Florence
🇺🇸Florence, South Carolina, United States
Charles Retina Specialists - Germantown
🇺🇸Memphis, Tennessee, United States
Austin Retina Associates - Central
🇺🇸Austin, Texas, United States
Retinal Consultants of Texas - Bellaire
🇺🇸Bellaire, Texas, United States
Texas Retina Associates
🇺🇸Fort Worth, Texas, United States
Medical Center Ophthalmology Associates - Northwest
🇺🇸San Antonio, Texas, United States
Retinal Consultants of Texas - San Antonio
🇺🇸San Antonio, Texas, United States
Rocky Mountain Retina Consultants - Main Office
🇺🇸Salt Lake City, Utah, United States
The Retina Group of Washington | Fairfax
🇺🇸Fairfax, Virginia, United States
Spokane Eye Clinical Research
🇺🇸Spokane, Washington, United States
University of Wisconsin - Madison
🇺🇸Madison, Wisconsin, United States
Eyeclinic Albury Wodonga
🇦🇺Albury, New South Wales, Australia
Marsden Eye Surgery Center
🇦🇺Parramatta, New South Wales, Australia
Sydney Eye Hospital
🇦🇺Sydney, New South Wales, Australia
Sydney Retina Clinic
🇦🇺Sydney, New South Wales, Australia
Sydney West Retina Pty Ltd
🇦🇺Westmead, New South Wales, Australia
Adelaide Eye and Retina Centre
🇦🇺Adelaide, South Australia, Australia
Hobart Eye Surgeons
🇦🇺Hobart, Tasmania, Australia
Centre for Eye Research
🇦🇺East Melbourne, Victoria, Australia
Lion Eye Institute
🇦🇺Nedlands, Western Australia, Australia
Klinikum Klagenfurt am Wörthersee
🇦🇹Klagenfurt, Kärnten, Austria
Konventhospital Barmherzige Brüder Linz
🇦🇹Linz, Oberösterreich, Austria
Medizinische Universität Graz
🇦🇹Graz, Steiermark, Austria
Universitätsklinikum AKH Wien
🇦🇹Wien, Austria
Specialized Hospital For Active Treatment of Eye Diseases Zora
🇧🇬Sofia, Bulgaria
Spec. Hosp. of Ophthalm. Disease for Active Treatment Varna
🇧🇬Varna, Bulgaria
The Second Hospital of Anhui medical university
🇨🇳Hefei, Anhui, China
Peking University First Hospital
🇨🇳Beijing, Beijing, China
Beijing Hospital
🇨🇳Beijing, Beijing, China
Guangzhou Aier Eye Hospital
🇨🇳Guangzhou, Guangdong, China
Hebei eye hospital
🇨🇳Hebei, Hebei, China
Shijiazhuang General Hospital
🇨🇳Shijiazhuang, Hebei, China
Henan Provincial Eye Hospital
🇨🇳Henan, Henan, China
Tongji Hosp. of Tongji Med Coll, Huazhong Uni of Sci & Tech.
🇨🇳Wuhan, Hubei, China
Eye Center of the second Bethune Hospital, jinlin University
🇨🇳Changchun, Jilin, China
The Fourth People's Hospital of Shenyang
🇨🇳Shenyang, Liaoning, China
Aier Eye Hospital (LIAONING)
🇨🇳Shenyang, Liaoning, China
People's Hospital of Ningxia Hui Autonomous Region - Opthalmology
🇨🇳Ningxia, Ningxia, China
Shanxi Eye Hospital
🇨🇳Shanxi, Shaanxi, China
Qilu Hosp., Shandong Univ.
🇨🇳Jinan, Shandong, China
Aier Eye Hospital (Chengdu)
🇨🇳Chengdu, Sichuan, China
ZheJiang Provincial People's Hospital
🇨🇳Hangzhou, Zhejiang, China
Dongyang People's Hospital
🇨🇳Jinhua, Zhejiang, China
Beijing Aier Intech Eye Hospital
🇨🇳Beijing, China
China-Japan Friendship Hospital
🇨🇳Beijing, China
Capital Medical University (CMU) - Beijing Tongren Hospital
🇨🇳Beijing, China
Peking Union Medical College Hospital CAMS
🇨🇳Beijing, China
Chongqing Aier Ophthalmology Hospital
🇨🇳Chongqing, China
Lanzhou University - The Second Hospital (The Second Clinical Medical College of Lanzhou University)
🇨🇳Lanzhou, China
Tianjin Medical University Eye Hospital
🇨🇳Tianjin, China
Fakultní Nemocnice Hradec Kralové
🇨🇿Hradec Kralove, Czechia
Fakultní nemocnice Ostrava
🇨🇿Ostrava, Czechia
Nemocnice Pardubickeho kraje, a.s., Pardubicka nemocnice
🇨🇿Pardubice, Czechia
Všeobecná fakultní nemocnice v Praze
🇨🇿Praha 2, Czechia
Lexum a.s., Evropska ocni klinika
🇨🇿Praha 4, Czechia
Axon Clinical, s.r.o.
🇨🇿Praha 5, Czechia
AS Ida-Tallinna Keskhaigla - Oftalmoloogiakeskus
🇪🇪Tallinn, Estonia
Dr. Kai Noor Silmakabinet OÜ
🇪🇪Tallinn, Estonia
Sihtasutus Tartu Ülikooli Kliinikum - Silmakliinik
🇪🇪Tartu, Estonia
Centre Hospitalier National d'Ophthalmologie Quinze-Vingt
🇫🇷Paris, Cedex 12, France
Clinique Rétine Tourny
🇫🇷Bordeaux, France
CHU Bordeaux - Hopital Pellegrin - Ophtalmologie
🇫🇷Bordeaux, France
Hôpital Intercommunal - Créteil Cedex
🇫🇷Creteil Cedex, France
CHU Dijon - Hopital Francois Miterrand
🇫🇷Dijon, France
Hôpital de la Croix Rousse
🇫🇷Lyon, France
Centre d'Ophtalmologie - Paradis-Monticelli
🇫🇷Marseille, France
Clinique Jules Verne - Nantes
🇫🇷Nantes, France
Centre d'ophtalmologie de l'Odéon
🇫🇷Paris, France
Centre Ophthalmologie d'Imagerie et de Laser
🇫🇷Paris, France
AP-HP - Hopital Lariboisiere
🇫🇷Paris, France
CM Wolff
🇫🇷Strasbourg, France
Centre Ophtalmologique Transparence - Tours
🇫🇷Tours, France
LTD "IQ Clinic"- Ophthalmology
🇬🇪Tbilisi, Georgia
LTD "Chichua Medical Center MZERA"
🇬🇪Tbilisi, Georgia
Knappschaftskrankenhaus Sulzbach
🇩🇪Sulzbach, Saarland, Germany
Uniklinik Bonn / Eye Clinic
🇩🇪Bonn, Germany
Medizinische Hochschule Hannover (MHH) - Universitätsklinik für Augenheilkunde
🇩🇪Hannover, Germany
Uni Heidelberg / Augenklinik
🇩🇪Heidelberg, Germany
Klinikum d. Stadt Ludwigshafen - Ophthalmology
🇩🇪Ludwigshafen, Germany
St. Franziskus-Hospital Münster - Eye Center
🇩🇪Muenster, Germany
Magyar Honvedseg Egeszsegugyi Kozpont
🇭🇺Budapest, Hungary
University of Semmelweis/ Semmelweis Egyetem
🇭🇺Budapest, Hungary
Budapesti Bajcsy-Zsilinszky Korhaz es Rendelointezet
🇭🇺Budapest, Hungary
Budapest Retina Associates
🇭🇺Budapest, Hungary
Meir Medical Center
🇮🇱Kfar Saba, Israel
Rabin Medical Center | Beilinson Hospital - Internal Medicine C Department
🇮🇱Petach Tikva, Israel
Kaplan Medical Center
🇮🇱Rehovot, Israel
Tel-Aviv Sourasky Medical Center
🇮🇱Tel Aviv, Israel
Assuta Medical Centers - HaShalom
🇮🇱Tel Aviv, Israel
Shamir Medical Center (Assaf Harofeh)
🇮🇱Zerifin, Israel
Azienda Ospedaliero Universitaria Delle Marche - Clinica Oculistica
🇮🇹Torrette, Ancona, Italy
Azienda Ospedaliera Policlinico Universitario Tor Vergata - Patologie Retiniche
🇮🇹Roma, Lazio, Italy
Fondazione Policlinico Universitario Agostino Gemelli IRCCS - UOC Oculistica
🇮🇹Roma, Lazio, Italy
Fondazione G.B.Bietti Per Lo Studio E La Ricerca In Oftalmologia
🇮🇹Roma, Lazio, Italy
ASST Fatebenefratelli Sacco
🇮🇹Milano, Lombardia, Italy
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
🇮🇹Milano, Lombardia, Italy
Ospedale San Raffaele s.r.l.
🇮🇹Milano, Lombardia, Italy
Aichi Medical University Hospital
🇯🇵Nagakute, Aichi, Japan
Nagoya City University Hospital
🇯🇵Nagoya, Aichi, Japan
International University of Health & Welfare Narita Hospital
🇯🇵Narita, Chiba, Japan
Toho University Sakura Medical Center
🇯🇵Sakura, Chiba, Japan
University of Fukui Hospital
🇯🇵Yoshida, Fukui, Japan
Kurume University Hospital
🇯🇵Kurume, Fukuoka, Japan
Southern Tohoku Eye Clinic
🇯🇵Koriyama, Fukushima, Japan
Gunma University Hospital
🇯🇵Maebashi, Gunma, Japan
Hyogo Prefectural Amagasaki General Medical Center
🇯🇵Amagasaki, Hyogo, Japan
Kobe University Hospital
🇯🇵Kobe, Hyogo, Japan
Hyogo Medical University Hospital
🇯🇵Nishinomiya, Hyogo, Japan
Kozawa Eye Hospital and Diabetes Center
🇯🇵Mito, Ibaraki, Japan
Matsumoto Eye Clinic
🇯🇵Toride, Ibaraki, Japan
Kagawa University Hospital
🇯🇵Kita-gun, Kagawa, Japan
Medical corporation Eiwakai Dannoue Ophthalmology clinic
🇯🇵Kawasaki, Kanagawa, Japan
St. Marianna University Hospital
🇯🇵Kawasaki, Kanagawa, Japan
Yokohama City University Medical Center
🇯🇵Yokohama, Kanagawa, Japan
Mie University Hospital
🇯🇵Tsu, Mie, Japan
Shinshu University Hospital
🇯🇵Matsumoto, Nagano, Japan
National Defense Medical College Hospital
🇯🇵Tokorozawa, Saitama, Japan
Shiga University of Medical Science Hospital
🇯🇵Otsu, Shiga, Japan
Shida Eye Clinic
🇯🇵Fujieda-shi, Shizuoka, Japan
Nihon University Hospital
🇯🇵Chiyoda-ku, Tkyo, Japan
The University of Tokyo Hospital
🇯🇵Bunkyo-ku, Tokyo, Japan
Chofu Eye Clinic
🇯🇵Chofu, Tokyo, Japan
Tokyo Medical University Hachioji Medical Center
🇯🇵Hachioji, Tokyo, Japan
Tokyo Metropolitan Institute for Geriatrics and Gerontology
🇯🇵Itabashi-ku, Tokyo, Japan
Tokiwadai Muranaka Eye Clinic
🇯🇵Itabashi-ku, Tokyo, Japan
National Hospital Organization Tokyo Medical Center
🇯🇵Meguro-ku, Tokyo, Japan
Keio University Hospital
🇯🇵Shinjuku-ku, Tokyo, Japan
Tokyo Women's Medical University Hospital
🇯🇵Shinjuku-ku, Tokyo, Japan
Yamaguchi University Hospital
🇯🇵Ube, Yamaguchi, Japan
University of Yamanashi Hospital
🇯🇵Chuo, Yamanashi, Japan
Akita University Hospital
🇯🇵Akita, Japan
Hayashi Eye Hospital
🇯🇵Fukuoka, Japan
Murakami Karindoh Hospital
🇯🇵Fukuoka, Japan
Fukushima Medical University Hospital
🇯🇵Fukushima, Japan
Kagoshima University Hospital
🇯🇵Kagoshima, Japan
University of Miyazaki Hospital
🇯🇵Miyazaki, Japan
Okayama University Hospital
🇯🇵Okayama, Japan
Osaka Metropolitan University Hospital
🇯🇵Osaka, Japan
Japanese Red Cross Saitama Hospital
🇯🇵Saitama, Japan
Toyama University Hospital
🇯🇵Toyama, Japan
Japanese Red Cross Wakayama Medical Center
🇯🇵Wakayama, Japan
Yamagata University Hospital
🇯🇵Yamagata, Japan
Seoul National University Bundang Hospital
🇰🇷Seongnam-si, Gyeonggido, Korea, Republic of
Severance Hospital, Yonsei University Health System
🇰🇷Seoul, Seoul Teugbyeolsi, Korea, Republic of
Asan Medical Center
🇰🇷Seoul, Seoul Teugbyeolsi, Korea, Republic of
Seoul National University Hospital
🇰🇷Seoul, Seoul Teugbyeolsi, Korea, Republic of
Gangnam Severance Hospital, Yonsei University Health System
🇰🇷Seoul, Seoul Teugbyeolsi, Korea, Republic of
Pusan National University Hospital
🇰🇷Busan, Korea, Republic of
Yeungnam University Medical Center
🇰🇷Daegu, Korea, Republic of
Korea University Ansan Hospital
🇰🇷Gyeonggi-do, Korea, Republic of
Samsung Medical Center
🇰🇷Seoul, Korea, Republic of
St. Mary Hospital
🇰🇷Seoul, Korea, Republic of
Kim's Eye Hospital
🇰🇷Seoul, Korea, Republic of
Department of Ophthalmology
🇱🇻Riga, Latvia
Riga East Clinical University Hospital "Gailezers"
🇱🇻Riga, Latvia
Hospital of LT University of Health Sciences Kaunas Clinics
🇱🇹Kaunas, Lithuania
Vilnius University Hospital Santaros Klinikos
🇱🇹Vilnius, Lithuania
Hospital Al-Sultan Abdullah, UiTM | Opthalmology
🇲🇾Bandar Puncak Alam, Selangor, Malaysia
Hospital Shah Alam | Ophthalmology
🇲🇾Shah Alam, Selangor, Malaysia
Hospital Selayang
🇲🇾Shah Alam, Selangor, Malaysia
OasisEye Specialists
🇲🇾Kuala Lumpur, Malaysia
Prywatna Klinika Okulistyczna OFTALMIKA
🇵🇱Bydgoszcz, Poland
CHLC - Hospital dos Capuchos - Servico de Oftalmologia
🇵🇹Lisboa, Portugal
Centro Hospitalar Universitario do Porto
🇵🇹Porto, Portugal
Centro Hospitalar Universitario de Sao Joao | Polo Porto - Centro de Investigacao e Ensaios Clinicos
🇵🇹Porto, Portugal
Centro Hospitalar Vila Nova de Gaia e Espinho | Unit 1 - Clinical Research Center
🇵🇹Porto, Portugal
Clinical Center of Serbia
🇷🇸Belgrade, Serbia
Clinical hospital center Zvezdara
🇷🇸Belgrade, Serbia
Klinicki centar Vojvodine
🇷🇸Novi Sad, Serbia
Fakultna Nemocnica s poliklinikou F.D.Roosevelta
🇸🇰Banska Bystrica, Slovakia
Univerzitna nemocnica Bratislava, Nemocnica Ruzinov
🇸🇰Bratislava, Slovakia
Univerzitna nemocnica Bratislava, Nem. Sv. Cyrila a Metoda
🇸🇰Bratislava, Slovakia
Fakultna nemocnica Nitra
🇸🇰Nitra, Slovakia
Fakultna nemocnica Trencin
🇸🇰Trencin, Slovakia
Specialized hospital for ophthalmology OPHTAL
🇸🇰Zvolen, Slovakia
Instituto Oftalmológico Francisco Gomez Ulla
🇪🇸Santiago de Compostela, A Coruña, Spain
Hospital General de Catalunya
🇪🇸Sant Cugat del Valles, Barcelona, Spain
Hospital Universitario Clinica Puerta de Hierro
🇪🇸Majadahonda, Madrid, Spain
Hospital Vall d'Hebron - Servei d'Oftalmologia
🇪🇸Barcelona, Spain
Hospital de la Santa Creu i de Sant Pau
🇪🇸Barcelona, Spain
Hospital Clínic i Provincial de Barcelona
🇪🇸Barcelona, Spain
Clínica Universidad de Navarra CUN
🇪🇸Pamplona, Spain
Hospital General Universitario de Valencia
🇪🇸Valencia, Spain
Hospital del Rio Hortega
🇪🇸Valladolid, Spain
Hospital Miguel Servet
🇪🇸Zaragoza, Spain
RétinElysée
🇨🇭Lausanne, Vaud, Switzerland
Inselspital Universitätsspital Bern
🇨🇭Bern, Switzerland
Berner Augenklinik am Lindenhofspital
🇨🇭Bern, Switzerland
Vista Klinik
🇨🇭Binningen, Switzerland
University Eye Hospital Jules Gonin
🇨🇭Lausanne, Switzerland
Chiangmai University
🇹🇭Chiangmai, Thailand
Srinagarind Hospital
🇹🇭Khon Kaen, Thailand
Ankara Etlik City Hospital | Ophthalmology
🇹🇷Ankara, Turkey
Leicester Royal Infirmary
🇬🇧Leicester, Leicestershire, United Kingdom
Frimley Park Hospital NHS
🇬🇧Frimley, Surrey, United Kingdom
Sunderland Eye Infirmary
🇬🇧Sunderland, Tyne And Wear, United Kingdom
New Cross Hospital
🇬🇧Wolverhampton, West Midlands, United Kingdom
Bradford Royal Infirmary
🇬🇧Bradford, West Yorkshire, United Kingdom
Leeds Teaching Hospitals NHS Trust | St James's University Hospital - Oncology
🇬🇧Leeds, West Yorkshire, United Kingdom
Hull and East Yorkshire Eye Hospital Hull and East Yorkshire
🇬🇧Hull, York, United Kingdom
Royal Liverpool University Hospital
🇬🇧Liverpool, United Kingdom
Moorfields Eye Hospital
🇬🇧London, United Kingdom
York Teaching Hospital
🇬🇧York, United Kingdom