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Trial Comparing Atropine to Atropine Plus a Plano Lens for the Sound Eye for Amblyopia in Children 3 to <7 Years Old

Information source: Jaeb Center for Health Research
ClinicalTrials.gov processed this data on August 20, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Amblyopia

Intervention: Atropine (Drug); Plano Lens (Device)

Phase: Phase 3

Status: Completed

Sponsored by: Jaeb Center for Health Research

Official(s) and/or principal investigator(s):
David Weakley, M.D., Study Chair, Affiliation: UT Southwestern Medical Center
Susan A. Cotter, O.D., Study Chair, Affiliation: Southern California College of Optometry

Summary

The purpose of the study is:

- To compare the effectiveness and safety of weekend atropine augmented with a plano lens

for the sound eye versus weekend atropine alone for moderate amblyopia (20/40 to 20/100) in children 3 to less than 7 years old.

- To provide data on the response of severe amblyopia (20/125 to 20/400) to atropine

treatment with and without a plano lens.

Clinical Details

Official title: A Randomized Trial Comparing Atropine to Atropine Plus a Plano Lens for the Sound Eye As Prescribed Treatments for Amblyopia in Children 3 to <7 Years Old

Study design: Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Primary outcome:

Visual Acuity Mean Score in the Amblyopic Eye

Visual Acuity Distribution in the Amblyopic Eye

Mean Change in Visual Acuity in the Amblyopic Eye

Distribution of Change in Visual Acuity in the Amblyopic Eye

Secondary outcome:

Randot Preschool Stereoacuity at 18 Weeks- Participants With All Causes of Amblyopia

Randot Preschool Stereoacuity at 18 Weeks- Anisometropic Participants Only

Mean Change in Visual Acuity in the Sound Eye

Distribution of Change in Visual Acuity in the Sound Eye

Visual Acuity Distribution in the Sound Eye

Detailed description: Atropine is an effective treatment of moderate amblyopia. Reduction of the plus sphere for the sound eye is an accepted method of enhancing and possibly accelerating the treatment effect. Demonstrating additional value of the plano lens in terms of speed of improvement will shorten the treatment period, possibly improving child and parental compliance, leading to improved overall outcomes for patients with amblyopia. If the plano lens leads to greater improvement, then there will be less permanent visual impairment in patients with a history of amblyopia. It also is important to determine if the use of a plano lens in conjunction with atropine has a deleterious effect on the sound eye, and if yes, how often this occurs. Little is known about the pharmacologic treatment of severe amblyopia. This study will provide important prospectively determined outcome data at little additional expense. In a study conducted by the Pediatric Eye Disease Investigator Group, A Randomized Trial Comparing Daily Atropine Versus Weekend Atropine for Moderate Amblyopia, the use of weekend atropine for moderate amblyopia was as effective as daily treatment. Intermittent atropine use (such as using it only on the weekends) has the theoretical potential benefit of the sound eye having some time each week during which cycloplegia is only partial. It is possible that allowing some loss of the cycloplegic effect over the course of each week may be safer for the sound eye. The study has been designed as a simple trial that, other than the type of amblyopia therapy being determined through the randomization process, approximates standard clinical practice. The two treatment regimes for the 18 week primary treatment period are: 1) Atropine 1% once each weekend day in the sound eye and 2) Atropine 1% once each weekend day in the sound eye plus a plano lens for the sound eye.

Eligibility

Minimum age: 3 Years. Maximum age: 6 Years. Gender(s): Both.

Criteria:

Inclusion Criteria:

- Patients must be 3 to less than 7 years old with amblyopia associated with

strabismus, anisometropia, or both.

- Visual acuity in the amblyopic eye must be between 20/40 and 20/400 inclusive, visual

acuity in the sound eye 20/40 or better and inter-eye acuity difference > 3 logMAR lines.

- Spectacles, if needed, must be worn for at least 16 weeks or until visual acuity

documented to be stable. Exclusion Criteria:

- Atropine treatment within 6 months of enrollment and other amblyopia treatment of any

type (other than normal spectacle lenses) used within one month of enrollment

- No myopia in amblyopic eye

Locations and Contacts

Southern California College of Optometry, Fullerton, California 92831, United States

UT Southwestern Medical Center, Dallas, Texas 75235, United States

Additional Information

PEDIG public website

Related publications:

Repka MX, Kraker RT, Beck RW, Birch E, Cotter SA, Holmes JM, Hertle RW, Hoover DL, Klimek DL, Marsh-Tootle W, Scheiman MM, Suh DW, Weakley DR; Pediatric Eye Disease Investigator Group. Treatment of severe amblyopia with weekend atropine: results from 2 randomized clinical trials. J AAPOS. 2009 Jun;13(3):258-63. doi: 10.1016/j.jaapos.2009.03.002.

Starting date: February 2005
Last updated: May 16, 2012

Page last updated: August 20, 2015

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