One Size Treats One

“One size fits all” approaches often show that, when you try to please everybody, you end up meeting the needs of very few. A good example of this is neovascular age-related macular degeneration (nAMD) therapeutics, where, despite the drastic impact of VEGF inhibitors, the current lack of tools for quantifying retinal fluid and precisely modeling its location means that clinicians can’t tailor treatments to individual patients and prevent over- or undertreatment, resulting in disappointing real-world outcomes.

Looking to surmount this, researchers from the Medical University of Vienna’s Department of Ophthalmology and Optometry are looking to AI to automate quantitative fluid volume measurement, enhancing treatment efficacy over the conventional qualitative fluid assessment approach to nAMD management (1). The research team outlined a protocol for a prospective, multicenter, randomized, double-masked phase III clinical trial that involves dividing 290 active nAMD patients into two test groups and assessing treatment patterns and visual acuity over the course of a year.

For the group receiving AI-assisted treatment, automated measurement of the fluid volumes in all retinal compartments, including intraretinal and subretinal fluid, will be taken and used as an objective tool in making retreatment decisions. This will mark the first time automated AI algorithms of this kind are implemented into real-world practice and, although results are yet to be gathered, the researchers hope that such a study could be the first steps toward optimized treatment regimens for all nAMD patients. This would increase healthcare systems’ treatment capacity by reducing the number of injections needed without affecting visual benefit or patient safety, ultimately reducing the burden of vision loss for all.

Moving forward and developing this technology, the team has formed a new company, RetInSight, a development of the work done at the University of Vienna which combines clinical expertise with technological innovation. RetInSight seeks to scale the research into an integrated management platform for nAMD. This includes not just the fluid monitor that can now be integrated into the clinical routine, (and is compatible with all major OCT technology) but also a wider AI platform that gives precise, real time analysis in any location. With these AI tools, the work of RetInSight represents the next evolution in managing and monitoring nAMD.