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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
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

Full criteria on ClinicalTrials.gov

Sites (22)

Sites in registry order. Pick your city on the disease page to sort them by distance.

SiteCityCountrySite status
Bedford Hospital
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BedfordUnited KingdomRecruiting
The Royal Hospitals Belfast
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BelfastUnited KingdomRecruiting
Birmingham and Midland Eye Centre
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BirminghamUnited KingdomRecruiting
Sussex Eye Hospital
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BrightonUnited KingdomRecruiting
Bristol Eye Hospital
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BristolUnited KingdomRecruiting
Frimley Park Hospital
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CamberleyUnited KingdomRecruiting
University Hospital of Wales
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CardiffUnited KingdomNot yet recruiting
Gloucestershire Royal Hospital
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GloucesterUnited KingdomRecruiting
Hull Royal Infirmary
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HullUnited KingdomRecruiting
Royal Liverpool University Hospital
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LiverpoolUnited KingdomRecruiting
Moorfields Eye Hospital
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LondonUnited KingdomRecruiting
Central Middlesex Hospital
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LondonUnited KingdomRecruiting
Kings College Hospital
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LondonUnited KingdomRecruiting
Chelsea And Westminster Hospital
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LondonUnited KingdomRecruiting
James Cook Hospital
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MiddlesbroughUnited KingdomRecruiting
Royal Gwent Hospital
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NewportUnited KingdomRecruiting
Queen'S Medical Centre
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NottinghamUnited KingdomNot yet recruiting
University Hospital Southampton
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SouthamptonUnited KingdomRecruiting
Sunderland Eye Hospital
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SunderlandUnited KingdomRecruiting
Singleton Hospital
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SwanseaUnited KingdomRecruiting
Torbay Hospital
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TorquayUnited KingdomRecruiting
Hillingdon Hospital
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UxbridgeUnited KingdomRecruiting

This page is information, not medical advice. Discuss any trial with your doctor.