Landscape analysis of ophthalmic clinical trials using the clinical trials information system

Background The Clinical Trials Information System (CTIS) provides a centralised platform for clinical trials conducted across the European Union and European Economic Area. This study aimed to characterise the landscape of ophthalmic clinical trials in Europe using the CTIS, with a focus on subfield distribution, sponsorship patterns, type and stage of research. Methods A cross-sectional analysis of ophthalmology trials registered in CTIS from 31 January 2022 to 10 March 2026 was conducted. Eligible studies were classified by ophthalmic subfield, sponsor type, intervention category and trial phase. Descriptive analyses were performed to evaluate trial distribution, sample size and sponsorship. A novel therapeutic modality score (range 0–4), based on early-phase design and advanced intervention types (gene therapy, biologics and devices), was calculated for each trial. Results Among 224 included trials, retinal disorders accounted for the largest proportion (n=94), followed by corneal (n=33) and oculoplastic (n=29) diseases. Age-related macular degeneration was the most frequently studied retinal condition (42.55%). Industry sponsorship predominated in oculoplastic (82.8%) and retinal (64.9%) trials, whereas neuro-ophthalmology and ocular oncology were primarily academic-led. Myopia trials had the largest median sample size (n=137) but limited representation of novel therapeutic modalities. In contrast, neuro-ophthalmology demonstrated a higher proportion of early-phase and gene therapy studies. Conclusion Ophthalmic clinical research in Europe is characterised by concentration in retinal diseases, strong industry involvement in selected subfields and uneven distribution of emerging therapeutic modalities. These findings highlight disparities in research priorities and may inform future strategies to promote balanced clinical development in ophthalmology.