Trial Outcomes & Findings for Trial of Overminus Spectacle Therapy for Intermittent Exotropia (NCT NCT02807350)

NCT ID: NCT02807350

Last Updated: 2022-06-03

Results Overview

A comparison of mean control of the distance exodeviation (average of 3 measurements over the exam) between the 2.50 diopters (D) overminus group and the non-overminus group (spectacles without overminus or no spectacles) at 12 months. The Office Control Score provides a rating of exodeviation control on a 0 to 5 scale, in subjects with intermittent exotropia. Scores 3 to 5 reflect the proportion of time a spontaneous manifest exotropia is present during 30 seconds of observation (\<50% score 3; \>50% score 4; 100% score 5). If no spontaneous manifest exotropia is observed, scores 0 to 2 reflect the longest time to regain fusion after three, 10-second dissociations (\>5 seconds score 2; 1-5 seconds score 1; \<1 second score 0).

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

386 participants

Primary outcome timeframe

12 months

Results posted on

2022-06-03

Participant Flow

Participant milestones

Participant milestones
Measure
Overminus Treatment
spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere Overminus treatment: spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere
Non-overminus Treatment
spectacles with full cycloplegic refraction without overminus Non-overminus treatment: spectacles with full cycloplegic refraction without overminus
Overall Study
STARTED
196
190
Overall Study
6 mo Follow Up Visit
188
171
Overall Study
12 mo Follow Up Visit
189
169
Overall Study
15 mo Follow Up Visit
180
153
Overall Study
COMPLETED
176
155
Overall Study
NOT COMPLETED
20
35

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Eight participants in the overminus group (5%) and 7 in the nonoverminus group (7%) did not understand test instructions to complete the stereotest; therefore, their stereoacuity at baseline was missing.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Overminus Treatment
n=196 Participants
spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere Overminus treatment: spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere
Non-overminus Treatment
n=190 Participants
spectacles with full cycloplegic refraction without overminus Non-overminus treatment: spectacles with full cycloplegic refraction without overminus
Total
n=386 Participants
Total of all reporting groups
Age, Customized
3 to <7 years
123 Participants
n=196 Participants
120 Participants
n=190 Participants
243 Participants
n=386 Participants
Age, Customized
7 to <11 years
73 Participants
n=196 Participants
70 Participants
n=190 Participants
143 Participants
n=386 Participants
Sex: Female, Male
Female
112 Participants
n=196 Participants
114 Participants
n=190 Participants
226 Participants
n=386 Participants
Sex: Female, Male
Male
84 Participants
n=196 Participants
76 Participants
n=190 Participants
160 Participants
n=386 Participants
Race/Ethnicity, Customized
Race/Ethnicity · Asian
6 Participants
n=196 Participants
10 Participants
n=190 Participants
16 Participants
n=386 Participants
Race/Ethnicity, Customized
Race/Ethnicity · Black/African American
34 Participants
n=196 Participants
28 Participants
n=190 Participants
62 Participants
n=386 Participants
Race/Ethnicity, Customized
Race/Ethnicity · Hispanic
31 Participants
n=196 Participants
40 Participants
n=190 Participants
71 Participants
n=386 Participants
Race/Ethnicity, Customized
Race/Ethnicity · White
113 Participants
n=196 Participants
91 Participants
n=190 Participants
204 Participants
n=386 Participants
Race/Ethnicity, Customized
Race/Ethnicity · Other
12 Participants
n=196 Participants
21 Participants
n=190 Participants
33 Participants
n=386 Participants
Refractive Error
>0.50 Diopters
58 Participants
n=196 Participants
59 Participants
n=190 Participants
117 Participants
n=386 Participants
Refractive Error
>-0.75 to 0.50 Diopters
101 Participants
n=196 Participants
96 Participants
n=190 Participants
197 Participants
n=386 Participants
Refractive Error
-0.75 to >-3.00 Diopters
29 Participants
n=196 Participants
32 Participants
n=190 Participants
61 Participants
n=386 Participants
Refractive Error
<=-3.00 Diopters
8 Participants
n=196 Participants
3 Participants
n=190 Participants
11 Participants
n=386 Participants
Prior Non Surgical Treatment of IXT
None
126 Participants
n=196 Participants
137 Participants
n=190 Participants
263 Participants
n=386 Participants
Prior Non Surgical Treatment of IXT
Patching only
53 Participants
n=196 Participants
33 Participants
n=190 Participants
86 Participants
n=386 Participants
Prior Non Surgical Treatment of IXT
Vision therapy only
10 Participants
n=196 Participants
11 Participants
n=190 Participants
21 Participants
n=386 Participants
Prior Non Surgical Treatment of IXT
Patching plus other
4 Participants
n=196 Participants
6 Participants
n=190 Participants
10 Participants
n=386 Participants
Prior Non Surgical Treatment of IXT
Other
3 Participants
n=196 Participants
3 Participants
n=190 Participants
6 Participants
n=386 Participants
Randot Preschool Stereoacuity test score at near
40-100 arcseconds
120 Participants
n=188 Participants • Eight participants in the overminus group (5%) and 7 in the nonoverminus group (7%) did not understand test instructions to complete the stereotest; therefore, their stereoacuity at baseline was missing.
112 Participants
n=183 Participants • Eight participants in the overminus group (5%) and 7 in the nonoverminus group (7%) did not understand test instructions to complete the stereotest; therefore, their stereoacuity at baseline was missing.
232 Participants
n=371 Participants • Eight participants in the overminus group (5%) and 7 in the nonoverminus group (7%) did not understand test instructions to complete the stereotest; therefore, their stereoacuity at baseline was missing.
Randot Preschool Stereoacuity test score at near
200-800 arcseconds
52 Participants
n=188 Participants • Eight participants in the overminus group (5%) and 7 in the nonoverminus group (7%) did not understand test instructions to complete the stereotest; therefore, their stereoacuity at baseline was missing.
55 Participants
n=183 Participants • Eight participants in the overminus group (5%) and 7 in the nonoverminus group (7%) did not understand test instructions to complete the stereotest; therefore, their stereoacuity at baseline was missing.
107 Participants
n=371 Participants • Eight participants in the overminus group (5%) and 7 in the nonoverminus group (7%) did not understand test instructions to complete the stereotest; therefore, their stereoacuity at baseline was missing.
Randot Preschool Stereoacuity test score at near
Nil
16 Participants
n=188 Participants • Eight participants in the overminus group (5%) and 7 in the nonoverminus group (7%) did not understand test instructions to complete the stereotest; therefore, their stereoacuity at baseline was missing.
16 Participants
n=183 Participants • Eight participants in the overminus group (5%) and 7 in the nonoverminus group (7%) did not understand test instructions to complete the stereotest; therefore, their stereoacuity at baseline was missing.
32 Participants
n=371 Participants • Eight participants in the overminus group (5%) and 7 in the nonoverminus group (7%) did not understand test instructions to complete the stereotest; therefore, their stereoacuity at baseline was missing.
Mean distance visual acuity
20/12 to 20/20
115 Participants
n=196 Participants
112 Participants
n=190 Participants
227 Participants
n=386 Participants
Mean distance visual acuity
20/25 to 20/32
70 Participants
n=196 Participants
69 Participants
n=190 Participants
139 Participants
n=386 Participants
Mean distance visual acuity
20/40 to 20/50
11 Participants
n=196 Participants
9 Participants
n=190 Participants
20 Participants
n=386 Participants
IOD of distance visual acuity
0 lines
130 Participants
n=196 Participants
115 Participants
n=190 Participants
245 Participants
n=386 Participants
IOD of distance visual acuity
0.1 lines
57 Participants
n=196 Participants
61 Participants
n=190 Participants
118 Participants
n=386 Participants
IOD of distance visual acuity
0.2 lines
9 Participants
n=196 Participants
14 Participants
n=190 Participants
23 Participants
n=386 Participants
Spectacle wear
Does not wear spectacles
140 Participants
n=196 Participants
142 Participants
n=190 Participants
282 Participants
n=386 Participants
Spectacle wear
Wearing spectacles for at least 1 week
56 Participants
n=196 Participants
48 Participants
n=190 Participants
104 Participants
n=386 Participants
Exotropia Control at Distance
0 to <1 points
NA Participants
n=196 Participants
NA Participants
n=190 Participants
NA Participants
n=386 Participants
Exotropia Control at Distance
1 to <2 points
NA Participants
n=196 Participants
NA Participants
n=190 Participants
NA Participants
n=386 Participants
Exotropia Control at Distance
2 to <3 points
84 Participants
n=196 Participants
78 Participants
n=190 Participants
162 Participants
n=386 Participants
Exotropia Control at Distance
3 to <4 points
56 Participants
n=196 Participants
52 Participants
n=190 Participants
108 Participants
n=386 Participants
Exotropia Control at Distance
4 to 5 points
56 Participants
n=196 Participants
60 Participants
n=190 Participants
116 Participants
n=386 Participants
Exotropia Control at near
0 to <1 points
37 Participants
n=196 Participants
46 Participants
n=190 Participants
83 Participants
n=386 Participants
Exotropia Control at near
1 to <2 points
80 Participants
n=196 Participants
65 Participants
n=190 Participants
145 Participants
n=386 Participants
Exotropia Control at near
2 to <3 points
39 Participants
n=196 Participants
44 Participants
n=190 Participants
83 Participants
n=386 Participants
Exotropia Control at near
3 to <4 points
31 Participants
n=196 Participants
27 Participants
n=190 Participants
58 Participants
n=386 Participants
Exotropia Control at near
4 to 5 points
9 Participants
n=196 Participants
8 Participants
n=190 Participants
17 Participants
n=386 Participants
PACT exodeviation at distance
No exodeviation (orthophoria)
NA Participants
n=196 Participants
NA Participants
n=190 Participants
NA Participants
n=386 Participants
PACT exodeviation at distance
1-9 Δ
NA Participants
n=196 Participants
NA Participants
n=190 Participants
NA Participants
n=386 Participants
PACT exodeviation at distance
10-15 Δ
5 Participants
n=196 Participants
6 Participants
n=190 Participants
11 Participants
n=386 Participants
PACT exodeviation at distance
16-18 Δ
42 Participants
n=196 Participants
22 Participants
n=190 Participants
64 Participants
n=386 Participants
PACT exodeviation at distance
19-25 Δ
86 Participants
n=196 Participants
91 Participants
n=190 Participants
177 Participants
n=386 Participants
PACT exodeviation at distance
30-35 Δ
54 Participants
n=196 Participants
50 Participants
n=190 Participants
104 Participants
n=386 Participants
PACT exodeviation at distance
40-45 Δ
9 Participants
n=196 Participants
19 Participants
n=190 Participants
28 Participants
n=386 Participants
PACT exodeviation at distance
>= 50 Δ
0 Participants
n=196 Participants
2 Participants
n=190 Participants
2 Participants
n=386 Participants
PACT exodeviation at distance
Esodeviation
NA Participants
n=196 Participants
NA Participants
n=190 Participants
NA Participants
n=386 Participants
PACT Exodeviation at near
No Exodeviation (orthophoria)
2 Participants
n=196 Participants
3 Participants
n=190 Participants
5 Participants
n=386 Participants
PACT Exodeviation at near
1-9 Δ
27 Participants
n=196 Participants
24 Participants
n=190 Participants
51 Participants
n=386 Participants
PACT Exodeviation at near
10-15 Δ
45 Participants
n=196 Participants
45 Participants
n=190 Participants
90 Participants
n=386 Participants
PACT Exodeviation at near
16-18 Δ
36 Participants
n=196 Participants
29 Participants
n=190 Participants
65 Participants
n=386 Participants
PACT Exodeviation at near
19-25 Δ
57 Participants
n=196 Participants
59 Participants
n=190 Participants
116 Participants
n=386 Participants
PACT Exodeviation at near
30-35 Δ
24 Participants
n=196 Participants
21 Participants
n=190 Participants
45 Participants
n=386 Participants
PACT Exodeviation at near
40-45 Δ
4 Participants
n=196 Participants
8 Participants
n=190 Participants
12 Participants
n=386 Participants
PACT Exodeviation at near
>= 50 Δ
1 Participants
n=196 Participants
0 Participants
n=190 Participants
1 Participants
n=386 Participants
PACT Exodeviation at near
Esodeviation
0 Participants
n=196 Participants
1 Participants
n=190 Participants
1 Participants
n=386 Participants

PRIMARY outcome

Timeframe: 12 months

A comparison of mean control of the distance exodeviation (average of 3 measurements over the exam) between the 2.50 diopters (D) overminus group and the non-overminus group (spectacles without overminus or no spectacles) at 12 months. The Office Control Score provides a rating of exodeviation control on a 0 to 5 scale, in subjects with intermittent exotropia. Scores 3 to 5 reflect the proportion of time a spontaneous manifest exotropia is present during 30 seconds of observation (\<50% score 3; \>50% score 4; 100% score 5). If no spontaneous manifest exotropia is observed, scores 0 to 2 reflect the longest time to regain fusion after three, 10-second dissociations (\>5 seconds score 2; 1-5 seconds score 1; \<1 second score 0).

Outcome measures

Outcome measures
Measure
Overminus Treatment
n=189 Participants
spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere Overminus treatment: spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere
Non-overminus Treatment
n=169 Participants
spectacles with full cycloplegic refraction without overminus Non-overminus treatment: spectacles with full cycloplegic refraction without overminus
Mean Distance Control at 12-Months (On-Treatment Visit)
1.8 points
Standard Deviation 1.3
2.8 points
Standard Deviation 1.5

PRIMARY outcome

Timeframe: 18 months

A comparison of mean control of the distance exodeviation (average of 3 measurements over the exam) between the 2.50D overminus group and the non-overminus group (spectacles without overminus or no spectacles) at 18 months (after treatment discontinuation). The Office Control Score provides a rating of exodeviation control on a 0 to 5 scale, in subjects with intermittent exotropia. Scores 3 to 5 reflect the proportion of time a spontaneous manifest exotropia is present during 30 seconds of observation (\<50% score 3; \>50% score 4; 100% score 5). If no spontaneous manifest exotropia is observed, scores 0 to 2 reflect the longest time to regain fusion after three, 10-second dissociations (\>5 seconds score 2; 1-5 seconds score 1; \<1 second score 0).

Outcome measures

Outcome measures
Measure
Overminus Treatment
n=176 Participants
spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere Overminus treatment: spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere
Non-overminus Treatment
n=155 Participants
spectacles with full cycloplegic refraction without overminus Non-overminus treatment: spectacles with full cycloplegic refraction without overminus
Mean Distance Control at 18-Months (Off-Treatment Visit)
2.4 points
Standard Deviation 1.5
2.7 points
Standard Deviation 1.6

SECONDARY outcome

Timeframe: 12 months

The number of subjects with no spontaneous tropia at 12 months and at 18 months will be compared between treatment groups.

Outcome measures

Outcome measures
Measure
Overminus Treatment
n=189 Participants
spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere Overminus treatment: spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere
Non-overminus Treatment
n=169 Participants
spectacles with full cycloplegic refraction without overminus Non-overminus treatment: spectacles with full cycloplegic refraction without overminus
Number of Participants With No Spontaneous Tropia
115 Participants
62 Participants

SECONDARY outcome

Timeframe: At 18 months

The proportion of subjects with no spontaneous tropia at 12 months and at 18 months will be compared between treatment groups.

Outcome measures

Outcome measures
Measure
Overminus Treatment
n=176 Participants
spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere Overminus treatment: spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere
Non-overminus Treatment
n=155 Participants
spectacles with full cycloplegic refraction without overminus Non-overminus treatment: spectacles with full cycloplegic refraction without overminus
No Spontaneous Tropia
85 Participants
60 Participants

SECONDARY outcome

Timeframe: 12 months

The proportion of subjects with ≥1 point improvement in distance control between baseline and 12 months will be compared between treatment groups. The proportion of subjects with ≥2 points improvement in distance control will be similarly compared between treatment groups. The Office Control Score provides a rating of exodeviation control on a 0 to 5 scale, in subjects with intermittent exotropia. Scores 3 to 5 reflect the proportion of time a spontaneous manifest exotropia is present during 30 seconds of observation (\<50% score 3; \>50% score 4; 100% score 5). If no spontaneous manifest exotropia is observed, scores 0 to 2 reflect the longest time to regain fusion after three, 10-second dissociations (\>5 seconds score 2; 1-5 seconds score 1; \<1 second score 0).

Outcome measures

Outcome measures
Measure
Overminus Treatment
n=189 Participants
spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere Overminus treatment: spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere
Non-overminus Treatment
n=169 Participants
spectacles with full cycloplegic refraction without overminus Non-overminus treatment: spectacles with full cycloplegic refraction without overminus
Change in Distance Control
>2 Points
65 Participants
24 Participants
Change in Distance Control
>1 Point
116 Participants
71 Participants

SECONDARY outcome

Timeframe: 18 months

The proportion of subjects with ≥1 point improvement in distance control between baseline and 18 months will be compared between treatment groups. The proportion of subjects with ≥2 points improvement in distance control will be similarly compared between treatment groups. The Office Control Score provides a rating of exodeviation control on a 0 to 5 scale, in subjects with intermittent exotropia. Scores 3 to 5 reflect the proportion of time a spontaneous manifest exotropia is present during 30 seconds of observation (\<50% score 3; \>50% score 4; 100% score 5). If no spontaneous manifest exotropia is observed, scores 0 to 2 reflect the longest time to regain fusion after three, 10-second dissociations (\>5 seconds score 2; 1-5 seconds score 1; \<1 second score 0).

Outcome measures

Outcome measures
Measure
Overminus Treatment
n=176 Participants
spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere Overminus treatment: spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere
Non-overminus Treatment
n=155 Participants
spectacles with full cycloplegic refraction without overminus Non-overminus treatment: spectacles with full cycloplegic refraction without overminus
Change in Distance Control
>1 Point
86 Participants
68 Participants
Change in Distance Control
>2 Points
48 Participants
30 Participants

SECONDARY outcome

Timeframe: 12 months

The cumulative proportion of subjects who meet deterioration criteria by the time point will be estimated for each treatment group. Participants who meet either of the following at any visit by a specific timepoint (e.g., 12 months, 18 months) will be considered to have met deterioration criteria by that timepoint. * Motor deterioration: Control of the exodeviation measures 5 (constant exotropia) on all three assessments at distance and near. The exodeviation does not need to be constant throughout the entire exam provided that it is constant during all three assessments of control. * Stereoacuity deterioration: Drop in near stereoacuity of at least 2 octaves from enrollment stereoacuity, or to nil, confirmed by a retest by a Masked Examiner on a subsequent day. Note: participants with nil stereoacuity at enrollment will not be able to deteriorate with respect to a drop in near stereoacuity.

Outcome measures

Outcome measures
Measure
Overminus Treatment
n=189 Participants
spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere Overminus treatment: spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere
Non-overminus Treatment
n=169 Participants
spectacles with full cycloplegic refraction without overminus Non-overminus treatment: spectacles with full cycloplegic refraction without overminus
Deterioration as Assessed by Motor Alignment and Stereoacuity at Near (12 Months)
5 Participants
7 Participants

SECONDARY outcome

Timeframe: 18 months

The cumulative proportion of subjects who meet deterioration criteria by the time point will be estimated for each treatment group. Participants who meet either of the following at any visit by a specific timepoint (e.g., 12 months, 18 months) will be considered to have met deterioration criteria by that timepoint. * Motor deterioration: Control of the exodeviation measures 5 (constant exotropia) on all three assessments at distance and near. The exodeviation does not need to be constant throughout the entire exam provided that it is constant during all three assessments of control. * Stereoacuity deterioration: Drop in near stereoacuity of at least 2 octaves from enrollment stereoacuity, or to nil, confirmed by a retest by a Masked Examiner on a subsequent day. Note: participants with nil stereoacuity at enrollment will not be able to deteriorate with respect to a drop in near stereoacuity.

Outcome measures

Outcome measures
Measure
Overminus Treatment
n=176 Participants
spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere Overminus treatment: spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere
Non-overminus Treatment
n=155 Participants
spectacles with full cycloplegic refraction without overminus Non-overminus treatment: spectacles with full cycloplegic refraction without overminus
Deterioration as Assessed by Motor Alignment and Stereoacuity at Near (18 Months)
6 Participants
16 Participants

SECONDARY outcome

Timeframe: 12 months

Mean control of the near exodeviation (average of 3 measurements over the exam). The Office Control Score provides a rating of exodeviation control on a 0 to 5 scale, in subjects with intermittent exotropia. Scores 3 to 5 reflect the proportion of time a spontaneous manifest exotropia is present during 30 seconds of observation (\<50% score 3; \>50% score 4; 100% score 5). If no spontaneous manifest exotropia is observed, scores 0 to 2 reflect the longest time to regain fusion after three, 10-second dissociations (\>5 seconds score 2; 1-5 seconds score 1; \<1 second score 0).

Outcome measures

Outcome measures
Measure
Overminus Treatment
n=189 Participants
spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere Overminus treatment: spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere
Non-overminus Treatment
n=169 Participants
spectacles with full cycloplegic refraction without overminus Non-overminus treatment: spectacles with full cycloplegic refraction without overminus
Near Control (12 Months)
0 to <1 points
96 Participants
64 Participants
Near Control (12 Months)
1 to <2 points
59 Participants
55 Participants
Near Control (12 Months)
2 to <3 points
21 Participants
13 Participants
Near Control (12 Months)
3 to <4 points
9 Participants
17 Participants
Near Control (12 Months)
4 to 5 points
4 Participants
20 Participants

SECONDARY outcome

Timeframe: 18 months

Mean control of the near exodeviation (average of 3 measurements over the exam). The Office Control Score provides a rating of exodeviation control on a 0 to 5 scale, in subjects with intermittent exotropia. Scores 3 to 5 reflect the proportion of time a spontaneous manifest exotropia is present during 30 seconds of observation (\<50% score 3; \>50% score 4; 100% score 5). If no spontaneous manifest exotropia is observed, scores 0 to 2 reflect the longest time to regain fusion after three, 10-second dissociations (\>5 seconds score 2; 1-5 seconds score 1; \<1 second score 0).

Outcome measures

Outcome measures
Measure
Overminus Treatment
n=176 Participants
spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere Overminus treatment: spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere
Non-overminus Treatment
n=155 Participants
spectacles with full cycloplegic refraction without overminus Non-overminus treatment: spectacles with full cycloplegic refraction without overminus
Near Control (18 Months)
4 to 5 points
13 Participants
16 Participants
Near Control (18 Months)
0 to <1 points
72 Participants
59 Participants
Near Control (18 Months)
1 to <2 points
60 Participants
46 Participants
Near Control (18 Months)
2 to <3 points
16 Participants
18 Participants
Near Control (18 Months)
3 to <4 points
15 Participants
16 Participants

SECONDARY outcome

Timeframe: 12 months

For each timepoint, the change in near control since baseline will be reported. The Office Control Score provides a rating of exodeviation control on a 0 to 5 scale, in subjects with intermittent exotropia. Scores 3 to 5 reflect the proportion of time a spontaneous manifest exotropia is present during 30 seconds of observation (\<50% score 3; \>50% score 4; 100% score 5). If no spontaneous manifest exotropia is observed, scores 0 to 2 reflect the longest time to regain fusion after three, 10-second dissociations (\>5 seconds score 2; 1-5 seconds score 1; \<1 second score 0).

Outcome measures

Outcome measures
Measure
Overminus Treatment
n=189 Participants
spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere Overminus treatment: spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere
Non-overminus Treatment
n=169 Participants
spectacles with full cycloplegic refraction without overminus Non-overminus treatment: spectacles with full cycloplegic refraction without overminus
Change in Near Control (12 Months)
0.7 points
Standard Deviation 1.3
0.1 points
Standard Deviation 1.4

SECONDARY outcome

Timeframe: 18 months

For each timepoint, the change in near control since baseline will be reported. The Office Control Score provides a rating of exodeviation control on a 0 to 5 scale, in subjects with intermittent exotropia. Scores 3 to 5 reflect the proportion of time a spontaneous manifest exotropia is present during 30 seconds of observation (\<50% score 3; \>50% score 4; 100% score 5). If no spontaneous manifest exotropia is observed, scores 0 to 2 reflect the longest time to regain fusion after three, 10-second dissociations (\>5 seconds score 2; 1-5 seconds score 1; \<1 second score 0).

Outcome measures

Outcome measures
Measure
Overminus Treatment
n=176 Participants
spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere Overminus treatment: spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere
Non-overminus Treatment
n=155 Participants
spectacles with full cycloplegic refraction without overminus Non-overminus treatment: spectacles with full cycloplegic refraction without overminus
Change in Near Control (18 Months)
0.4 points
Standard Deviation 1.4
0.1 points
Standard Deviation 1.5

SECONDARY outcome

Timeframe: 12 months

The magnitude of the deviation by Prism Alternate Cover Test (PACT) will be compared between treatment groups.

Outcome measures

Outcome measures
Measure
Overminus Treatment
n=189 Participants
spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere Overminus treatment: spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere
Non-overminus Treatment
n=169 Participants
spectacles with full cycloplegic refraction without overminus Non-overminus treatment: spectacles with full cycloplegic refraction without overminus
Angle Magnitude (12 Months)
20.0 Prism Diopters
Standard Deviation 9.0
25.0 Prism Diopters
Standard Deviation 8.0

SECONDARY outcome

Timeframe: 18 months

The magnitude of the deviation by Prism Alternate Cover Test (PACT) will be compared between treatment groups.

Outcome measures

Outcome measures
Measure
Overminus Treatment
n=176 Participants
spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere Overminus treatment: spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere
Non-overminus Treatment
n=155 Participants
spectacles with full cycloplegic refraction without overminus Non-overminus treatment: spectacles with full cycloplegic refraction without overminus
Angle Magnitude (18 Months)
23.0 Prism Diopters
Standard Deviation 9.0
24.0 Prism Diopters
Standard Deviation 11.0

SECONDARY outcome

Timeframe: 12 months

A comparison of near stereoacuity will be assessed using the Randot Preschool stereotest at near (performed at 40 cm) between treatment groups.

Outcome measures

Outcome measures
Measure
Overminus Treatment
n=189 Participants
spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere Overminus treatment: spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere
Non-overminus Treatment
n=169 Participants
spectacles with full cycloplegic refraction without overminus Non-overminus treatment: spectacles with full cycloplegic refraction without overminus
Stereoacuity at 12 Months
2.0 arcseconds
Standard Deviation 0.4
2.0 arcseconds
Standard Deviation 0.4

SECONDARY outcome

Timeframe: 18 months

A comparison of near stereoacuity will be assessed using the Randot Preschool stereotest at near (performed at 40 cm) between treatment groups.

Outcome measures

Outcome measures
Measure
Overminus Treatment
n=176 Participants
spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere Overminus treatment: spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere
Non-overminus Treatment
n=155 Participants
spectacles with full cycloplegic refraction without overminus Non-overminus treatment: spectacles with full cycloplegic refraction without overminus
Stereoacuity at 18 Months
1.9 arcseconds
Standard Deviation 0.4
1.9 arcseconds
Standard Deviation 0.4

SECONDARY outcome

Timeframe: 12 months

Compliance with spectacle wear will be assessed at the 12-month and 18-month outcome exam. Parents will give an estimate of the proportion of the time their children wore their spectacles. Proportion of time worn will be described as excellent (76% to 100%), good (51% to 75%), fair (26% to 50%), or poor (≤ 25%). The distribution of compliance will be assessed for each treatment group at the outcome exam.

Outcome measures

Outcome measures
Measure
Overminus Treatment
n=189 Participants
spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere Overminus treatment: spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere
Non-overminus Treatment
n=169 Participants
spectacles with full cycloplegic refraction without overminus Non-overminus treatment: spectacles with full cycloplegic refraction without overminus
Compliance With Spectacle Wear (12 Months)
Prescribed not wearing (0%)
3 Participants
2 Participants
Compliance With Spectacle Wear (12 Months)
Discontinued
1 Participants
1 Participants
Compliance With Spectacle Wear (12 Months)
Excellent (76-100%)
143 Participants
128 Participants
Compliance With Spectacle Wear (12 Months)
Good (51-75%)
26 Participants
28 Participants
Compliance With Spectacle Wear (12 Months)
Fair (26-50%)
10 Participants
8 Participants
Compliance With Spectacle Wear (12 Months)
Poor (1-25%)
6 Participants
2 Participants

SECONDARY outcome

Timeframe: 18 months

Compliance with spectacle wear will be assessed at the 12-month and 18-month outcome exam. Parents will give an estimate of the proportion of the time their children wore their spectacles. Proportion of time worn will be described as excellent (76% to 100%), good (51% to 75%), fair (26% to 50%), or poor (≤ 25%). The distribution of compliance will be assessed for each treatment group at the outcome exam.

Outcome measures

Outcome measures
Measure
Overminus Treatment
n=176 Participants
spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere Overminus treatment: spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere
Non-overminus Treatment
n=155 Participants
spectacles with full cycloplegic refraction without overminus Non-overminus treatment: spectacles with full cycloplegic refraction without overminus
Compliance With Spectacle Wear (18 Months)
Good (51-75%)
23 Participants
14 Participants
Compliance With Spectacle Wear (18 Months)
Excellent (76-100%)
128 Participants
120 Participants
Compliance With Spectacle Wear (18 Months)
Fair (26-50%)
8 Participants
13 Participants
Compliance With Spectacle Wear (18 Months)
Poor (1-25%)
9 Participants
5 Participants
Compliance With Spectacle Wear (18 Months)
Prescribed not wearing (0%)
5 Participants
1 Participants
Compliance With Spectacle Wear (18 Months)
Discontinued
3 Participants
2 Participants

SECONDARY outcome

Timeframe: At 12 months

Population: When number analyzed differs from full population size, it indicates that those children were not wearing spectacles, and therefore could not answer the spectacle related questions.

A brief survey of symptoms that may be associated with overminus such as headaches, eye strain, and problems with spectacle wear will be administered to the parents of the subjects. Parents are asked to respond to the survey questions based on their observations of their child in the past 2 weeks. Response options are based on frequency of observations; never, rarely, sometimes, often, always, and not applicable.

Outcome measures

Outcome measures
Measure
Overminus Treatment
n=189 Participants
spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere Overminus treatment: spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere
Non-overminus Treatment
n=169 Participants
spectacles with full cycloplegic refraction without overminus Non-overminus treatment: spectacles with full cycloplegic refraction without overminus
Parent Symptom Survey [12 Months]
Did your child have blurry vision? · Missing
1 Participants
1 Participants
Parent Symptom Survey [12 Months]
Did your child have blurry vision? · Often
5 Participants
1 Participants
Parent Symptom Survey [12 Months]
Did your child have blurry vision? · Almost Always
2 Participants
0 Participants
Parent Symptom Survey [12 Months]
Did your child look over their spectacles? · Missing
1 Participants
1 Participants
Parent Symptom Survey [12 Months]
Did your child look over their spectacles? · Sometimes
45 Participants
52 Participants
Parent Symptom Survey [12 Months]
Did your child complain about hurt ears/nose? · Missing
1 Participants
1 Participants
Parent Symptom Survey [12 Months]
Did your child have headaches? · Missing
1 Participants
1 Participants
Parent Symptom Survey [12 Months]
Did your child have headaches? · Never
74 Participants
71 Participants
Parent Symptom Survey [12 Months]
Did your child have headaches? · Almost never
58 Participants
64 Participants
Parent Symptom Survey [12 Months]
Did your child have headaches? · Sometimes
46 Participants
32 Participants
Parent Symptom Survey [12 Months]
Did your child have headaches? · Often
7 Participants
1 Participants
Parent Symptom Survey [12 Months]
Did your child have headaches? · Almost Always
3 Participants
0 Participants
Parent Symptom Survey [12 Months]
Did your child have eyestrain? · Missing
1 Participants
1 Participants
Parent Symptom Survey [12 Months]
Did your child have eyestrain? · Never
75 Participants
56 Participants
Parent Symptom Survey [12 Months]
Did your child have eyestrain? · Almost never
43 Participants
56 Participants
Parent Symptom Survey [12 Months]
Did your child have eyestrain? · Sometimes
60 Participants
50 Participants
Parent Symptom Survey [12 Months]
Did your child have eyestrain? · Often
9 Participants
6 Participants
Parent Symptom Survey [12 Months]
Did your child have eyestrain? · Almost Always
1 Participants
0 Participants
Parent Symptom Survey [12 Months]
Did your child avoid reading? · Missing
1 Participants
1 Participants
Parent Symptom Survey [12 Months]
Did your child avoid reading? · Never
112 Participants
100 Participants
Parent Symptom Survey [12 Months]
Did your child avoid reading? · Almost never
46 Participants
43 Participants
Parent Symptom Survey [12 Months]
Did your child avoid reading? · Sometimes
21 Participants
18 Participants
Parent Symptom Survey [12 Months]
Did your child avoid reading? · Often
7 Participants
5 Participants
Parent Symptom Survey [12 Months]
Did your child avoid reading? · Almost Always
2 Participants
2 Participants
Parent Symptom Survey [12 Months]
Did your child have blurry vision? · Never
106 Participants
105 Participants
Parent Symptom Survey [12 Months]
Did your child have blurry vision? · Almost never
41 Participants
36 Participants
Parent Symptom Survey [12 Months]
Did your child have blurry vision? · Sometimes
34 Participants
26 Participants
Parent Symptom Survey [12 Months]
Did your child look over their spectacles? · Never
66 Participants
53 Participants
Parent Symptom Survey [12 Months]
Did your child look over their spectacles? · Almost never
37 Participants
40 Participants
Parent Symptom Survey [12 Months]
Did your child look over their spectacles? · Often
25 Participants
17 Participants
Parent Symptom Survey [12 Months]
Did your child look over their spectacles? · Almost Always
11 Participants
4 Participants
Parent Symptom Survey [12 Months]
Did your child take their spectacles off? · Missing
1 Participants
1 Participants
Parent Symptom Survey [12 Months]
Did your child take their spectacles off? · Never
38 Participants
32 Participants
Parent Symptom Survey [12 Months]
Did your child take their spectacles off? · Almost never
45 Participants
51 Participants
Parent Symptom Survey [12 Months]
Did your child take their spectacles off? · Sometimes
63 Participants
66 Participants
Parent Symptom Survey [12 Months]
Did your child take their spectacles off? · Often
28 Participants
16 Participants
Parent Symptom Survey [12 Months]
Did your child take their spectacles off? · Almost Always
10 Participants
2 Participants
Parent Symptom Survey [12 Months]
Did your child complain about hurt ears/nose? · Never
112 Participants
96 Participants
Parent Symptom Survey [12 Months]
Did your child complain about hurt ears/nose? · Almost never
43 Participants
47 Participants
Parent Symptom Survey [12 Months]
Did your child complain about hurt ears/nose? · Sometimes
18 Participants
22 Participants
Parent Symptom Survey [12 Months]
Did your child complain about hurt ears/nose? · Often
10 Participants
2 Participants
Parent Symptom Survey [12 Months]
Did your child complain about hurt ears/nose? · Almost Always
2 Participants
0 Participants

SECONDARY outcome

Timeframe: At 18 months

Population: When number analyzed differs from full population size, it indicates that those children were not wearing spectacles, and therefore could not answer the spectacle related questions.

A brief survey of symptoms that may be associated with overminus such as headaches, eye strain, and problems with spectacle wear will be administered to the parents of the subjects. Parents are asked to respond to the survey questions based on their observations of their child in the past 2 weeks. Response options are based on frequency of observations; never, rarely, sometimes, often, always, and not applicable.

Outcome measures

Outcome measures
Measure
Overminus Treatment
n=176 Participants
spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere Overminus treatment: spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere
Non-overminus Treatment
n=155 Participants
spectacles with full cycloplegic refraction without overminus Non-overminus treatment: spectacles with full cycloplegic refraction without overminus
Parent Symptom Survey [18 Months]
Did your child have eyestrain? · Sometimes
53 Participants
49 Participants
Parent Symptom Survey [18 Months]
Did your child have eyestrain? · Often
3 Participants
6 Participants
Parent Symptom Survey [18 Months]
Did your child have eyestrain? · Almost always
2 Participants
0 Participants
Parent Symptom Survey [18 Months]
Did your child avoid reading? · Missing
0 Participants
1 Participants
Parent Symptom Survey [18 Months]
Did your child avoid reading? · Never
102 Participants
94 Participants
Parent Symptom Survey [18 Months]
Did your child avoid reading? · Almost never
44 Participants
41 Participants
Parent Symptom Survey [18 Months]
Did your child avoid reading? · Sometimes
24 Participants
14 Participants
Parent Symptom Survey [18 Months]
Did your child avoid reading? · Often
4 Participants
4 Participants
Parent Symptom Survey [18 Months]
Did your child avoid reading? · Almost always
2 Participants
1 Participants
Parent Symptom Survey [18 Months]
Did your child have blurry vision? · Missing
0 Participants
1 Participants
Parent Symptom Survey [18 Months]
Did your child have blurry vision? · Never
99 Participants
92 Participants
Parent Symptom Survey [18 Months]
Did your child have blurry vision? · Almost never
46 Participants
37 Participants
Parent Symptom Survey [18 Months]
Did your child have blurry vision? · Sometimes
29 Participants
23 Participants
Parent Symptom Survey [18 Months]
Did your child have blurry vision? · Often
1 Participants
1 Participants
Parent Symptom Survey [18 Months]
Did your child have blurry vision? · Almost always
1 Participants
1 Participants
Parent Symptom Survey [18 Months]
Did your child look over their spectacles? · Missing
0 Participants
1 Participants
Parent Symptom Survey [18 Months]
Did your child look over their spectacles? · Never
54 Participants
55 Participants
Parent Symptom Survey [18 Months]
Did your child look over their spectacles? · Almost never
46 Participants
33 Participants
Parent Symptom Survey [18 Months]
Did your child look over their spectacles? · Sometimes
47 Participants
48 Participants
Parent Symptom Survey [18 Months]
Did your child look over their spectacles? · Often
18 Participants
9 Participants
Parent Symptom Survey [18 Months]
Did your child look over their spectacles? · Almost always
8 Participants
5 Participants
Parent Symptom Survey [18 Months]
Did your child take their spectacles off? · Missing
0 Participants
1 Participants
Parent Symptom Survey [18 Months]
Did your child take their spectacles off? · Never
38 Participants
32 Participants
Parent Symptom Survey [18 Months]
Did your child take their spectacles off? · Almost never
36 Participants
43 Participants
Parent Symptom Survey [18 Months]
Did your child take their spectacles off? · Sometimes
69 Participants
55 Participants
Parent Symptom Survey [18 Months]
Did your child take their spectacles off? · Often
22 Participants
13 Participants
Parent Symptom Survey [18 Months]
Did your child take their spectacles off? · Almost always
7 Participants
8 Participants
Parent Symptom Survey [18 Months]
Did your child complain about hurt ears/nose? · Missing
0 Participants
1 Participants
Parent Symptom Survey [18 Months]
Did your child complain about hurt ears/nose? · Never
109 Participants
96 Participants
Parent Symptom Survey [18 Months]
Did your child complain about hurt ears/nose? · Almost never
41 Participants
36 Participants
Parent Symptom Survey [18 Months]
Did your child complain about hurt ears/nose? · Sometimes
18 Participants
14 Participants
Parent Symptom Survey [18 Months]
Did your child complain about hurt ears/nose? · Often
2 Participants
4 Participants
Parent Symptom Survey [18 Months]
Did your child complain about hurt ears/nose? · Almost always
4 Participants
1 Participants
Parent Symptom Survey [18 Months]
Did your child have headaches? · Missing
0 Participants
1 Participants
Parent Symptom Survey [18 Months]
Did your child have headaches? · Never
76 Participants
63 Participants
Parent Symptom Survey [18 Months]
Did your child have headaches? · Almost never
49 Participants
55 Participants
Parent Symptom Survey [18 Months]
Did your child have headaches? · Sometimes
46 Participants
31 Participants
Parent Symptom Survey [18 Months]
Did your child have headaches? · Often
4 Participants
3 Participants
Parent Symptom Survey [18 Months]
Did your child have headaches? · Almost always
1 Participants
2 Participants
Parent Symptom Survey [18 Months]
Did your child have eyestrain? · Missing
0 Participants
1 Participants
Parent Symptom Survey [18 Months]
Did your child have eyestrain? · Never
66 Participants
49 Participants
Parent Symptom Survey [18 Months]
Did your child have eyestrain? · Almost never
52 Participants
50 Participants

Adverse Events

Overminus Treatment

Serious events: 0 serious events
Other events: 47 other events
Deaths: 0 deaths

Non-overminus Treatment

Serious events: 0 serious events
Other events: 15 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Overminus Treatment
n=196 participants at risk
spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere Overminus treatment: spectacles with full cycloplegic refraction plus 2.50 D overminus added to the sphere
Non-overminus Treatment
n=190 participants at risk
spectacles with full cycloplegic refraction without overminus Non-overminus treatment: spectacles with full cycloplegic refraction without overminus
Eye disorders
Development of Esotropia
2.0%
4/196 • Number of events 4 • 18 months
Although no adverse events are anticipated as a result of overminus therapy or non-overminus spectacle wear, any new cases of amblyopia, constant esotropia, or constant exotropia at distance and near will be reported. No surgical procedures are part of the protocol and no treatments are being prescribed that are not part of usual care. Investigators will abide by local IRB reporting requirements.
2.1%
4/190 • Number of events 4 • 18 months
Although no adverse events are anticipated as a result of overminus therapy or non-overminus spectacle wear, any new cases of amblyopia, constant esotropia, or constant exotropia at distance and near will be reported. No surgical procedures are part of the protocol and no treatments are being prescribed that are not part of usual care. Investigators will abide by local IRB reporting requirements.
Eye disorders
>1 Diopter of Myopic Shift
16.8%
33/196 • Number of events 33 • 18 months
Although no adverse events are anticipated as a result of overminus therapy or non-overminus spectacle wear, any new cases of amblyopia, constant esotropia, or constant exotropia at distance and near will be reported. No surgical procedures are part of the protocol and no treatments are being prescribed that are not part of usual care. Investigators will abide by local IRB reporting requirements.
1.1%
2/190 • Number of events 2 • 18 months
Although no adverse events are anticipated as a result of overminus therapy or non-overminus spectacle wear, any new cases of amblyopia, constant esotropia, or constant exotropia at distance and near will be reported. No surgical procedures are part of the protocol and no treatments are being prescribed that are not part of usual care. Investigators will abide by local IRB reporting requirements.
Eye disorders
2 or more line decrease in visual acuity
6.1%
12/196 • Number of events 12 • 18 months
Although no adverse events are anticipated as a result of overminus therapy or non-overminus spectacle wear, any new cases of amblyopia, constant esotropia, or constant exotropia at distance and near will be reported. No surgical procedures are part of the protocol and no treatments are being prescribed that are not part of usual care. Investigators will abide by local IRB reporting requirements.
5.3%
10/190 • Number of events 10 • 18 months
Although no adverse events are anticipated as a result of overminus therapy or non-overminus spectacle wear, any new cases of amblyopia, constant esotropia, or constant exotropia at distance and near will be reported. No surgical procedures are part of the protocol and no treatments are being prescribed that are not part of usual care. Investigators will abide by local IRB reporting requirements.
Eye disorders
Amblyopia treatment prescribed by 12 months
1.0%
2/196 • Number of events 2 • 18 months
Although no adverse events are anticipated as a result of overminus therapy or non-overminus spectacle wear, any new cases of amblyopia, constant esotropia, or constant exotropia at distance and near will be reported. No surgical procedures are part of the protocol and no treatments are being prescribed that are not part of usual care. Investigators will abide by local IRB reporting requirements.
0.53%
1/190 • Number of events 1 • 18 months
Although no adverse events are anticipated as a result of overminus therapy or non-overminus spectacle wear, any new cases of amblyopia, constant esotropia, or constant exotropia at distance and near will be reported. No surgical procedures are part of the protocol and no treatments are being prescribed that are not part of usual care. Investigators will abide by local IRB reporting requirements.

Additional Information

Raymond Kraker, Coordinating Center Director

Jaeb Center for Health Research

Phone: (813)-975-8690

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place