Rethinking Clinical Trials in Age-Related Macular Degeneration: How AI-Based OCT Analysis Can Support Successful Outcomes

AI Generated Summary*

A review surveys how AI analysis of optical coherence tomography could strengthen trials in age-related macular degeneration. For neovascular disease, it argues central subfield thickness inadequately captures exudation and describes post hoc analyses of HARBOR, HAWK, HARRIER and FLUID where automated fluid quantification revealed distinct compartment dynamics and repeatedly linked intraretinal fluid to worse vision. For geographic atrophy, it presents ellipsoid zone loss as a more sensitive endpoint: post hoc OAKS and DERBY analyses found pegcetacoplan slowed ellipsoid zone loss 46 to 53 percent versus sham but retinal pigment epithelium loss only 20 to 27 percent. It also covers personalized microperimetry, automated prescreening nearly doubling eligible patients versus record searches, and limitations including device specificity, dataset representativeness and ethics.

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