Home OCT-Guided Treatment Versus Treat and Extend for the Management of Neovascular AMD

NCT ID: NCT05904028

Last Updated: 2026-01-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

600 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-11-09

Study Completion Date

2027-07-30

Brief Summary

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Home optical coherence tomography- guided treatment versus treat and extend for the management of neovascular age-related macular degeneration.

Detailed Description

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Treatment of Neovascular Age-Related Macular Degeneration (nAMD) with anti-vascular endothelial growth factor therapy is highly effective but is associated with considerable treatment burden and cost for patients and the healthcare system. One of the principal barriers to reducing burden and cost is that the optimal number of injections needed to achieve best visual acuity and disease control for any one person is unknown. At present, there are several algorithms that modestly reduce treatment burden, but at the expense of overtreatment in some patients and less optimal disease control in others. The lack of precision in disease management may be due in part to the low frequency of disease monitoring, which typically occurs every one to two months by standard optical coherence tomography (OCT) imaging during an office visit. Home OCT imaging allows daily disease activity monitoring and the possibility of a tailored and more personalized approach to managing neovascular AMD. To understand the role of Home OCT in clinical practice, it is essential to perform a randomized clinical trial that compares visual acuity outcomes, and visit and injection frequencies, obtained using a Home OCT-guided treatment strategy versus outcomes obtained using "Treat and Extend," the treatment algorithm widely perceived to be the most common regimen in clinical practice today.

The main objective of this study is to determine if Home OCT-guided treatment results in 1) better visual acuity outcomes and/or 2) fewer number of injections over 104 weeks compared with treat and extend (T\&E) dosing for nAMD.

Procedures at the baseline visit include eligibility assessment, vision testing, ocular examination, various imaging, and test session on the in-office Home OCT device. Eligible study eyes will enter the run-in phase and receive a baseline intravitreal faricimab injection. If the non-study eye also has nAMD and needs an injection, study faricimab must be used unless the protocol chair has approved of an alternative anti-VEGF. The Notal Vision Monitoring Center must confirm adequate scan quality from the study eye prior to randomization. The Reading Center must also confirm nAMD status based on a preliminary review of baseline images. One Notal Vision confirms the screening Home OCT scans are of good quality and the Reading Center confirms nAMD criteria Is met, the participant can be randomized.

Randomization of eligible study eyes must occur within 14 days of the baseline visit. Prior to randomization, the site must call the participant to confirm they are still willing to participate and agree to follow the daily Home OCT scan requirement if randomized to the Home OCT group. Sites will also confirm the participant's understanding of the trial, willingness to accept the assigned treatment group, and commitment to the follow-up schedule, and compliance with device use.

Eyes receiving an initial faricimab injection that are not eligible for the randomization phase will have a final closeout safety visit 1 month after injection.

Eyes eligible for the randomization phase will be randomly assigned 1:1 into one of two groups to guide follow-up treatment: (1) Treat and Extend or (2) Home OCT-guided treatment. Follow-up for treatment group comparisons of vision and imaging outcomes will occur at 52- and 104-week visits. Additional visits will occur every 4-18 weeks in the T\&E group. Participants assigned to the Home OCT group will self-scan daily using the Home OCT device and will only return for a visit if fluid passing the threshold for an office visit is seen on Home OCT. Follow-up visit procedures include vision testing, ocular exam, and various imaging. The primary outcomes are a comparison of mean change in visual acuity and number of injections from baseline to 104 weeks between the Home OCT vs. T\&E groups (study eye only)

Conditions

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Neovascular Age-related Macular Degeneration

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
Visual acuity and imaging technicians will be masked to the participant's treatment group assignment, as will the central Reading Centers. Investigators, coordinators, and participants will be unmasked to treatment group assignment.

Study Groups

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Treat and Extend

Intravitreal injections of 6 mg faricimab on a Treat and Extend schedule

Group Type EXPERIMENTAL

Intravitreal injections of 6 mg faricimab on a Treat and Extend schedule

Intervention Type DRUG

Intravitreal injections of 6 mg faricimab on a Treat and Extend schedule

Home optical coherence tomography-Guided Treatment

Intravitreal injections of 6 mg faricimab on a Home OCT-guided treatment schedule

Group Type EXPERIMENTAL

Intravitreal injections of 6 mg faricimab on a home optical coherence tomography-guided treatment schedule

Intervention Type DEVICE

Intravitreal injections of 6 mg faricimab on a Home OCT-guided treatment schedule

Interventions

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Intravitreal injections of 6 mg faricimab on a Treat and Extend schedule

Intravitreal injections of 6 mg faricimab on a Treat and Extend schedule

Intervention Type DRUG

Intravitreal injections of 6 mg faricimab on a home optical coherence tomography-guided treatment schedule

Intravitreal injections of 6 mg faricimab on a Home OCT-guided treatment schedule

Intervention Type DEVICE

Other Intervention Names

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Home OCT

Eligibility Criteria

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Inclusion Criteria

* Age ≥ 50 years
* Have the capacity to consent on his/her own behalf
* Able to successfully and independently complete at least one self-scanning session on the Home OCT device located at the enrolling clinical site
* Willing to perform once daily Home OCT monitoring tests for 2 years without significant interruption (such as travel of more than 14 days)
* Best corrected E-ETDRS visual acuity ≥24 ETDRS letters (approximately 20/320 or better (Snellen))
* Previously untreated, active MNV lesion (i.e., any intraretinal or subretinal fluid within the center 3 mm diameter circle on OCT) secondary to age-related macular degeneration
* ≥ 1 intermediate drusen (≥ 63 microns) in either eye OR late AMD (MNV or macular atrophy) in the contralateral eye

Exclusion Criteria

* Previous treatment for MNV (intravitreal injection of any anti-VEGF or anti-VEGF/anti-Ang2 agent, or any other AMD therapy)
* Prior treatment with intravitreal injection of any anti-VEGF or anti-VEGF/anti-Ang2 agent or with macular laser for any indication
* Treatment with intravitreal corticosteroids within the last 6 months
* A condition that, in the opinion of the investigator, would preclude participation in the study or ability to complete daily Home OCT scans for 2 years (e.g., unstable medical status that may preclude successful completion of follow-up, dementia, Alzheimer's disease, uncontrollable tremors)
* MNV due to other causes, such as ocular histoplasmosis, central serous choroidopathy, or pathologic myopia
Minimum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institutes of Health (NIH)

NIH

Sponsor Role collaborator

National Eye Institute (NEI)

NIH

Sponsor Role collaborator

Juvenile Diabetes Research Foundation

OTHER

Sponsor Role collaborator

Jaeb Center for Health Research

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Kent W. Small, MD, AMC

Glendale, California, United States

Site Status RECRUITING

Loma Linda University

Loma Linda, California, United States

Site Status RECRUITING

East Bay Retina Consultants, Inc.

Oakland, California, United States

Site Status RECRUITING

Kaiser Permanente - Oakland

Oakland, California, United States

Site Status RECRUITING

Southern California Desert Retina Consultants, Inc.

Palm Desert, California, United States

Site Status RECRUITING

UC Davis Health Eye Center

Sacramento, California, United States

Site Status RECRUITING

Macula Retina Vitreous Institute

Torrance, California, United States

Site Status RECRUITING

Bay Area Retina Associates A Medical Group

Walnut Creek, California, United States

Site Status RECRUITING

Retina Consultants

Manchester, Connecticut, United States

Site Status RECRUITING

National Ophthalmic Research Institute

Fort Myers, Florida, United States

Site Status RECRUITING

National Ophthalmic Research Institute

Fort Myers, Florida, United States

Site Status RECRUITING

University of Florida- Jacksonville

Jacksonville, Florida, United States

Site Status RECRUITING

Florida Retina Institute, James A. Staman, MD, PA- Jacksonville

Jacksonville, Florida, United States

Site Status RECRUITING

Argus Research Center, Inc

Naples, Florida, United States

Site Status RECRUITING

Southeast Eye Institute, P.A. dba Eye Associates of Pinellas

Pinellas Park, Florida, United States

Site Status RECRUITING

Retina Associates of Sarasota

Sarasota, Florida, United States

Site Status RECRUITING

Sarasota Retina Institute

Sarasota, Florida, United States

Site Status RECRUITING

Retina Associates of Florida, LLC

Tampa, Florida, United States

Site Status RECRUITING

Southeast Retina Center, P.C.

Augusta, Georgia, United States

Site Status RECRUITING

Thomas Eye Group

Sandy Springs, Georgia, United States

Site Status RECRUITING

Northwestern Memorial Group

Chicago, Illinois, United States

Site Status RECRUITING

Rush University Medical Center

Chicago, Illinois, United States

Site Status RECRUITING

UIC - Dept of Ophthalmology & Visual Sciences

Chicago, Illinois, United States

Site Status RECRUITING

The Trustees of Indiana University

Indianapolis, Indiana, United States

Site Status RECRUITING

Midwest Eye Institute

Indianapolis, Indiana, United States

Site Status RECRUITING

Wolfe Clinic, P.C.- West Des Moines

West Des Moines, Iowa, United States

Site Status RECRUITING

Mid-America Retina Consultants, P.A.

Overland Park, Kansas, United States

Site Status RECRUITING

University of Kentucky Advanced Eye Care

Lexington, Kentucky, United States

Site Status RECRUITING

Elman Retina Group, BA

Baltimore, Maryland, United States

Site Status RECRUITING

Johns Hopkins University

Baltimore, Maryland, United States

Site Status RECRUITING

Valley Eye Physicians and Surgeons

Ayer, Massachusetts, United States

Site Status RECRUITING

Joslin Diabetes Center

Boston, Massachusetts, United States

Site Status RECRUITING

Henry Ford Health System

Detroit, Michigan, United States

Site Status RECRUITING

Retina Associates of Michigan

Grand Blanc, Michigan, United States

Site Status RECRUITING

Associated Retinal Consultants, P.C.

Royal Oak, Michigan, United States

Site Status RECRUITING

Associated Retinal Consultants

Traverse City, Michigan, United States

Site Status RECRUITING

The Retina Institute

St Louis, Missouri, United States

Site Status RECRUITING

Associated Retinal Surgeons d/b/a Mid Atlantic Retina

Cherry Hill, New Jersey, United States

Site Status RECRUITING

New York University Langone Health

New York, New York, United States

Site Status RECRUITING

Macula Care

New York, New York, United States

Site Status RECRUITING

Vitreous Retina Macula Consultants of NY - VRMNY

New York, New York, United States

Site Status RECRUITING

Retina Associates of Western NY, P.C.

Rochester, New York, United States

Site Status RECRUITING

The Cleveland Clinic Foundation DBA Cleveland Clinic Lerner College of Medicine

Cleveland, Ohio, United States

Site Status RECRUITING

Retina Vitreous Center

Edmond, Oklahoma, United States

Site Status RECRUITING

Verum Research LLC

Eugene, Oregon, United States

Site Status RECRUITING

Oregon Health & Science University

Portland, Oregon, United States

Site Status RECRUITING

Cascade Medical Research Institute, LLC

Springfield, Oregon, United States

Site Status RECRUITING

Retina Vitreous Consultants

Monroeville, Pennsylvania, United States

Site Status RECRUITING

The Trustees of the University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status RECRUITING

Hilton Head Retina Institute

Hilton Head Island, South Carolina, United States

Site Status RECRUITING

Ophthalmology Ltd.

Sioux Falls, South Dakota, United States

Site Status RECRUITING

Southeastern Retina Associates, P.C.

Knoxville, Tennessee, United States

Site Status RECRUITING

Austin Research Center for Retina

Austin, Texas, United States

Site Status RECRUITING

Retina Consultants of Texas, PA

Bellaire, Texas, United States

Site Status RECRUITING

UT Southwestern Medical Center

Dallas, Texas, United States

Site Status RECRUITING

Southwest Retina Consultants

El Paso, Texas, United States

Site Status RECRUITING

Baylor College of Medicine, Baylor Eye Physicians and Surgeons

Houston, Texas, United States

Site Status RECRUITING

Texas Retina Associates

Lubbock, Texas, United States

Site Status RECRUITING

Retina Associates of South Texas

San Antonio, Texas, United States

Site Status RECRUITING

Retinal Consultants of Texas

San Antonio, Texas, United States

Site Status RECRUITING

The Board of Regents of the University of Wisconsin System

Madison, Wisconsin, United States

Site Status RECRUITING

Eye Clinic of Wisconsin

Wausau, Wisconsin, United States

Site Status RECRUITING

Chow Berger Koushan Medicine Professional Corporation o/a Toronto Retina Institute

North YORK, Ontario, Canada

Site Status RECRUITING

University Health Network

Toronto, Ontario, Canada

Site Status RECRUITING

Countries

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United States Canada

Facility Contacts

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Kent W Small, MD, AMC

Role: primary

818-552-5040

David I. Sierpina, MD

Role: primary

909-558-2169

Soraya Rofagha

Role: primary

510-444-1600

Amar Patel

Role: primary

5107526198

Clement K. Chan, MD, FACS

Role: primary

(760) 340-2394

Ala Moshiri, MD, PhD

Role: primary

916-734-6074

Mehran Taban, MD

Role: primary

4242479090

Yingna S. Liu, MD

Role: primary

9252654146

Noam Rudnick, MD, PhD

Role: primary

2036458430

A. T Ghuman, MD

Role: primary

239-939-4323

A. T. Ghuman, MD

Role: primary

239-939-4323

Sandeep Grover, MD

Role: primary

(904) 244-9361

Benjamin J. Thomas, MD

Role: primary

904-997-9202

Marilyn A. Marquez, MD

Role: primary

2395422020

Jason M. Handza, DO

Role: primary

727-541-4469

Elizabeth R Richter, MD, PhD

Role: primary

941-924-0303

Marc H Levy, MD, FACS

Role: primary

941-921-5335

Marc C Peden, MD

Role: primary

813-875-6373

Dennis Marcus

Role: primary

706-650-0061

Paul L. Kaufman, MD

Role: primary

404-256-1507

Rukhsana Mirza, MD, MS

Role: primary

312-695-2567

Mathew W. MacCumber, MD, PhD

Role: primary

312-942-2117

Jennifer I. Lim, MD

Role: primary

(312) 355-3743

Denis Jusufbegovic, MD

Role: primary

317-944-2020

Raj K. Maturi, MD

Role: primary

317-817-1414

Jared S. Nielsen, MD, MS, MBA

Role: primary

515-223-8685

William N. Rosenthal, MD

Role: primary

(913) 663-5900

Michelle Abou-Jaoude, MD

Role: primary

8595623570

Michael J Elman, MD

Role: primary

410-686-3394

Sharon D. Solomon, MD

Role: primary

410-614-6908

Gisela Velez, MD, MPH, MA

Role: primary

978-772-4000

Lloyd P Aiello, MD, PhD

Role: primary

614-309-2520

Paul A. Edwards, MD

Role: primary

313-874-9167

Raafay Sophie, MD

Role: primary

8104874500

Matthew G. Trese, DO

Role: primary

2482889132

Diane K. Fiander, MD

Role: primary

231-938-0710

Kevin Blinder

Role: primary

314-367-1181

Jason Hsu, MD

Role: primary

2159283092

Vaidehi Dedania

Role: primary

9294555522

Daniel F. Rosberger, MD, PhD, MPH

Role: primary

212-439-9600

Irene Barbazetto, MD

Role: primary

2128619797

Edward F. Hall, MD

Role: primary

585-442-3411

Aleksandra V. Rachitskaya, MD

Role: primary

216-445-9519

Michael P. Hood, MD

Role: primary

(405) 607-6699

Albert O. Edwards, MD, PhD

Role: primary

541-762-2763

Merina Thomas, MD

Role: primary

503-494-3055

John W. Karth, MD

Role: primary

541-687-1927

Karl R Olsen, MD

Role: primary

412-683-5300

Alexander J. Brucker, MD

Role: primary

215-662-9702

Carl W. Baker, MD

Role: primary

8437152424

Elizabeth A. Atchison, MD

Role: primary

6053366294

R. K. Shuler, Jr., MD

Role: primary

865-588-0811

Chirag Jhaveri, MD

Role: primary

737-704-0130

Charles C. Wykoff, MD, PhD

Role: primary

713-524-3434

Judy E. Kim, MD

Role: primary

214-645-2012

Richard Y Hwang, MD

Role: primary

9155323912

Christina Y. Weng, MD, MBA

Role: primary

713-798-3493

Michel Shami, MD

Role: primary

806-792-0066

Juan E. Rubio, MD

Role: primary

2106157600

Moises A. Chica, MD

Role: primary

210-615-1311

Kathleen Schildroth

Role: primary

608-263-7290

Deepak Sambhara, MD

Role: primary

8002618500

Keyvan Koushan

Role: primary

416-449-3937

Michael H. Brent, MD, FRCSC

Role: primary

416-603-5444

Other Identifiers

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UG1EY014231

Identifier Type: NIH

Identifier Source: secondary_id

View Link

Protocol AO

Identifier Type: -

Identifier Source: org_study_id

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