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GlaucomaGlaukomAIcareNCT07668193

GlaukomAI: Clinical Validation of an AI System for Early Glaucoma Screening

A study testing GlaukomAI (Sens-vue GlaukomAI) in people with Glaucoma, run by Fondazione G.B. Bietti, IRCCS.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

Glaucoma is one of the leading causes of irreversible blindness worldwide. Early diagnosis is crucial to prevent vision loss, but current diagnostic pathways require multiple specialist visits and tests, leading to long waiting times and delayed diagnosis. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Glaucoma
What is being tested?
GlaukomAI (Sens-vue GlaukomAI)
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1,200 participants
Where
No sites listed yet
Study dates
Oct 2026to May 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Age >18 years
  • Freely given informed consent obtained prior to study initiation
  • The participant has the capacity to understand and the willingness to follow study instructions and is likely to complete all required visits and procedures
  • Patients affected by any type of glaucoma (primary open-angle, primary angle-closure, secondary glaucoma) on pharmacological therapy
  • Absence of ocular pathologies
  • IOP <21 mmHg
  • Visual field and OCT within normal limits
  • Optic disc of normal appearance on clinical evaluation

Who cannot join

  • Presence of media opacities preventing the acquisition of adequate quality fundus imaging (e.g., advanced cataract, vitreous hemorrhage, severe corneal opacities)
  • Retinal or optic nerve pathologies that could confound the diagnosis (e.g., non-glaucomatous optic neuropathies (ischemic, inflammatory, compressive), moderate-to-severe diabetic retinopathy, advanced macular degeneration, retinal vascular occlusions)
  • Having undergone any ocular surgery in the past 3 months
  • Inability to cooperate with perimetric examination

Trial locations and contacts

No sites are listed yet. Contact the study team or a site near you to ask about taking part.

About this study

Official title: GlaukomAI: Clinical Validation of an Artificial Intelligence-Based System for Early Glaucoma Screening and Diagnosis - A Case-Control Study and Referral Accuracy Assessment

Glaucoma is one of the leading causes of irreversible blindness worldwide. Early diagnosis is crucial to prevent vision loss, but current diagnostic pathways require multiple specialist visits and tests, leading to long waiting times and delayed diagnosis.

This study aims to evaluate the accuracy of GlaukomAI, an artificial intelligence (AI)-based software that analyzes fundus photographs of the eye to detect glaucoma at an early stage.

Read more

The study is conducted at IRCCS Fondazione G. B. Bietti (Rome, Italy) and is structured in two phases:

  • Phase 1 enrolls 200 participants (100 with diagnosed glaucoma and 100 healthy controls) to assess how accurately GlaukomAI can distinguish between glaucoma and healthy eyes, compared to the judgment of a panel of three expert glaucoma specialists.
  • Phase 2 enrolls 1,000 consecutive outpatients to evaluate whether GlaukomAI can correctly identify patients who need referral to a glaucoma specialist, and to compare its performance with that of non-specialist ophthalmologists.

Participants undergo a single study visit including standard ophthalmic examinations (visual acuity, eye pressure measurement, visual field test, OCT, and fundus photography). No investigational drugs or invasive procedures are involved.

The results of this study will provide evidence to support the integration of AI-based tools into routine glaucoma screening pathways, with the goal of reducing diagnostic delays and improving access to care.

Read the detailed description

Glaucoma is a chronic optic neuropathy representing one of the leading causes of irreversible blindness worldwide, with an estimated 111.8 million cases projected by 2040. Despite the availability of effective treatments, approximately 50% of affected individuals remain undiagnosed, as the disease progresses insidiously and symptoms often appear only when damage is already advanced and irreversible.

Current diagnostic limitations include high inter-operator variability in optic disc assessment, limited sensitivity of visual field testing in early stages, and suboptimal specificity of OCT (estimated at 72% in a Cochrane systematic review). No single examination provides sufficient diagnostic accuracy, accessibility, and cost-effectiveness for large-scale screening.

GlaukomAI (Sens-vue GlaukomAI) is an AI-based diagnostic software using deep learning with Convolutional Neural Network and Transformer architecture. It analyzes standard fundus photographs to detect key glaucoma biomarkers (neuroretinal rim appearance, inferior and superior sectors) and provides a diagnostic classification (Referable Glaucoma / Non-Referable Glaucoma) within 2-8 seconds per image. The system was trained on over 100,000 fundus images from diverse ethnicities, annotated by 30 eye care professionals and validated by 243 ophthalmologists and 208 optometrists across Europe.

Study Design

This is a prospective interventional clinical investigation with a non-CE-marked medical device, structured in two complementary phases:

  • Phase 1 - Case-Control Diagnostic Accuracy Study: 200 participants (100 with diagnosed glaucoma, 100 healthy controls) are enrolled to assess the sensitivity and specificity of GlaukomAI against a gold standard defined by the consensus of a panel of three expert glaucoma specialists, based on multimodal assessment (fundus photography, OCT, and visual field).
  • Phase 2 - Prospective Referral Accuracy Assessment: 1,000 consecutive outpatients attending IRCCS Fondazione Bietti for any clinical reason are enrolled to evaluate the referral accuracy of GlaukomAI (binary output: Referable / Non-Referable) in a real-world setting, and to compare its performance with that of non-glaucoma-specialist ophthalmologists evaluating the same pseudonymized fundus images.

All participants undergo a single study visit (or two visits within one week if needed) including: best-corrected visual acuity measurement, slit-lamp biomicroscopy, Goldmann applanation tonometry, Humphrey visual field testing (24-2 SITA Standard or SITA Faster), fundus examination with Cup-to-Disc Ratio assessment, fundus photography using a widefield TrueColor Confocal imaging system (iCare DRS Plus), and retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL+IPL) thickness assessment via Cirrus HD-OCT (Carl Zeiss). No investigational drugs or invasive procedures beyond standard clinical practice are involved.

Statistical Analysis For Phase 1, sample size was calculated to detect an expected sensitivity and specificity of 88% with 95% confidence and ±8% precision, yielding 100 subjects per group. For Phase 2, enrollment of 1,000 patients allows estimation of real-world sensitivity and specificity with ±5% precision, assuming a 10% glaucoma prevalence in a tertiary referral center. Both eyes will be included in the analysis using generalized estimating equations (GEE) or mixed-effects models to account for intra-subject correlation. Diagnostic performance metrics (sensitivity, specificity, PPV, NPV, AUC) will be calculated with 95% confidence intervals. Agreement between methods will be assessed using Cohen's kappa; comparisons will use McNemar's test.

Funding This study is funded under the Transforming Health and Care Systems (THCS) partnership, co-funded by the EU Horizon Europe Research and Innovation Programme (Grant Agreement No. 101095654).

Conditions
Glaucoma
Being tested
GlaukomAI (Sens-vue GlaukomAI)
Keywords
Glaucoma, Artificial Intelligence, Fundus Photography, Glaucoma Screening, Early Diagnosis, Optic Nerve, GlaukomAI
Medical subject headings
Glaucoma, Disease

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • GlaukomAI (Sens-vue GlaukomAI)Device

    GlaukomAI is an AI-based diagnostic software (Sens-vue ApS) that analyzes standard fundus photographs to detect glaucomatous changes. The system uses deep learning with Convolutional Neural Network and Transformer architecture to evaluate key glaucoma biomarkers, including neuroretinal rim appearance in the inferior and superior sectors. It accepts standard fundus images acquired with conventional fundus cameras or portable devices and provides a diagnostic classification (Referable Glaucoma / Non-Referable Glaucoma) within 2-8 seconds per image. The system is not CE-marked. Fundus images are acquired using a widefield TrueColor Confocal fundus imaging system (iCare DRS Plus), pseudonymized, and uploaded to the GlaukomAI secure platform by an operator blinded to the clinical diagnosis.

Study groups in NCT07668193
Study groupRoleWhat they receive
Glaucoma PatientsOtherParticipants with diagnosed glaucoma (primary open-angle, primary angle-closure or secondary glaucoma) undergoing standard ophthalmological examination and AI-based image analysis.
Receives: Device: GlaukomAI (Sens-vue GlaukomAI)
Healthy ControlsOtherParticipants without ocular pathology and with normal ophthalmological examination undergoing standard ophthalmological examination and AI-based image analysis.
Receives: Device: GlaukomAI (Sens-vue GlaukomAI)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Diagnostic Accuracy of GlaukomAI - Sensitivity and Specificity

    Sensitivity and specificity of GlaukomAI in the diagnosis of glaucoma, calculated against the gold standard defined by the consensus of a panel of three expert glaucoma specialists based on multimodal assessment (fundus photography, OCT, and visual field). Additional metrics include positive predictive value (PPV), negative predictive value (NPV), and area under the ROC curve (AUC) with 95% confidence intervals. The optimal diagnostic cut-off will be identified using the Youden index.

    Measured: At enrollment visit (single visit, or two consecutive visits within 1 week)

Secondary outcomes (2)
  1. Referral Accuracy of GlaukomAI vs. Non-Specialist Ophthalmologists

    Sensitivity and specificity of GlaukomAI in recommending referral to a glaucoma specialist (binary output: Referable / Non-Referable), compared to the gold standard and to the independent referral decisions of non-glaucoma-specialist ophthalmologists evaluating the same pseudonymized fundus images.

    Measured: At enrollment visit

  2. Diagnostic Agreement - Cohen's Kappa

    Diagnostic agreement between GlaukomAI and the gold standard, and between non-glaucoma-specialist ophthalmologists and the gold standard, assessed using Cohen's kappa coefficient (κ). Comparison between diagnostic methods on the same subjects will be performed using McNemar's test.

    Measured: At enrollment visit

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Jun 2026
  2. Study startOct 2026 (estimated)
  3. Primary completionNov 2027 (estimated)
  4. Study completionMay 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Diagnosis
Allocation
Non-randomised
Intervention model
Single group
Model description
The study is structured in two sequential phases. In Phase 1, a case-control design is used to assess diagnostic accuracy: 100 participants with diagnosed glaucoma and 100 healthy controls all undergo fundus photography analysis with GlaukomAI, compared against a gold standard defined by a panel of three expert glaucoma specialists. In Phase 2, 1,000 consecutive outpatients attending a tertiary ophthalmological centre undergo the same AI-based fundus image analysis; results are compared both to the expert panel gold standard and to the independent assessment of non-glaucoma-specialist ophthalmologists evaluating the same images.
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
1,200 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07668193
Sponsor's protocol ID
GLC 02-26
Other IDs
101095654
Acronym
GlaukomAIcare
Status last verified
Sep 2026
First submitted
19 Jun 2026
Last updated
4 Sep 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Li Z, He Y, Keel S, Meng W, Chang RT, He M. Efficacy of a Deep Learning System for Detecting Glaucomatous Optic Neuropathy Based on Color Fundus Photographs. Ophthalmology. 2018 Aug;125(8):1199-1206. doi: 10.1016/j.ophtha.2018.01.023. Epub 2018 Mar 2.

    PubMed 29506863
  • Lemij HG, Vente C, Sanchez CI, Vermeer KA. Characteristics of a Large, Labeled Data Set for the Training of Artificial Intelligence for Glaucoma Screening with Fundus Photographs. Ophthalmol Sci. 2023 Mar 17;3(3):100300. doi: 10.1016/j.xops.2023.100300. eCollection 2023 Sep.

    PubMed 37113471
  • Michelessi M, Quaranta L, Riva I, Martini E, Figus M, Frezzotti P, Agnifili L, Manni G, Miglior S, Posarelli C, Fazio S, Oddone F. Exploring the gap between diagnostic research outputs and clinical use of OCT for diagnosing glaucoma. Br J Ophthalmol. 2020 Aug;104(8):1114-1119. doi: 10.1136/bjophthalmol-2019-314607. Epub 2019 Nov 15.

    PubMed 31732524
  • Oddone F, Lucenteforte E, Michelessi M, Rizzo S, Donati S, Parravano M, Virgili G. Macular versus Retinal Nerve Fiber Layer Parameters for Diagnosing Manifest Glaucoma: A Systematic Review of Diagnostic Accuracy Studies. Ophthalmology. 2016 May;123(5):939-49. doi: 10.1016/j.ophtha.2015.12.041. Epub 2016 Feb 15.

    PubMed 26891880
  • Tham YC, Li X, Wong TY, Quigley HA, Aung T, Cheng CY. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology. 2014 Nov;121(11):2081-90. doi: 10.1016/j.ophtha.2014.05.013. Epub 2014 Jun 26.

    PubMed 24974815
  • Quigley HA, Broman AT. The number of people with glaucoma worldwide in 2010 and 2020. Br J Ophthalmol. 2006 Mar;90(3):262-7. doi: 10.1136/bjo.2005.081224.

    PubMed 16488940

Questions about this trial

What is this clinical trial studying?

A study testing GlaukomAI (Sens-vue GlaukomAI) in people with Glaucoma, run by Fondazione G.B. Bietti, IRCCS.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 4 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Francesco Oddone, MD, PhD (+39 06 84009442, francesco.oddone@fondazionebietti.it), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Diagnostic Accuracy of GlaukomAI - Sensitivity and Specificity (time frame: At enrollment visit (single visit, or two consecutive visits within 1 week)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07668193, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Sep 2026.

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