AmblyopiaPhase 3ATS22NCT04378790
A Randomized Trial to Evaluate Sequential vs Simultaneous Patching
A Phase 3 study testing Patching and Glasses in people with Amblyopia, run by Jaeb Center for Health Research at 68 sites in United States.
Trial summary
A randomized trial to determine whether simultaneous treatment with spectacles and patching has an equivalent VA outcome compared with sequential treatment, first with spectacles alone followed by patching (if needed), for previously untreated amblyopia in children 3 to <13 years of age. Read more about this study
- Who is it for?
- Ages 3 to 13 years
- Conditions the study is for
- Amblyopia
- What is being tested?
- Patching and Glasses
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 544 participants
- Where
- 68 sitesUnited States
- Study dates
- 8 Dec 2020to 1 May 2028
- Phase
- Phase 3
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 3 to 13 years
- All sexes
- No healthy volunteers
- Child
Who may be able to join
- Age 3 to <13 years at the time of randomization
- Amblyopia associated with anisometropia, strabismus, or both
- o 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 or without optical correction)
- Documented history of strabismus which is no longer present (which in the judgment of the investigator could have caused amblyopia)
- Criteria for anisometropia: At least one of the following criteria must be met:
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- 1.00 D difference between eyes in spherical equivalent (SE)
- 1.50 D difference in astigmatism between corresponding meridians in the two eyes
- Criteria for combined-mechanism amblyopia: Both of the following criteria must be met:
- Criteria for strabismus are met (see above)
- 1.00 D difference between eyes in spherical equivalent OR ≥1.50 D difference in astigmatism between corresponding meridians in the two eyes
- No previous treatment for amblyopia, including no more than 24 hours of spectacle wear.
- Investigator planning to initiate spectacle correction of refractive error meeting the following criteria based on a cycloplegic refraction that has been performed within 30 days:
- Full correction of anisometropia
- Full correction of astigmatism with the same axis found by the cycloplegic refraction
- Full correction of any myopia
- Hyperopia must not be under corrected by more than 1.50 D, and reduction in plus sphere must be symmetric in the two eyes.
- At enrollment, single VA measured in each eye assessed in trial frames with the spectacle correction the investigator plans to prescribe, using the investigator's routine method as follows:
- VA in the amblyopic eye 20/40 to 20/200 inclusive.
- Age-normal VA in the fellow eye:40,41
- 3 years: 0.4 logMAR (20/50) or better
- 4 years: 0.3 logMAR (20/40) or better
- 5-6 years: 0.2 logMAR (20/32) or better
- 7-12 years: 0.12 logMAR (78 letters) or better
- Interocular difference ≥ 3 logMAR lines (0.3 logMAR) or ≥ 15 letters o When participants return for the Spectacle Baseline / Randomization Visit with their new spectacles, they will need to meet the same criteria as above using the ATS-HOTV or E-ETDRS protocol after wearing the new spectacles for at least 10 minutes (based upon the mean of a test and retest of VA in those new spectacles).
- Investigator is willing to prescribe spectacle wear followed sequentially by patching or simultaneous spectacles and patching treatment per protocol.
- Parent understands the protocol and is willing to accept randomization.
- Parent has phone (or access to phone) and is willing to be contacted by Jaeb Center staff or other study staff.
- Relocation outside of area of an active PEDIG site for this study within the next 56 weeks is not anticipated.
Who cannot join
- Myopia greater than -6.00 D spherical equivalent in either eye.
- Previous intraocular or refractive surgery.
- Planned strabismus surgery in the next 56 weeks.
- Any previous treatment for amblyopia (patching, atropine, Bangerter filter, vision therapy, or binocular treatment).
- Previous spectacle or contact lens wear for more than 24 hours.
- Parent and participant willing to forego option of contact lens wear for the duration of the study.
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- 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 VA criteria are met).
- 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 or attention deficit hyperactivity disorder (ADHD) are not excluded.
- Known allergy to adhesive patches.
- Known allergy to silicone.
Trial locations and contacts
68 sites in 1 country. Contact the study team or a site near you to ask about taking part.
Brooke P Fimbel contact
68 sites in 1 country
United States68 sites, 68 recruiting
- Recruiting
Akron Children's Hospital
Akron, Ohio, 44308
Cassandra S Solis, O.D, 330-543-5150, csolis@akronchildrens.org
- Recruiting
River View Family Eyecare
Albany, Oregon, 97321
Aaron D Salzano, OD, 541-967-3097, aaron.salzano@gmail.com
- Recruiting
Wilmer Eye Institute
Baltimore, Maryland, 21287-9028
Michael X Repka, MD, (410) 955-8314, mrepka@jhmi.edu
- Recruiting
Univ. of California- Berkeley
Berkeley, California, 94720
Jennifer H Fisher, OD, 510-642-2020, jenhfisher@berkeley.edu
- Recruiting
UAB Pediatric Eye Care; Birmingham Health Care
Birmingham, Alabama, 35294
Kristine Hopkins, O.D.
- Recruiting
University of Alabama at Birmingham
Birmingham, Alabama, 35294
Katherine Weise, OD, MBA, 205-934-6739, kweise@uab.edu
- Recruiting
Indiana School of Optometry
Bloomington, Indiana, 47405
Don W. Lyon, O.D., 317-856-1964, dwlyon@Indiana.edu
Don W. Lyon, O.D.
- Recruiting
St Luke's Hospital
Boise, Idaho, 83702
Kevin Gertsch, MD, gertschk@slhs.org
- Recruiting
Boston Medical Center
Boston, Massachusetts, 02118
Stephen Christiansen, MD, 617-414-2020, spchris@bu.edu
- Recruiting
Boston Children's Hospital Waltham
Boston, Massachusetts, 02453
Aparna Raghuram, O.D., Ph.D., 617-355-6401, aparna.raghuram@childrens.harvard.edu
- Recruiting
Ross Eye Institute, University of Buffalo, Med School Dept Ophthalmology
Buffalo, New York, 14209
John H Lillvis, MD PhD, 716-881-7900, jhlillvi@buffalo.edu
- Recruiting
University of North Carolina
Chapel Hill, North Carolina, 27599
Katherine O Whitfield, MD, 919-966-5296, katherine_whitfield@med.unc.edu
- Recruiting
Ann & Robert H. Lurie Children's Hospital of Chicago
Chicago, Illinois, 60611
Bahram Rahmani, MD, 312-227-6189, BRahmani@luriechildrens.org
- Recruiting
Ticho Eye Associates
Chicago Ridge, Illinois, 60415
Benjamin Ticho, 708-423-4070, Bticho@mac.com
- Recruiting
Cincinnati Children's Hospital
Cincinnati, Ohio, 45229
Michael Gray, MD, 513-636-4751, Michael.Gray@cchmc.org
- Recruiting
Prisma Health
Columbia, South Carolina, 29203
Katie Keck, MD, katie.keck@prismahealth.org
Amelia Bartholdi, RN, 803-434-4328, amelia.bartholdi2@prismahealth.org
- Recruiting
Ohio State University College of Optometry
Columbus, Ohio, 43210-1280
Marjean T Kulp, O.D., (614) 688-3336, mtkulp@optometry.ohio-state.edu
Marjean T Kulp, O.D.
- Recruiting
Midwestern U Chicago College of Optometry
Downers Grove, Illinois, 60515
Samantha Rice, O.D, 630-743-4500, srice@midwestern.edu
- Recruiting
Zenith Vision Development Center
Duluth, Minnesota, 55811
RaeAnn M Nordwall, OD, 2182490685, rnordwall@zenithvisiondevelopment.com
- Recruiting
Duke University Eye Center
Durham, North Carolina, 27710
Nathan L Cheung, OD, nathan.cheung@duke.edu
- Recruiting
Pediatric Ophthalmology of Erie
Erie, Pennsylvania, 16501
Nicholas A Sala, D.O., (814) 454-6307, nasala@kidseyeserie.com
- Recruiting
Nova Southeastern University College of Optometry, The Eye Institute
Fort Lauderdale, Florida, 33382
Micheal Au, OD, 954-262-1426, michau@nova.edu
- Recruiting
Pediatric Eye Specialists, LLP
Fort Worth, Texas, 76014
Michael G Hunt, MD
- Recruiting
Marshall B. Ketchum University
Fullerton, California, 92831
Angela Chen, O.D., M.S., 714-449-7432, angelachen@ketchum.edu
Angela Chen, O.D., M.S.
- Recruiting
Midwestern University Eye Institute
Glendale, Arizona, 85308
Alicia Feis, OD, 623-806-7271, afeis@midwestern.edu
Christina A Esposito, OD
- Recruiting
Corewell Health
Grand Rapids, Michigan, 49503
Brooke Geddie, DO, 616-267-2605, brooke.geddie@helendevoschildrens.org
- Recruiting
Pediatric Ophthalmology, P.C.
Grand Rapids, Michigan, 49546
Patrick Droste, MD, (616) 957-0866, drdroste@comcast.net
- Recruiting
Baylor College of Medicine
Houston, Texas, 77030
Irene T Tung, MD, 832-822-3230
- Recruiting
Indiana University School of Optometry
Indianapolis, Indiana, 47405
Kathryn M Haider, MD, 317-944-8103, khaider@iupui.edu
Kathyrn M Haider, MD
- Recruiting
Univ of California, Irvine- Gavin Herbert Eye Institute
Irvine, California, 92697
Donny Suh, MD, MBA, 949-824-9089, dowsuh@gmail.com
- Recruiting
Nemours Children's Clinic
Jacksonville, Florida, 32207
John Erickson, OD, 904-697-3775, john.erickson@nemours.org
- Recruiting
Children's Mercy Hospitals and Clinics
Kansas City, Missouri, 64108
Jennifer Qayum, MD, 816-701-1337, jvqayum@cmh.edu
- Recruiting
Conestoga Eye
Lancaster, Pennsylvania, 17601
David Silbert, MD, 717-541-9700, davidsilbertmd@gmail.com
- Recruiting
Snowy Range Vision Center
Laramie, Wyoming, 82070
Amy Aldrich, 307-742-2020, aldrich@snowyrangevision.com
- Recruiting
Progressive Eye Care
Lisle, Illinois, 60532
Patricia Davis, M.D., 630-245-0989, idocmd@comcast.net
- Recruiting
Loma Linda University Health Care, Dept. of Ophthalmology
Loma Linda, California, 92354
Timothy Winter, M.D., 909-558-2168, twwinter@llu.edu
- Recruiting
Children's Hospital of Los Angeles (CHLA)
Los Angeles, California, 90027
Melinda Chang, MD, mchang@chla.usc.edu
- Recruiting
Texas Tech University Health Science Center
Lubbock, Texas, 79430
Lingkun Kong, 832-283-1577, lxxkong@gmail.com
- Recruiting
Southern College of Optometry
Memphis, Tennessee, 38104
Marie Bodack, OD, (901) 722-3276, mbodack@sco.edu
- Recruiting
Eye Physicians & Surgeons, PC
Milford, Connecticut, 06460
Jennifer A Galvin, MD, 203-795-0766, jennygalvin@gmail.com
- Recruiting
Vanderbilt University Medical Center - Vanderbilt Eye Institute
Nashville, Tennessee, 37232
Lori Ann Kehler, OD, 615-936-2020, lori.kehler@vanderbilt.edu
- Recruiting
NYU Langone Health
New York, New York, 10017
Zachary Elkin, MD, zachary.elkin@nyulangone.org
- Recruiting
State University of New York, College of Optometry
New York, New York, 10036
Marilyn Vricella, OD, (212) 780-5182, mvricella@sunyopt.edu
- Recruiting
Virginia Pediatric Eye Center
Norfolk, Virginia, 23502
Eric Crouch, MD, 757-461-0050, ercrouch@gmail.com
- Recruiting
Dean A. McGee Eye Institute
Oklahoma City, Oklahoma, 73104
Maria E Lim, maria-lim@dmei.org
- Recruiting
University of Nebraska Medical Center
Omaha, Nebraska, 68114
Samiksha Jain, MD, sjain@childrensomaha.org
- Recruiting
Stanford University
Palo Alto, California, 94303
Tawna L Roberts, OD, 650-724-7115, tawnar@stanford.edu
- Recruiting
Wills Eye Hospital
Philadelphia, Pennsylvania, 19107
Kammi B Gunton, MD, 215-928-3914, kbgunton@comcast.net
- Recruiting
Salus University/Pennsylvania College of Optometry
Philadelphia, Pennsylvania, 19141
Erin Jenewein, OD, (215) 276-6000, Ejenewein@salus.edu
- Recruiting
Arizonia Pediatric Eye Specialists
Phoenix, Arizona, 85006
James L Plotnik, MD, 480-513-6920, JPlotnik@phoenixchildrens.com
- Recruiting
UPMC Children's Eye Center of Children's Hospital of Pittsburgh
Pittsburgh, Pennsylvania, 15224
Ken Nischal, MD, 412-692-5918, nischalkk@upmc.edu
- Recruiting
Western University College of Optometry
Pomona, California, 91766
Ida Chung, OD, 909-469-8687, ichung@westernu.edu
- Recruiting
Casey Eye Institute
Portland, Oregon, 97239
Allison Summers, OD, 503-494-7830, summersa@ohsu.edu
- Recruiting
Mayo Clinic
Rochester, Minnesota, 55905
Erick D Bothun, bothun.erick@mayo.edu
- Recruiting
University of California, Davis
Sacramento, California, 95817
Benjamin G Jastrzembski, MD, benjast@ucdavis.edu
- Recruiting
Rocky Mountain Eye Care Associates
Salt Lake City, Utah, 84107
David Petersen, MD, 801-264-4450, DPetersen@RMEyecare.com
David Petersen, MD
- Recruiting
University of the Incarnate Word
San Antonio, Texas, 78209
Raelyn Ottenbreit, OD, ottenbre@uiwtx.edu
- Recruiting
San Antonio Eye Center
San Antonio, Texas, 78215
manpreet Chhabra, 210-226-6169 ext. 1005, manpreetch@gmail.com
- Recruiting
University of Incarnate Word Rosenberg School of Optometry
San Antonio, Texas, 78229
Aubrey D Breithaupt, OD, 210-283-6881, breithau@uiwtx.edu
- Recruiting
University of California San Francisco Department of Ophthalmology
San Francisco, California, 94143
Alejandra de Alba Campomanes, MD, 415-353-2560, dealbaa@vision.ucsf.edu
- Recruiting
PineCone Vision Center
Sartell, Minnesota, 56377
Kevy M Simmons, OD, 320-258-3915, ksimmons@pineconevisioncenter.com
- Recruiting
Seattle Children's Hospital, University of Washington
Seattle, Washington, 98105
Vivian Manh, O.D., M.S., 206-987-4950, vmanh@uw.edu
Vivian Manh, O.D., M.S>
- Recruiting
Spokane Eye Clinical Research
Spokane, Washington, 99204
Jeffrey Colburn, 509-456-0107, jcolburn@spokaneeye.com
- Recruiting
St. Louis Children's Hospital Eye Center
St Louis, Missouri, 63110
Margaret M Reynolds, MD, (314) 454-6026, margaret.reynolds@wustl.edu
- Recruiting
U of MO St. Louis College of Optometry
St Louis, Missouri, 63121
Erin Brooks, 314-516-5808, brooksem@umsl.edu
- Recruiting
University of South Florida (USF) Eye
Tampa, Florida, 33620
Syeda Basith, sysumara@gmail.com
- Recruiting
University of Arizona
Tucson, Arizona, 85711
Jonathan M Holmes, MD, (520) 321-3677, jmholmes@arizona.edu
- Recruiting
Wolfe Eye Clinic
West Des Moines, Iowa, 50266
Derek Bitner, MD, (800) 542-7957, dbitner@wolfeclinic.com
About this study
Official title: A Randomized Trial to Evaluate Sequential vs Simultaneous Spectacles Plus Patching for Amblyopia in Children 3 to <13 Years Old
A randomized trial to determine whether simultaneous treatment with spectacles and patching has an equivalent VA outcome compared with sequential treatment, first with spectacles alone followed by patching (if needed), for previously untreated amblyopia in children 3 to <13 years of age.
Read the detailed description
At an enrollment visit, distance VA will be measured in trial frames with or without cycloplegia based on a cycloplegic refraction performed within 30 days. If still apparently eligible, children will be prescribed spectacles and will then return for a spectacle baseline visit, where they will wear their new spectacles for the first time for at least 10 minutes (but no more than 24 hours) and will be tested in those new spectacles to confirm final eligibility prior to randomization.
Participants not found to be eligible in their new spectacles will end study participation. Participants eligible for the study will be randomly allocated to one of two treatment groups: Sequential (spectacles alone) and then patching if needed (monitored by ODM), or Simultaneous (spectacles and patching monitored by ODM).
After randomization, follow-up visits will occur at 8-week intervals through 56 weeks. At each visit on or after the 8-week visit, participants will be classified as either: stable/worsening or improving; those stable/worsening are then classified as having either resolved or residual amblyopia, provided that the current and most recent previous visit were completed at least 6-weeks apart (target 8 weeks) and provided the required test and retest VA testing was completed. Participants who are stable/worsening and have residual amblyopia in the sequential group will start patching (monitored by ODM) and continue to be followed every 8 weeks. Participants in the simultaneous group, or in the sequential group after having advanced to patching, who are stable/worsening but have residual amblyopia will be released to treatment at investigator discretion.
All participants continue 8-weekly visits until 56 weeks when Study participation ends.
- Conditions
- Amblyopia
- Being tested
- Patching, Glasses
- Keywords
- patching, glasses, spectacles, simultaneous, sequential
- Medical subject headings
- Amblyopia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PatchingOther
Also called Eye Patch
Procedure in which the eye is covered utilizing a patch to increase the strength of the uncovered eye.
GlassesOther
Also called Spectacles
Eye Glasses are created and worn by patient to improve vision
| Study group | Role | What they receive |
|---|---|---|
| Sequential treatment | Active comparator | full-time spectacle correction first, with subsequent patching for 2 hours per day/7 days per week only if needed (no improvement (stable/worsening) and residual) Receives: Other: Patching; Other: Glasses |
| Simultaneous treatment | Experimental | full-time spectacle correction and part-time patching for 2 hours per day/7 days per week Receives: Other: Patching; Other: Glasses |
What is being measured
The primary outcome is the main question the study is designed to answer.
Mean Change in Amblyopic Eye logMAR distance Visual Acuity
- Amblyopic eye VA (calculated as mean of test and retest) at the last visit that was the basis for a "stable resolved" or "stable residual" determination (in the sequential group, stable residual amblyopia criteria can be reached only after patching has been instituted); or
- 56-week visit amblyopic-eye VA (calculated as mean of test and retest) in those completing a 56-week visit without ever meeting criteria for "stable resolved" or "stable residual" amblyopia (if retest missing at 56 weeks, the single test value will be used).
Measured: 56 weeks
Secondary outcomes (7)
Pediatric Eye Questionnaire (PedEyeQ)
Rasch scores for each questionnaire item will be obtained from published look-up tables available at www.pedig.net, and used to calculate a score for each participant and a separate treatment group mean for the three PedEyeQ domains of the Child, Proxy and Parent PedEyeQ at randomization and at each visit. Scores will also be converted to a 0-100 scale to aid in interpretation. Multiplicity adjusted two sided P-values and confidence intervals will be produced.
Child PedEyeQ: Functional Vision, Bothered by Eyes and Vision, Social, Frustration / Worry Proxy PedEyeQ: Functional Vision, Bothered by Eyes and Vision, Social, Frustration / Worry, Eyecare Parent PedEyeQ: Impact on Parent and Family, Worry about Child's Eye Condition, Worry about Self-perception and Interactions, Worry about Functional Vision
Measured: 56 weeks
Proportion Achieving Stable Resolved Outcome with Spectacles Alone
The proportion of participants in the Sequential Spectacles group who achieve "stable resolved" outcome status with spectacles alone will be calculated, along with a multiplicity adjusted two sided P-value and confidence interval.
Measured: 56 Weeks
Proportion of participants who achieve Binary distance visual acuity outcomes
The proportion of participants who achieve the following binary outcomes will be tabulated by treatment group to aid in the interpretation of the primary outcome:
- The proportion of participants with outcome amblyopic-eye distance VA improvement of ≥ 2 logMAR lines (≥ 10 letters if E-ETDRS) from baseline.
- The proportion of participants with stable resolved VA.
Poisson regression with the log link will be used to estimate the relative risk of each outcome for the sequential versus simultaneous and a multiplicity adjusted two sided P-value and confidence interval. The Poisson models will include an adjustment for baseline amblyopic eye VA.
In the event the number of outcomes is too small for reliable estimation with Poisson regression,43 a treatment group difference and 95% confidence interval will be estimated using the Farrington-Manning Score test or other exact method with no adjustment for baseline VA.
Measured: 56 weeks
Time to Stable Resolved Amblyopia
For those participants who are classified as "stable resolved," the time from baseline to the time meeting that classification will be compared between treatment groups, using a Kaplan-Meier analysis with the logrank test. Multiplicity adjusted two sided P-values and confidence intervals will be produced.
Measured: 56 weeks
Difference in Mean Change of Distance Visual Acuity after 8 Weeks on Randomized Treatment
An analysis of covariance (ANCOVA) will be performed to compute the difference in mean change in amblyopic-eye distance logMAR VA after 8 weeks between the sequential and simultaneous treatment groups, adjusted for baseline amblyopic eye distance VA, and a multiplicity adjusted two sided P-value and confidence interval will be constructed on the treatment group difference for each time point.
Measured: 56 Weeks
Change in binocularity levels
Binocularity will be assessed on an ordered scale combining the results of the Randot Preschool Test, Randot butterfly, and Worth 4-Dot (W4D) at near. Results of each individual test also will be tabulated at baseline and at the final study visit according to treatment group.
The possible levels of binocularity will be 40, 60, 100, 200, 400, 800 seconds of arc (Randot Preschool test), 2000 seconds of arc (Randot butterfly), binocular perception by W4D (4 or 5 lights), or no binocular perception by W4D (2 or 3 lights). This yields an ordered binocularity scale with 9 ordered levels. The change in binocularity levels for each test will be tabulated and compared between treatment groups using the exact Wilcoxon rank-sum test. The proportion of participants in each treatment group unable to perform testing will be tabulated but these participants will not be included in the analysis of change.
Measured: 56 Weeks
Difference in mean change in amblyopic-eye log contrast sensitivity
Contrast sensitivity scores range from unable (<0.90), and then from 0.90 to 2.05 (by 0.05 log contrast sensitivity units). An analysis of covariance (ANCOVA) will be performed to compute the difference in mean change in amblyopic-eye log contrast sensitivity units between the sequential and simultaneous treatment groups, adjusted for baseline amblyopic eye contrast sensitivity, and a multiplicity adjusted two sided P-value and confidence interval will be produced.
Measured: 56 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted7 May 2020
- Study start8 Dec 2020
- Primary completion1 May 2028 (estimated)
- Study completion1 May 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for AmblyopiaStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 544 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Jaeb Center for Health Research
- Sponsor type
- University, hospital or other
- Collaborators
- National Eye Institute (NEI), Pediatric Eye Disease Investigator Group
- Responsible party
- Sponsor
- Investigators
- Vivian Manh, Study chair, Seattle Children's Hospital, University of WashingtonMichael Gray, Study chair, Children's Hospital Medical Center, Cincinnati
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04378790
- Sponsor's protocol ID
- ATS22
- Other IDs
- 2UG1EY011751
- Acronym
- ATS22
- Status last verified
- Feb 2026
- First submitted
- 5 May 2020
- Last updated
- 11 Feb 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: In accordance with the NIH data sharing policy, a de-identified database is placed in the public domain on the Pediatric Eye Disease Investigator Group (PEDIG) public website after the completion of each protocol and publication of the primary manuscript.
Study at a glance
From the registry record, last updated by the sponsor on 11 Feb 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized Trial to Evaluate Sequential vs Simultaneous Spectacles Plus Patching for Amblyopia in Children 3 to <13 Years Old
- ClinicalTrials.gov ID
- NCT04378790
- Acronym / sponsor ID
- ATS22 / ATS22
- Conditions
- Amblyopia
- Keywords
- patching, glasses, spectacles, simultaneous, sequential
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 544 participants (estimated)
- Lead sponsor
- Jaeb Center for Health ResearchUniversity, hospital or other
- Collaborators
- National Eye Institute (NEI), Pediatric Eye Disease Investigator Group
- Study start
- 8 Dec 2020 (actual)
- Primary completion
- 1 May 2028 (estimated)
- Study completion
- 1 May 2028 (estimated)
- First posted
- 7 May 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
A randomized trial to determine whether simultaneous treatment with spectacles and patching has an equivalent VA outcome compared with sequential treatment, first with spectacles alone followed by patching (if needed), for previously untreated amblyopia in children 3 to <13 years of age.
Detailed description
At an enrollment visit, distance VA will be measured in trial frames with or without cycloplegia based on a cycloplegic refraction performed within 30 days. If still apparently eligible, children will be prescribed spectacles and will then return for a spectacle baseline visit, where they will wear their new spectacles for the first time for at least 10 minutes (but no more than 24 hours) and will be tested in those new spectacles to confirm final eligibility prior to randomization.
Participants not found to be eligible in their new spectacles will end study participation. Participants eligible for the study will be randomly allocated to one of two treatment groups: Sequential (spectacles alone) and then patching if needed (monitored by ODM), or Simultaneous (spectacles and patching monitored by ODM).
After randomization, follow-up visits will occur at 8-week intervals through 56 weeks. At each visit on or after the 8-week visit, participants will be classified as either: stable/worsening or improving; those stable/worsening are then classified as having either resolved or residual amblyopia, provided that the current and most recent previous visit were completed at least 6-weeks apart (target 8 weeks) and provided the required test and retest VA testing was completed. Participants who are stable/worsening and have residual amblyopia in the sequential group will start patching (monitored by ODM) and continue to be followed every 8 weeks. Participants in the simultaneous group, or in the sequential group after having advanced to patching, who are stable/worsening but have residual amblyopia will be released to treatment at investigator discretion.
All participants continue 8-weekly visits until 56 weeks when Study participation ends.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Sequential treatment | Active comparator | Other: Patching, Other: Glassesfull-time spectacle correction first, with subsequent patching for 2 hours per day/7 days per week only if needed (no improvement (stable/worsening) and residual) |
| Simultaneous treatment | Experimental | Other: Patching, Other: Glassesfull-time spectacle correction and part-time patching for 2 hours per day/7 days per week |
Who may qualify
- Ages
- 3 to 13 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
Key inclusion criteria (29 listed)
- Age 3 to <13 years at the time of randomization
- Amblyopia associated with anisometropia, strabismus, or both
- No previous treatment for amblyopia, including no more than 24 hours of spectacle wear.
- Investigator planning to initiate spectacle correction of refractive error meeting the following criteria based on a cycloplegic refraction that has been performed within 30 days:
- At enrollment, single VA measured in each eye assessed in trial frames with the spectacle correction the investigator plans to prescribe, using the investigator's routine method as follows:
Key exclusion criteria (10 listed)
- Myopia greater than -6.00 D spherical equivalent in either eye.
- Previous intraocular or refractive surgery.
- Planned strabismus surgery in the next 56 weeks.
- Any previous treatment for amblyopia (patching, atropine, Bangerter filter, vision therapy, or binocular treatment).
- Previous spectacle or contact lens wear for more than 24 hours.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| PatchingAlso: Eye PatchProcedure in which the eye is covered utilizing a patch to increase the strength of the uncovered eye. | Other | Sequential treatment, Simultaneous treatment |
| GlassesAlso: SpectaclesEye Glasses are created and worn by patient to improve vision | Other | Sequential treatment, Simultaneous treatment |
Primary outcome
Mean Change in Amblyopic Eye logMAR distance Visual Acuity
Time frame: 56 weeks
1. Amblyopic eye VA (calculated as mean of test and retest) at the last visit that was the basis for a "stable resolved" or "stable residual" determination (in the sequential group, stable residual amblyopia criteria can be reached only after patching has been instituted); or 2. 56-week visit amblyopic-eye VA (calculated as mean of test and retest) in those completing a 56-week visit without ever meeting criteria for "stable resolved" or "stable residual" amblyopia (if retest missing at 56 weeks, the single test value will be used).
7 secondary outcomes
Pediatric Eye Questionnaire (PedEyeQ)
Time frame: 56 weeks
Proportion Achieving Stable Resolved Outcome with Spectacles Alone
Time frame: 56 Weeks
Proportion of participants who achieve Binary distance visual acuity outcomes
Time frame: 56 weeks
Time to Stable Resolved Amblyopia
Time frame: 56 weeks
Difference in Mean Change of Distance Visual Acuity after 8 Weeks on Randomized Treatment
Time frame: 56 Weeks
Change in binocularity levels
Time frame: 56 Weeks
Difference in mean change in amblyopic-eye log contrast sensitivity
Time frame: 56 weeks
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Feb 2026.
- Individual participant dataSharing planned: Yes. In accordance with the NIH data sharing policy, a de-identified database is placed in the public domain on the Pediatric Eye Disease Investigator Group (PEDIG) public website after the completion of each protocol and publication of the primary manuscript.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Brooke P Fimbel contact
Vivian Manh study chair
Seattle Children's Hospital, University of Washington
Michael Gray study chair
Children's Hospital Medical Center, Cincinnati
68 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Patching and Glasses in people with Amblyopia, run by Jaeb Center for Health Research at 68 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 29 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 11 Feb 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 68 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Raymond T Kraker, MSPH (813-975-8690, rkraker@jaeb.org), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Mean Change in Amblyopic Eye logMAR distance Visual Acuity (time frame: 56 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Feb 2026.