Dichoptic treatment for amblyopia in children aged 8 to 12
A Randomized Trial of Dichoptic Treatment for Amblyopia in Children 8 to 12 Years of Age
This study is testing two new treatments for lazy eye in kids aged 8 to 12 to see if they can improve their vision better than just wearing glasses.
Quick facts
| Phase | Phase 3 |
|---|---|
| Study type | Interventional |
| Enrollment | 252 (estimated) |
| Ages | 8 Years to 12 Years |
| Sex | All |
| Sponsor | Jaeb Center for Health Research Academic / other |
| Locations | 58 sites (Birmingham, Alabama and 57 other locations) |
| Trial ID | NCT06524882 on ClinicalTrials.gov |
What this trial studies
This clinical trial evaluates the effectiveness of two dichoptic treatments, Luminopia and Vivid Vision, for children aged 8 to 12 with amblyopia. Participants will be randomly assigned to receive one of the treatments or continue with optical correction alone. Clinical assessments will be conducted at 9 and 18 weeks post-randomization to measure visual acuity improvements. If participants initially assigned to optical correction alone show significant interocular differences, they may be offered a chance to switch to one of the dichoptic therapies.
Who should consider this trial
Good fit: Ideal candidates are children aged 8 to 12 with amblyopia characterized by specific visual acuity differences between their eyes.
Not a fit: Patients with amblyopia who do not meet the specified visual acuity criteria or those outside the age range may not benefit from this study.
Why it matters
Potential benefit: If successful, this treatment could significantly improve visual acuity in children with amblyopia, potentially leading to better long-term visual outcomes.
How similar studies have performed: Previous studies have shown promise with dichoptic treatments for amblyopia, indicating potential for success in this approach.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria:
1. Age 8 to \<13 years.
2. VA, measured in each eye without cycloplegia in current refractive correction (if applicable) using the E-ETDRS VA protocol on a study-approved device displaying single surrounded optotypes, as follows:
1. VA in the amblyopic eye 20/40 to 20/200 inclusive (33 to 72 letters with E-ETDRS).
2. VA in the fellow eye 20/25 or better (≥ 78 letters with E-ETDRS).
3. Interocular difference ≥ 3 logMAR lines (≥ 15 letters) i.e., amblyopic eye VA at least 3 logMAR lines worse than fellow eye VA).
3. Amblyopia associated with strabismus, anisometropia, or both (previously treated or untreated).
1. Criteria for strabismic amblyopia: At least one of the following must be met:
* Presence of a heterotropia on examination at distance or near fixation (with optical correction), must be \<=5 prism diopters (∆) by SPCT at distance and near fixation.
* Documented history of strabismus which is no longer present (which in the judgment of the investigator could have caused amblyopia).
2. Criteria for anisometropia: At least one of the following criteria must be met:
* ≥1.00 D difference between eyes in spherical equivalent (SE).
* ≥1.50 D difference in astigmatism between corresponding meridians in the two eyes.
3. Criteria for combined-mechanism: Both of the following criteria must be met:
* A criterion for strabismus is met (see above).
* ≥1.00 D difference between eyes in SE OR ≥1.50 D difference in astigmatism between corresponding meridians in the two eyes.
4. No more than 2 weeks (cumulative) of prior dichoptic treatment
5. No treatment with cycloplegic eyedrops (e.g., atropine) in the past 2 weeks; other treatments allowed up to enrollment but then must be discontinued.
6. Refractive correction is required (single vision lenses or contact lenses) for any of the following refractive errors based on a cycloplegic refraction completed within the last 7 months:
* Hypermetropia of 2.50 D or more by SE
* Myopia of amblyopic eye of 0.50D or more SE
* Astigmatism of 1.00D or more
* Anisometropia of more than 0.50D SE
NOTE: Children with cycloplegic refractive errors that do not fall within the requirements above for refractive correction may be given refractive correction at investigator discretion but must follow the study-specified prescribing guidelines, as detailed below.
NOTE: Monocular or binocular contact lens wear is allowed provided the contact lenses meet the refractive error correction requirements below. For each child, all testing must be performed using the same form of optical correction (i.e., no changing between contacts and spectacles).
1. Spectacles/contact lens correction prescribing instructions referenced to the cycloplegic refraction completed within the last 7 months:
* SE must be within 0.50D of fully correcting the anisometropia (if new glasses are prescribed, reduction in plus sphere must be symmetric in the two eyes).
* SE must not be under corrected by more than 1.50D SE.
* Cylinder power in both eyes must be within 0.50D of fully correcting the astigmatism.
* Axis must be within +/- 10 degrees if cylinder power is ≤1.00D, and within +/- 5 degrees if cylinder power is \>1.00D.
* Myopia must not be under corrected by more than 0.25D or over corrected by more than 0.50D SE, and any change must be symmetrical in the two eyes.
2. Spectacles/contact lens correction (with or without other treatment such as patching) meeting the above criteria must be worn:
* For at least 18 weeks OR until VA stability is documented (defined as \<1-line change by the same testing method measured on 2 consecutive exams at least 9 weeks apart).
* For determining VA stability (non-improvement):
* The first of two measurements may be made 1) in current correction, or 2) in trial frames with or without cycloplegia or 3) without correction (if new correction is prescribed),
* The second measurement must be made without cycloplegia in the correct spectacles/contact lens correction that has been worn for at least 9 weeks.
* NOTE: Because this determination is a pre-randomization, the method of measuring VA is not mandated.
7. Participant is willing to wear a headset.
8. Participant is willing to continue full-time spectacles/contact lens wear (if needed).
9. Interpupillary distance of 52mm to 72mm inclusive.
10. Investigator is willing to prescribe continued spectacles/contact lens correction (if needed) or either dichoptic device per protocol.
11. Participant is willing to accept assignment to either continued spectacles/ contact lens wear alone, dichoptic movies/shows (view 1 hour per day 6 days per week) OR dichoptic games (play approximately 25 minutes per day, 6 days per week) for 19 weeks.
12. Parent understands the protocol and is willing to accept randomization.
13. Parent has phone (or access to phone) and is willing to be contacted by JAEB Center staff.
14. Relocation outside of area of an active PEDIG site for this study within the next 36 weeks is not anticipated.
Exclusion Criteria:
1. Heterotropia more than 5∆ at distance or near (measured by SPCT in current correction)
2. Prism greater than a total of 8 diopters horizontal and 1 diopter vertical in the refractive correction at time of enrollment.
3. Current bifocal spectacles (eligible only if bifocal discontinued 2 weeks prior to enrollment).
4. Myopia greater than -6.00D spherical equivalent in either eye.
5. Ocular co-morbidity that may reduce VA determined by an ocular examination performed within the past 7 months (Note: nystagmus per se does not exclude the participant if the above visual acuity criteria are met using patch occlusion. Fogging is not permitted).
6. Diplopia more than once per week over the last week prior to enrollment by parental report.
7. History of light-induced seizures.
8. Known simulator sickness.
9. Severe developmental delay that would interfere with treatment or evaluation (in the opinion of the investigator). Participants with mild speech delay or reading and/or learning disabilities are not excluded.
10. Immediate family member (biological or legal guardian, child, sibling, parent) of investigative site personnel directly affiliated with this study or an employee of the JAEB center for Health Research.
Where this trial is running
Birmingham, Alabama and 57 other locations
- UAB Pediatric Eye Care; Birmingham Health Care — Birmingham, Alabama, United States (Recruiting)
- Midwestern University Eye Institute — Glendale, Arizona, United States (Recruiting)
- Phoenix Children's Medical Group - Ophthalmology — Scottsdale, Arizona, United States (Recruiting)
- University of Arizona — Tucson, Arizona, United States (Recruiting)
- Arkansas Childrens — Little Rock, Arkansas, United States (Recruiting)
- McFarland Eye Care Center — Little Rock, Arkansas, United States (Recruiting)
- University Eye Center at Ketchum Health — Anaheim, California, United States (Recruiting)
- Univ. of California- Berkeley — Berkeley, California, United States (Recruiting)
- Univ of California, Irvine- Gavin Herbert Eye Institute — Irvine, California, United States (Recruiting)
- Stanford University — Palo Alto, California, United States (Recruiting)
- Western University College of Optometry — Pomona, California, United States (Recruiting)
- University of California, Davis — Sacramento, California, United States (Recruiting)
- University of California San Francisco Department of Ophthalmology — San Francisco, California, United States (Recruiting)
- Nova Southeastern University College of Optometry, The Eye Institute — Fort Lauderdale, Florida, United States (Recruiting)
- University of South Florida (USF) Eye — Tampa, Florida, United States (Recruiting)
- Ann & Robert H. Lurie Children's Hospital of Chicago — Chicago, Illinois, United States (Recruiting)
- Illinois College of Optometry — Chicago, Illinois, United States (Recruiting)
- Midwestern University Eye Institute — Downers Grove, Illinois, United States (Recruiting)
- Progressive Eye Care — Lisle, Illinois, United States (Recruiting)
- Indiana School of Optometry — Bloomington, Indiana, United States (Recruiting)
- University of Iowa — Iowa City, Iowa, United States (Recruiting)
- University of Kansas Dept of Ophthalmology — Prairie Village, Kansas, United States (Recruiting)
- Greater Baltimore Medical Center — Baltimore, Maryland, United States (Recruiting)
- Wilmer Eye Institute — Baltimore, Maryland, United States (Recruiting)
- New England College of Optometry — Boston, Massachusetts, United States (Recruiting)
- Boston Medical Center — Boston, Massachusetts, United States (Recruiting)
- Boston Children's Hospital Waltham — Boston, Massachusetts, United States (Recruiting)
- Michigan College of Optometry at Ferris State Univ — Big Rapids, Michigan, United States (Recruiting)
- Pediatric Ophthalmology, P.C. — Grand Rapids, Michigan, United States (Recruiting)
- Zenith Vision Development Center — Duluth, Minnesota, United States (Recruiting)
- University of Minnesota-Minnesota Lions Children's Eye Clinic — Minneapolis, Minnesota, United States (Recruiting)
- Mayo Clinic Department of Ophthalmology — Rochester, Minnesota, United States (Recruiting)
- PineCone Vision Center — Sartell, Minnesota, United States (Recruiting)
- Children's Mercy Hospitals and Clinics — Kansas City, Missouri, United States (Recruiting)
- University of Nebraska Medical Center — Omaha, Nebraska, United States (Recruiting)
- NYU Langone Health — New York, New York, United States (Recruiting)
- State University of New York, College of Optometry — New York, New York, United States (Recruiting)
- University of North Carolina — Chapel Hill, North Carolina, United States (Recruiting)
- Duke University Eye Center — Durham, North Carolina, United States (Recruiting)
- University of North Dakota — Grand Forks, North Dakota, United States (Recruiting)
- Cincinnati Children's Hospital — Cincinnati, Ohio, United States (Recruiting)
- Cole Eye Institute — Cleveland, Ohio, United States (Recruiting)
- Ohio State University College of Optometry — Columbus, Ohio, United States (Recruiting)
- Rainbow Babies and Children's Hospital Dept of Ophth — Mayfield Heights, Ohio, United States (Recruiting)
- River View Family Eyecare — Albany, Oregon, United States (Recruiting)
- OHSU Casey Eye Institute — Portland, Oregon, United States (Recruiting)
- Pediatric Ophthalmology of Erie — Erie, Pennsylvania, United States (Recruiting)
- Conestoga Eye — Lancaster, Pennsylvania, United States (Recruiting)
- Wills Eye Hospital — Philadelphia, Pennsylvania, United States (Recruiting)
- Salus University/Pennsylvania College of Optometry — Philadelphia, Pennsylvania, United States (Recruiting)
+8 more sites — see ClinicalTrials.gov for the full list.
Study contacts
- Study coordinator: Raymond T Kraker, MSPH
- Email: rkraker@jaeb.org
- Phone: 813-975-8690
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.