NCT06985706RecruitingPhase 3
Anti-vascular Endothelial Growth Factor (Anti-VEGF) Monotherapy vs Anti-VEGF Followed by Subthreshold Micropulse Laser for Treating Severe Diabetic Macular Oedema When the Central Retina Goes <400 Microns
Treatment of Severe Diabetic Macular Oedema With Anti-vascular Endothelial Growth Factor (Anti-VEGF) Monotherapy vs Anti-VEGF Followed by Subthreshold Micropulse Laser When the Thickness of the Central Retina Goes Below 400 Microns: Pragmatic Randomised Equivalence Trial
Source: ClinicalTrials.gov · Last updated 28 Sept 2026
Brief summary (registry, in English)
The macula is the centre of the retina; it gives central sight, colour and fine detail. People with diabetes may develop diabetic macular oedema (DMO). In DMO, fluid leaks from blood vessels and builds up at the macula, causing sight loss. DMO can be mild or severe; this is determined by measuring, in microns (µm), how thick the macula is. One µm is one-thousandth of a millimetre. People presenting with mild DMO (macula less than 400 µm thick; normally it is around 250 µm but varies with sex and ethnicity) are offered macular laser treatment. Laser works well for these patients. Subthreshold micropulse laser (SML), which does not damage the macula, works as well as standard laser, which produces a burn, and is cost-effective. However, many people present with severe DMO (macula 400 µm or thicker) where the laser does not work well. The standard treatment is eye injections of anti-VEGFs. VEGF stands for vascular endothelial growth factor. VEGF is high in eyes with DMO and causes blood vessel leakage. Anti-VEGFs block VEGF. They are given monthly to begin with, then every 2-3 months for months or years until DMO clears. In many patients DMO comes back after clearing and anti-VEGFs need to be re-started most often monthly initially again. To improve the care of people with severe DMO this study will compare the current standard care (anti-VEGFs alone) with a strategy in which patients begin with an anti-VEGF but switch to SML once the macula is less than 400 µm thick. Patients aged over 18 years with type 1 or type 2 diabetes and severe DMO can participate. They are randomly allocated either anti-VEGFs alone or anti-VEGFs then SML when the macula is less than 400 µm thick.
- Status (registry)
- Recruiting
- Phase (registry)
- Phase 3
- Study type
- Interventional
- Enrollment
- 264 (estimated)
- First submitted
- 10 May 2025
- Start date
- 19 May 2025
- Primary completion date
- 30 Nov 2028
- Lead sponsor
- Belfast Health and Social Care Trust
- Diseases
- Diabetic eye disease
- NCT number
- NCT06985706
What you commit to
- Study type: Interventional · Phase 3
- Planned participants: 264
- From 19 May 2025 to the primary completion date, 30 Nov 2028
- 22 sites in 1 country
- Visits and tests: ask the trial team, the registry does not list them
Built from the registry fields of ClinicalTrials.gov. It describes the study, not your situation.
Who cannot take part
Copied verbatim from ClinicalTrials.gov and grouped by topic. Only the trial team decides who can take part.
Prior treatment
- Receipt of anti-VEGFs before their presentation with severe DMO (previous macular laser treatment for DMO is allowed)
- Use of unlicensed anti-VEGFs (e.g. bevacizumab)
- Cataract surgery or laser pan-retinal photocoagulation (PRP) within the previous 6 weeks
Other
- Causes of macular oedema other than DMO
- DMO with CRT ≥400 μm
- Inability, for any reason, to attend study visits
- Active proliferative diabetic retinopathy (PDR) (treated and inactive PDR is allowed)
- Use of pioglitazone which cannot be stopped for the duration of the trial
- Currently enrolled in a Clinical Trial of an Investigational Medical Product
- Declined consent for participation
Who the study is looking for
- Adults (\>18 years)
- Diabetes type 1 or type 2
- Presented with severe centre-involving (CI)-DMO (CRT ≥400 μm)
- Within the first year of initiating anti-VEGF therapy but who still have DMO and their CRT is below 400 μm (and it remains, at the time of randomisation) following anti-VEGF therapy in either one eye or both eyes
Age in the registry: 18 years to - · Sex: All · Does not accept healthy volunteers
Sites (22)
Sites in registry order. Pick your city on the disease page to sort them by distance.
| Site | City | Country | Site status |
|---|---|---|---|
| Bedford Hospital Coordinator of this site? Confirm its status | Bedford | United Kingdom | Recruiting |
| The Royal Hospitals Belfast Coordinator of this site? Confirm its status | Belfast | United Kingdom | Recruiting |
| Birmingham and Midland Eye Centre Coordinator of this site? Confirm its status | Birmingham | United Kingdom | Recruiting |
| Sussex Eye Hospital Coordinator of this site? Confirm its status | Brighton | United Kingdom | Recruiting |
| Bristol Eye Hospital Coordinator of this site? Confirm its status | Bristol | United Kingdom | Recruiting |
| Frimley Park Hospital Coordinator of this site? Confirm its status | Camberley | United Kingdom | Recruiting |
| University Hospital of Wales Coordinator of this site? Confirm its status | Cardiff | United Kingdom | Not yet recruiting |
| Gloucestershire Royal Hospital Coordinator of this site? Confirm its status | Gloucester | United Kingdom | Recruiting |
| Hull Royal Infirmary Coordinator of this site? Confirm its status | Hull | United Kingdom | Recruiting |
| Royal Liverpool University Hospital Coordinator of this site? Confirm its status | Liverpool | United Kingdom | Recruiting |
| Moorfields Eye Hospital Coordinator of this site? Confirm its status | London | United Kingdom | Recruiting |
| Central Middlesex Hospital Coordinator of this site? Confirm its status | London | United Kingdom | Recruiting |
| Kings College Hospital Coordinator of this site? Confirm its status | London | United Kingdom | Recruiting |
| Chelsea And Westminster Hospital Coordinator of this site? Confirm its status | London | United Kingdom | Recruiting |
| James Cook Hospital Coordinator of this site? Confirm its status | Middlesbrough | United Kingdom | Recruiting |
| Royal Gwent Hospital Coordinator of this site? Confirm its status | Newport | United Kingdom | Recruiting |
| Queen'S Medical Centre Coordinator of this site? Confirm its status | Nottingham | United Kingdom | Not yet recruiting |
| University Hospital Southampton Coordinator of this site? Confirm its status | Southampton | United Kingdom | Recruiting |
| Sunderland Eye Hospital Coordinator of this site? Confirm its status | Sunderland | United Kingdom | Recruiting |
| Singleton Hospital Coordinator of this site? Confirm its status | Swansea | United Kingdom | Recruiting |
| Torbay Hospital Coordinator of this site? Confirm its status | Torquay | United Kingdom | Recruiting |
| Hillingdon Hospital Coordinator of this site? Confirm its status | Uxbridge | United Kingdom | Recruiting |
This page is information, not medical advice. Discuss any trial with your doctor.