The Emmetropization Via Accommodation (EVA) - II Study (EVA-II)
To determine if wearing a novel treatment during a 15-month period will enhance emmetropization in 4-month-old infants who have demonstrated poor ocular accommodation (eye focusing).
Visão geral do estudo
Status
Condições
Intervenção / Tratamento
Descrição detalhada
Uncorrected hyperopia (farsightedness) in children can lead to significant learning and visual problems, affecting their overall well-being and academic potential. Normally, infants are born with a moderate degree of hyperopia which should decrease as undergo a normal, developmental process called emmetropization, which mostly occurs during the first 18 months of life. Sometimes, this process fails, leaving children with higher-than-normal levels of hyperopia, which significantly increases their risk of developing conditions like strabismus (crossed eyes), amblyopia (lazy eye), and early literacy and scholastic issues. Infants who are at the greatest risk of not undergoing the normal emmetropization process are those with significantly higher levels of hyperopia early in infancy and those with poor ocular accommodation. The emmetropization process is not perfectly understood in human infants but may allow a window of opportunity for early intervention to help reduce the risk of debilitating vision conditions, while the visual system is still plastic. This study seeks to determine if early intervention, specifically partial refractive correction and visual engagement exercises (meant to stimulate ocular accommodation), can help improve the accommodative response and therefore reduce hyperopia in infants at high risk of not undergoing emmetropization. By treating 4-month-old infants with poor accommodation, the study aims to facilitate emmetropization and potentially reduce the risk of long-term visual problems. The study will also explore whether hyperopic defocus or accommodative effort is the primary signal guiding emmetropization, the two major theories of human emmetropization. Positive outcomes from this research could lead to new standards of care for hyperopic infants, potentially preventing a lifetime of vision-related issues and improving early literacy and academic performance.
Tipo de estudo
Inscrição (Estimado)
Estágio
- Não aplicável
Contactos e Locais
Contato de estudo
- Nome: Ann M Morrison, OD, PhD
- Número de telefone: 614-247-0010
- E-mail: morrison.421@osu.edu
Locais de estudo
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Ohio
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Columbus, Ohio, Estados Unidos, 43209
- The Ohio State University College of Optometry
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Contato:
- Ann M Morrison, OD, PhD
- Número de telefone: 614-247-0010
- E-mail: morrison.421@osu.edu
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Descrição
Inclusion Criteria:
- Signed parental permission and HIPAA authorization and willingness to comply with study procedures.
- Infant 13-19 weeks of age at baseline.
- Either sex and any race or ethnicity.
- Good general health based on parent-provided history, normal pregnancy and delivery without serious complications, and birthweight >2500 g.
- Mean MEM accommodative lag >+1.25 D based on three measurements throughout the baseline examination.
- Cycloplegic spherical-equivalent hyperopia ≥+3.50 D in one or both eyes.
Exclusion Criteria:
- Astigmatism >2.00 D in either eye.
- Anisometropia >1.50 D spherical equivalent.
- Strabismus.
- Previous difficulty with pupil dilation.
- Cardiac, liver, asthma, or other respiratory disease.
- Ocular disease/abnormality, prior intraocular surgery, retinal detachment, optic nerve hypoplasia, malformation of the eye, cortical visual impairment, or active ocular inflammation.
- Hydrocephalus, Down syndrome, cerebral palsy, severe developmental delay, or seizure disorder.
- A condition preventing spectacle wear for the study duration (e.g., plagiocephaly).
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Solteiro
Armas e Intervenções
Grupo de Participantes / Braço |
Intervenção / Tratamento |
|---|---|
|
Sem intervenção: Observation
No treatment is administered in this arm. |
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Experimental: Spectacles and At-Home Therapy
Participants will receive experimental treatment. |
Infants will receive spectacles that have a prescription relative to the spherical equivalent in each eye as measured by the cycloplegic retinoscopy performed at baseline. Changes in spectacle lens power will be made as needed at follow-up visits to keep the level of under-correction within 0.50D from the study protocol. An experimental non-invasive treatment will be prescribed as well. Treatment will continue until study completion at 18 months of age or until the infant reaches a spherical equivalent refractive error of +2.00D or less hyperopia. Participants will also receive a non-invasive treatment to be used at home. |
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Ocular Accommodation measured with MEM
Prazo: 14 months
|
Change in accommodative lag (in Diopters), measured with Monocular Estimation Method (MEM). |
14 months
|
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Correlation between refractive error and ocular accommodation measured with MEM
Prazo: 14 months
|
Refractive error will be measured using retinoscopy, in Diopters (D) and ocular accommodation will be measured with MEM retinoscopy, in Diopters (D) |
14 months
|
|
Correlation between refractive error and ocular accommodation measured with PowerRefractor
Prazo: 14 months
|
Refractive error will be measured using retinoscopy, in Diopters (D) and ocular accommodation will be measured with the PlusOptix PowerRefractor, in Diopters (D) |
14 months
|
Colaboradores e Investigadores
Patrocinador
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Estimado)
Conclusão Primária (Estimado)
Conclusão do estudo (Estimado)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- 20261737
Plano para dados de participantes individuais (IPD)
Planeja compartilhar dados de participantes individuais (IPD)?
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