Enhancement of Emmetropization in Hyperopic Infants

NCT ID: NCT00574717

Last Updated: 2012-10-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE1/PHASE2

Total Enrollment

6 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-12-31

Study Completion Date

2010-09-30

Brief Summary

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To determine if wearing a moderate spectacle under-correction (3.00D) and performing activities designed to stimulate accurate accommodation during a 15-month period will enhance emmetropization in highly hyperopic (between +5.00D and +7.00D) 3-month old infants.

Detailed Description

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The purpose of the project is to determine if emmetropization can be enhanced in very farsighted babies. We will give them glasses with a partial correction, an amount that is less than their full degree of farsightedness but enough to put them in the zone of effective emmetropization. This 'boost' is meant to enable very farsighted babies to use their eyes in a normal way and emmetropize as normal infants. This partial correction would be given at 3 months of age for a period of up to 15 months. A program of visual engagement is also provided in order to encourage the normal development and use of accommodation. As changes in farsightedness occur, the power of the glasses will be reduced at follow up appointments to keep the farsightedness within the zone of effective emmetropization. Once an infant reaches a normal amount of farsightedness, the glasses would be discontinued.

Conditions

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Hyperopia Hypermetropia Farsightedness

Keywords

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hyperopia ocular refraction infant vision

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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A

Infants will receive spectacle under-correction of their hyperopia.

Group Type EXPERIMENTAL

Spectacles

Intervention Type PROCEDURE

Infants will receive spectacles with 3.00D of under-correction relative to the spherical equivalent in each eye as measured by the cycloplegic retinoscopy performed at baseline. They will also receive the full amount of measured astigmatism in their glasses. Changes in spectacle lens power will be made as needed at follow-up visits to keep the level of under-correction within 0.50D of the target 3.00D. A program of visual engagement is also provided to encourage the normal development and use of accommodation. Treatment will continue for 15 months (until 18 months of age) or until the infant reaches a spherical equivalent refractive error of +3.00D or less hyperopia.

Interventions

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Spectacles

Infants will receive spectacles with 3.00D of under-correction relative to the spherical equivalent in each eye as measured by the cycloplegic retinoscopy performed at baseline. They will also receive the full amount of measured astigmatism in their glasses. Changes in spectacle lens power will be made as needed at follow-up visits to keep the level of under-correction within 0.50D of the target 3.00D. A program of visual engagement is also provided to encourage the normal development and use of accommodation. Treatment will continue for 15 months (until 18 months of age) or until the infant reaches a spherical equivalent refractive error of +3.00D or less hyperopia.

Intervention Type PROCEDURE

Other Intervention Names

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Under-correction

Eligibility Criteria

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Inclusion Criteria

* 3 months of age (between 8 weeks and 20 weeks)at the baseline examination
* Either gender, any ethnicity
* Birthweight greater than 2500g
* Normal pregnancy and delivery (including Cesarean section delivery but excluding serious complications or conditions such as eclampsia or rubella)
* Hyperopia of +5.00D or more but less than +7.00D spherical equivalent refractive error in each eye by cycloplegic retinoscopy using cyclopentolate 1%
* Currently under the care of a pediatrician

Exclusion Criteria

* Anisometropia greater than 1.00D (difference in spherical equivalent)
* Strabismus
* Previous history of difficulty with pupillary dilation
* History of cardiac, liver, asthma, or other respiratory disease
* History of ocular disease or active ocular inflammation
Minimum Eligible Age

8 Weeks

Maximum Eligible Age

20 Weeks

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Ohio Lions Eye Research Foundation

UNKNOWN

Sponsor Role collaborator

Ohio State University

OTHER

Sponsor Role lead

Responsible Party

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Donald Mutti

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Donald O. Mutti, OD, PhD

Role: PRINCIPAL_INVESTIGATOR

The Ohio State University College of Optometry

Locations

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The Ohio State University College of Optometry

Columbus, Ohio, United States

Site Status

Countries

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United States

References

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Atkinson J, Anker S, Bobier W, Braddick O, Durden K, Nardini M, Watson P. Normal emmetropization in infants with spectacle correction for hyperopia. Invest Ophthalmol Vis Sci. 2000 Nov;41(12):3726-31.

Reference Type BACKGROUND
PMID: 11053269 (View on PubMed)

Ingram RM, Gill LE, Lambert TW. Effect of spectacles on changes of spherical hypermetropia in infants who did, and did not, have strabismus. Br J Ophthalmol. 2000 Mar;84(3):324-6. doi: 10.1136/bjo.84.3.324.

Reference Type BACKGROUND
PMID: 10684846 (View on PubMed)

Mutti DO, Mitchell GL, Jones LA, Friedman NE, Frane SL, Lin WK, Moeschberger ML, Zadnik K. Axial growth and changes in lenticular and corneal power during emmetropization in infants. Invest Ophthalmol Vis Sci. 2005 Sep;46(9):3074-80. doi: 10.1167/iovs.04-1040.

Reference Type BACKGROUND
PMID: 16123404 (View on PubMed)

Mutti DO, Mitchell GL, Jones LA, Friedman NE, Frane SL, Lin WK, Moeschberger ML, Zadnik K. Refractive astigmatism and the toricity of ocular components in human infants. Optom Vis Sci. 2004 Oct;81(10):753-61. doi: 10.1097/00006324-200410000-00007.

Reference Type BACKGROUND
PMID: 15557849 (View on PubMed)

Anker S, Atkinson J, Braddick O, Nardini M, Ehrlich D. Non-cycloplegic refractive screening can identify infants whose visual outcome at 4 years is improved by spectacle correction. Strabismus. 2004 Dec;12(4):227-45. doi: 10.1080/09273970490517935.

Reference Type BACKGROUND
PMID: 15545141 (View on PubMed)

Hung LF, Crawford ML, Smith EL. Spectacle lenses alter eye growth and the refractive status of young monkeys. Nat Med. 1995 Aug;1(8):761-5. doi: 10.1038/nm0895-761.

Reference Type BACKGROUND
PMID: 7585177 (View on PubMed)

Schaeffel F, Glasser A, Howland HC. Accommodation, refractive error and eye growth in chickens. Vision Res. 1988;28(5):639-57. doi: 10.1016/0042-6989(88)90113-7.

Reference Type BACKGROUND
PMID: 3195068 (View on PubMed)

Smith EL 3rd, Hung LF. The role of optical defocus in regulating refractive development in infant monkeys. Vision Res. 1999 Apr;39(8):1415-35. doi: 10.1016/s0042-6989(98)00229-6.

Reference Type BACKGROUND
PMID: 10343811 (View on PubMed)

Related Links

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http://optometry.osu.edu/?n=0

College of Optometry Website

Other Identifiers

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2004H0157

Identifier Type: -

Identifier Source: org_study_id