Evaluation of Clinical Progression, Prognostic Factors, and Quality of Life in Patients with Age-related Macular Degeneration. (VERA-AMD)

Evaluation of Clinical Progression, Prognostic Factors, and Quality of Life in Patients with Age-related Macular Degeneration (VERA-nAMD).

The VERA-AMD study is a prospective, observational study designed to evaluate clinical progression, prognostic factors, and quality of life in patients with age-related macular degeneration (AMD). The study aims to analyze real-world clinical data to identify key predictors of disease progression and functional outcomes, with the goal of optimizing AMD management. The study involves 200 patients aged ≥50 with a confirmed diagnosis of AMD, monitored through routine clinical practice. Primary outcomes include progression rates to advanced AMD and changes in visual acuity, while secondary outcomes focus on retinal morphology and quality of life. Anti-VEGF therapy and AI-based fluid analysis will be integrated to explore their impact on disease progression and patient outcomes.

Study Overview

• Status: Recruiting
• Conditions: Age-Related Macular Degeneration

Detailed Description

The VERA-AMD study is a prospective, non-interventional, observational study investigating the clinical course, prognostic factors, and quality of life in patients with age-related macular degeneration (AMD). AMD is a leading cause of vision loss among the elderly, manifesting as either neovascular ("wet") AMD (nAMD) or geographic atrophy ("dry") AMD (GA-AMD). Despite advances in treatment, there is considerable variability in disease progression and response to therapy. This study aims to fill this gap by analyzing real-world data to identify predictors of disease progression and functional outcomes, ultimately improving clinical management strategies.

Study Objectives

The study's main objectives are to:

Assess the clinical progression of AMD in routine clinical practice. Identify prognostic factors associated with favorable or unfavorable disease outcomes.

Evaluate the impact of AMD on patient quality of life using validated questionnaires.

Methodology

Design: Prospective, non-profit, observational study. Population: 200 patients aged ≥50 years with confirmed AMD in at least one eye. Inclusion Criteria: Confirmed diagnosis of AMD, scheduled follow-up according to clinical practice.

Exclusion Criteria: Significant ocular or systemic diseases affecting visual outcomes.

Outcomes

Primary Outcome: Progression rate to advanced AMD, expressed as cases per 100 patient-years.

Secondary Outcomes: Changes in visual acuity, retinal morphology assessed by optical coherence tomography (OCT), and patient-reported quality of life.

Anti-VEGF Therapy and AI-Based Fluid Analysis

A significant part of the study focuses on the role of anti-VEGF treatment in controlling disease progression, especially in nAMD. Anti-VEGF agents such as aflibercept and ranibizumab are standard treatments for neovascular AMD, aiming to reduce fluid accumulation and neovascularization. The study will explore the relationship between treatment regimens (fixed vs. as-needed dosing) and clinical outcomes, including visual acuity and anatomical changes.

Artificial intelligence (AI)-based analysis of retinal fluid dynamics will be employed using OCT imaging data. Machine learning algorithms will be applied to identify patterns in fluid accumulation and disease progression, improving early detection and personalized treatment approaches.

Data Collection and Statistical Analysis

Data will be collected through regular clinical visits, OCT imaging, and visual acuity testing. Statistical analysis will include repeated measures models to evaluate disease progression and predictors of clinical outcomes. Sample size calculations anticipate a 5.2% annual progression rate in early/intermediate AMD and a 19.7% rate in advanced AMD, with an 80% statistical power at a 0.05 significance level.

Timeline

Interim analysis after 12 months (50 patients with follow-up). Primary analysis after 12 months (all patients). Follow-up analysis at 36 months. Consent and Ethics

Informed consent will be obtained from all participants. Data will be anonymized and handled according to ethical guidelines and institutional review board (IRB) protocols.

• Study Type: Observational
• Enrollment (Estimated): 200

Contacts and Locations

• Study Contact: Name: Daniele Veritti; Phone Number: +390432559907; Email: daniele.veritti@uniud.it

Study Locations

• Italy
  • UD
    • Udine, UD, Italy, 33100
      • Recruiting
      • Department of Ophthalmology
      • Contact: Daniele Veritti; Phone Number: +390432559907; Email: daniele.veritti@uniud.it

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

Patients affected by age-related macular degeneration

Description

Inclusion Criteria:

• age ≥ 50 years.
• confirmed diagnosis of AMD in at least one eye.
• follow-up scheduled according to standard clinical practice.

Exclusion Criteria:

• presence of other significant ocular conditions that could affect visual acuity.
• systemic conditions that make the patient unsuitable for long-term follow-up.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Observational cohort of patients with age-related macular degeneration; Observational cohort of patients with age-related macular degeneration eventually receiving anti-VEGF agents as per clinical practice.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Best-corrected visual acuity (BCVA)	visual acuity measured as ETDRS letters	through study completion, 36 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Self-reported vision-targeted quality of life	Self-reported vision-targeted quality of life will be measured using National Eye Institute Visual Functioning Questionnaire 25 (VFQ-25). [Score 0-100, higher scores mean a better outcome]	through study completion, 36 months
Fluid volume (nL) in the retinal compartments	Artificial intelligence based fluid analysis. Measurement of fluid volume (nL) in the intraretinal, subretinal and sub retinal pigment epithelium compartments	through study completion, 36 months
central retinal thickness	central retinal thickness	through study completion, 36 months

Collaborators and Investigators

• Sponsor: University of Udine
• Investigators: Principal Investigator: Daniele Veritti, Department of Ophthalmology, University of Udine

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2024
• Primary Completion (Estimated): October 1, 2026
• Study Completion (Estimated): October 1, 2029

Study Registration Dates

• First Submitted: March 12, 2025
• First Submitted That Met QC Criteria: March 20, 2025
• First Posted (Actual): March 27, 2025

Study Record Updates

• Last Update Posted (Actual): March 27, 2025
• Last Update Submitted That Met QC Criteria: March 20, 2025
• Last Verified: March 1, 2025

More Information

Terms related to this study

• Keywords: anti-VEGF; artificial intelligence; age-related macular degeneration
• Additional Relevant MeSH Terms: Eye Diseases; Retinal Diseases; Retinal Degeneration; Macular Degeneration
• Other Study ID Numbers: OCU_DMED_2025_1

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No