Binocular Visual Therapy and Video Games for Amblyopia Treatment.

NCT ID: NCT03655912

Last Updated: 2024-05-08

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

RECRUITING

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-10-09

Study Completion Date

2025-12-31

Brief Summary

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Amblyopia, or lazy eye, is best defined by the American Academy of Ophthalmology as a unilateral or bilateral reduction of the best corrected visual acuity that occurs in the setting of an otherwise normal eye, or a structural abnormality involving the eye or visual pathway with reduction in visual acuity that cannot be attributed only to the effect of the structural abnormality. Which causes an abnormal visual experience early in life, with consequences such as deficiencies in the ability to perceive contrast and/or movement, visual acuity, accommodation and stereopsis. The treatment of choice consists in patching of the fellow eye 2 hours per day. The disadvantage of this treatment modality is that patients end up not complying and when treatment is interrupted, lazy eye reappears. Amblyopia was thought to be a monocular disease, now a days there are reports of cortical visual paths changes in both eyes (the fellow and amblyopia eye), believing that it might be a monocular consequence of a binocular disease. Following that statement new treatment studies have arisen, stimulating both eyes not only to improve visual acuity in the lazy eye, but to restore binocular function as well. These treatments use videogames in celular phones, computers, or tablets where the fellow eye is exposed to reduced contrast and the lazy eye is exposed to full-contrast. Although the evidence is promising, more studies are needed to establish effectivity and security of this treatment modality.

Detailed Description

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The objective of this study is to determine if the binocular visual therapy with red-green glasses and the use of electronic devices is effective for amblyopia treatment in children.

Participants will be randomly assigned to one of three treatment modalities: Group A: eye patch on the fellow eye and to near-vision activities (such as reading, drawing, etc) Group B: an eye patch on the fellow eye and a electronic tablet Group C: red/green glasses and a electronic tablet

Treatment will be done buy the three groups daily during 2 consecutive hours, and will be completed for four months. Children will then suspend the therapy for 2 months, and will be reevaluated to determine lazy eye relapses . All groups will be compared to see which patients achieved greater improvement on visual acuity and depth perception.

Conditions

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Amblyopia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Caregivers
Neither the patient or the care provider will be aware of the treatment modality group the patient is in. In order to achieve that, patients in different modality groups will be evaluated in different days preventing information of group modality gossip between the patients parents.

Study Groups

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Patch

Eye patch on the fellow eye and to near-vision activities (such as reading, drawing, etc)

Group Type ACTIVE_COMPARATOR

Eye patch

Intervention Type DEVICE

The use of eye patch on the fellow eye and near vision activities for 2 hours a day during 4 months.

Electronic Devices

Eye patch on the fellow eye and a electronic tablet

Group Type EXPERIMENTAL

Electronic Tablet

Intervention Type DEVICE

The use of eye patch on the fellow eye and electronic tablet for 2 hours a day during 4 months.

Red/Green Glasses

Red/green glasses and a electronic tablet

Group Type EXPERIMENTAL

Red/green glasses

Intervention Type DEVICE

The use of red/green glasses and electronic devices for two hours a day during 4 months.

Interventions

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Red/green glasses

The use of red/green glasses and electronic devices for two hours a day during 4 months.

Intervention Type DEVICE

Electronic Tablet

The use of eye patch on the fellow eye and electronic tablet for 2 hours a day during 4 months.

Intervention Type DEVICE

Eye patch

The use of eye patch on the fellow eye and near vision activities for 2 hours a day during 4 months.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Patients with anisometropic amblyopia, strabismic amblyopia or both
* Patients with out previous amblyopia treatment
* Patient with previous strabismus surgery or use of there best corrected visual acuity glasses for at least 1 month
* Birth at term gestational age
* Without any systemic or ophthalmic comorbidities
* Previous patients parent verbal and fiscal assessment.

Exclusion Criteria

* Any other amblyopia diagnosis (deprivation)
* Any previous amblyopia treatment
* Any previous intraocular surgery
* Any ocular condition
* Any neurologic conditions or psychomotor development alterations
* Patients not able to cooperate for visual acuity or stereopsis evaluation
Minimum Eligible Age

4 Years

Maximum Eligible Age

10 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital Universitario Dr. Jose E. Gonzalez

OTHER

Sponsor Role collaborator

Universidad Autonoma de Nuevo Leon

OTHER

Sponsor Role lead

Responsible Party

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Karim Mohamed-Noriega

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Marissa L. Fernandez-de Luna, MD

Role: PRINCIPAL_INVESTIGATOR

Universidad Autonoma de Nuevo Leon

Locations

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Departamento de Oftalmologia, Hospital Universitario "Dr. Jose Eleuterio Gonzalez"

Monterrey, Nuevo León, Mexico

Site Status RECRUITING

Countries

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Mexico

Central Contacts

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Marissa L. Fernandez-de Luna, MD

Role: CONTACT

+528183469259

Facility Contacts

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Karim Mohamed-Noriega, M.D.

Role: primary

+52 81 83469259

References

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Tailor V, Bossi M, Bunce C, Greenwood JA, Dahlmann-Noor A. Binocular versus standard occlusion or blurring treatment for unilateral amblyopia in children aged three to eight years. Cochrane Database Syst Rev. 2015 Aug 11;2015(8):CD011347. doi: 10.1002/14651858.CD011347.pub2.

Reference Type BACKGROUND
PMID: 26263202 (View on PubMed)

Kelly KR, Jost RM, Dao L, Beauchamp CL, Leffler JN, Birch EE. Binocular iPad Game vs Patching for Treatment of Amblyopia in Children: A Randomized Clinical Trial. JAMA Ophthalmol. 2016 Dec 1;134(12):1402-1408. doi: 10.1001/jamaophthalmol.2016.4224.

Reference Type BACKGROUND
PMID: 27832248 (View on PubMed)

Hunter D. Amblyopia: The clinician's view. Vis Neurosci. 2018 Jan;35:E011. doi: 10.1017/S0952523817000189. No abstract available.

Reference Type BACKGROUND
PMID: 29905115 (View on PubMed)

Carlton J, Karnon J, Czoski-Murray C, Smith KJ, Marr J. The clinical effectiveness and cost-effectiveness of screening programmes for amblyopia and strabismus in children up to the age of 4-5 years: a systematic review and economic evaluation. Health Technol Assess. 2008 Jun;12(25):iii, xi-194. doi: 10.3310/hta12250.

Reference Type BACKGROUND
PMID: 18513466 (View on PubMed)

Grant S, Melmoth DR, Morgan MJ, Finlay AL. Prehension deficits in amblyopia. Invest Ophthalmol Vis Sci. 2007 Mar;48(3):1139-48. doi: 10.1167/iovs.06-0976.

Reference Type BACKGROUND
PMID: 17325157 (View on PubMed)

Grant S, Moseley MJ. Amblyopia and real-world visuomotor tasks. Strabismus. 2011 Sep;19(3):119-28. doi: 10.3109/09273972.2011.600423.

Reference Type BACKGROUND
PMID: 21870915 (View on PubMed)

Hrisos S, Clarke MP, Kelly T, Henderson J, Wright CM. Unilateral visual impairment and neurodevelopmental performance in preschool children. Br J Ophthalmol. 2006 Jul;90(7):836-8. doi: 10.1136/bjo.2006.090910. Epub 2006 Mar 15.

Reference Type BACKGROUND
PMID: 16540485 (View on PubMed)

Niechwiej-Szwedo E, Goltz HC, Chandrakumar M, Hirji Z, Wong AM. Effects of anisometropic amblyopia on visuomotor behavior, III: Temporal eye-hand coordination during reaching. Invest Ophthalmol Vis Sci. 2011 Jul 29;52(8):5853-61. doi: 10.1167/iovs.11-7314.

Reference Type BACKGROUND
PMID: 21540479 (View on PubMed)

O'Connor AR, Birch EE, Anderson S, Draper H; FSOS Research Group. The functional significance of stereopsis. Invest Ophthalmol Vis Sci. 2010 Apr;51(4):2019-23. doi: 10.1167/iovs.09-4434. Epub 2009 Nov 20.

Reference Type BACKGROUND
PMID: 19933184 (View on PubMed)

Rahi JS, Cumberland PM, Peckham CS. Does amblyopia affect educational, health, and social outcomes? Findings from 1958 British birth cohort. BMJ. 2006 Apr 8;332(7545):820-5. doi: 10.1136/bmj.38751.597963.AE. Epub 2006 Mar 6.

Reference Type BACKGROUND
PMID: 16520328 (View on PubMed)

Webber AL, Wood JM, Gole GA, Brown B. The effect of amblyopia on fine motor skills in children. Invest Ophthalmol Vis Sci. 2008 Feb;49(2):594-603. doi: 10.1167/iovs.07-0869.

Reference Type BACKGROUND
PMID: 18235004 (View on PubMed)

Guo CX, Babu RJ, Black JM, Bobier WR, Lam CS, Dai S, Gao TY, Hess RF, Jenkins M, Jiang Y, Kowal L, Parag V, South J, Staffieri SE, Walker N, Wadham A, Thompson B; BRAVO study team. Binocular treatment of amblyopia using videogames (BRAVO): study protocol for a randomised controlled trial. Trials. 2016 Oct 18;17(1):504. doi: 10.1186/s13063-016-1635-3.

Reference Type BACKGROUND
PMID: 27756405 (View on PubMed)

Other Identifiers

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OF17-00013

Identifier Type: -

Identifier Source: org_study_id

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