Across 95 ophthalmology Phase II/III trials, the dataset maps 1,684 European site allocations and 10,122 planned participants across 23 countries. Hospital Universitario Virgen De La Macarena leads the site ranking with 19 distinct trial participations, while Spain is the largest national capacity pool with 303 sites and 2,016 planned participants. Retina-heavy indications dominate: neovascular age-related macular degeneration (AMD), geographic atrophy/dry AMD, and diabetic macular edema account for 996 of 1,684 sites (59.1%).
The top-ranked site is Hospital Universitario Virgen De La Macarena, appearing in 19 of 95 trials (20.0%). Budapest Retina Associates follows with 18 trials (18.9%), while five institutions each appear in 17 trials (17.9%), showing a tight tier of repeat ophthalmology site contributors.
The leading repeat sites are concentrated in Spain, Hungary, France, Italy, and Germany. This suggests that late-stage ophthalmology site selection is not only driven by large university hospitals; high-throughput retina-specialist organizations also form a recurring operational backbone.
Spain, Germany, France, Italy, and Poland account for 1,231 of 1,684 site allocations (73.1%). Spain leads both site footprint and participant allocation, with 303 sites (18.0%) and 2,016 planned participants (19.9%).
Ophthalmology Phase II/III recruitment capacity is concentrated in the five largest countries, but the next tier remains operationally meaningful: Hungary contributes 128 sites and 612 participants, while Czechia contributes 64 sites and 595 participants.
Retina indications dominate the site footprint. Neovascular AMD leads with 427 sites across 10 trials, followed by geographic atrophy/dry AMD with 312 sites and diabetic macular edema/diabetic retina with 257 sites. Together, these three clusters represent 996 sites (59.1%) and 5,277 planned participants (52.1%).
The site market is structurally retina-led. Sponsors planning AMD, geographic atrophy, or DME studies are competing for the same retina-capable site base, while lower-volume clusters such as inherited retinal disease and glaucoma rely on narrower specialized networks.
Small molecules appear in 42 of 95 trials (44.2%), but monoclonal antibody programs produce the largest site footprint among named modalities, with 698 site allocations and 3,720 planned participants. Gene therapy appears in 17 trials and contributes 228 site allocations, reflecting a more specialized site network.
| Modality | Trials | Sites | Participants |
|---|---|---|---|
| Small molecule | 42 | 580 | 4,951 |
| Monoclonal antibody | 21 | 698 | 3,720 |
| Peptide/protein/enzyme | 20 | 422 | 2,240 |
| Gene therapy | 17 | 228 | 1,115 |
| Oligonucleotide | 8 | 148 | 701 |
| Cell therapy | 4 | 17 | 73 |
| Other | 3 | 82 | 472 |
| Bispecific antibody | 2 | 64 | 179 |
The modality picture reinforces the retina concentration: antibody and protein-based programs require large site networks, while gene therapy and cell therapy remain smaller but strategically important because they require highly specialized ophthalmology capabilities.
The largest participant allocation appears in 2024, with 4,788 planned participants across 40 trials. The largest site allocation appears in 2025, with 835 planned sites across 36 trials. The 2026 cohort contributes 19 trials, 240 sites, and 1,664 planned participants.
The 2025 cohort has the densest site footprint, while 2024 carries the largest planned participant volume. For site identification, this means recent ophthalmology trial activity is broad rather than dependent on a single authorization-year wave.
A site participation means one institution appearing in one unique clinical trial. A country site allocation means the planned number of sites assigned to a country in a trial. Planned participants are summed from country-level allocations. Disease clusters are normalized from the listed trial disease terms to group closely related ophthalmology indications.