Supplemental Coordinator Funding Addendum "Diabetic Retinopathy Clinical Research Network"

Treatment of neovascular AMD (nAMD) with anti-VEGF therapy is highly effective but is associated with considerable treatment burden and cost for patients and the healthcare system. One of the principle barriers to reducing burden and cost that both the optimal timing and the optimal number of injections needed to achieve best visual acuity and disease control for any on person are unknown. At present, there are several algorithms that modestly reduce treatment burden, but at the expense of overtreatment in some patients and less optimal disease control in others. The lack of precision in disease management may be due in part to the low frequency of disease monitoring, which typically occurs every one to two months by standard OCT imaging during an office visit. Home OCT imaging allows daily disease activity monitoring and the possibility of a tailored and more personalized approach to managing neovascular AMD. To understand the role of Home OCT in clinical practice, it is essential to perform a randomized clinical trial that compares visual acuity outcomes, and visit and injection frequencies, obtained using a Home OCT-guided treatment strategy versus outcomes obtained using Treat and Extend, the treatment algorithm widely perceived to be the most common regiment in clinical practice today.