AmblyopiaPhase 3ATS17NCT01190813
Levodopa for the Treatment of Residual Amblyopia
A Phase 3 study testing Levodopa/Carbidopa and Patching in people with Amblyopia, run by Jaeb Center for Health Research at 1 site in United States.
Trial summary
The purpose of this study is to evaluate the efficacy and safety of oral levodopa and patching versus oral placebo and patching as treatment for residual amblyopia in children 7 to <13 years old with visual acuity of 20/50 to 20/400 in the amblyopic eye. Read more about this study
- Who is it for?
- Ages 7 to 12 years
- Conditions the study is for
- Amblyopia
- What is being tested?
- Levodopa/Carbidopa and Patching
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 139 participants
- Where
- 1 siteUnited States
- Study dates
- Sep 2010to Apr 2014
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
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 7 to 12 years
- All sexes
- No healthy volunteers
- Child
Who may be able to join
- Age 7 to 12
- Amblyopia associated with strabismus, anisometropia, or both
- Criteria for strabismus: One of the following criteria must be met: Heterotropia at distance and/or near fixation on examination (with or without spectacles); History of strabismus surgery; Documented history of strabismus which is no longer present (which in the judgment of the investigator could have caused amblyopia)
- Criteria for anisometropia: One of the following criteria must be met: ≥0.50 D difference between eyes in spherical equivalent; ≥1.50 D difference between eyes in astigmatism in any meridian
- Visual acuity, measured in each eye (amblyopic eye without cycloplegia) within 7 days prior to enrollment using the E-ETDRS protocol by a study certified visual acuity tester as follows:
- Visual acuity in the amblyopic eye 18 to 67 letters inclusive (20/50 to 20/400)
Show all 24Show fewer
- Visual acuity in the fellow eye ≥78 letters (20/25 or better)
- Current amblyopia treatment (other than spectacles)
- 12 weeks of at least 2 hours of occlusion per day prescribed for the fellow eye during the immediate pre-enrollment period.
- While on current treatment, visual acuity has not improved one line (5 letters) or more since a non-study visit at least 6 weeks ago. Both acuity measurements to define no improvement must have been done using the same testing method.
- Treatment with atropine at any time during this pre-enrollment period is not allowed.
- Any treatment prior to the current patching episode with stable acuity is acceptable.
- Spectacle correction (if applicable) for measurement of enrollment visual acuity must meet the following criteria and be based on a cycloplegic refraction that is no more than 6 months old:
- Requirements for spectacle correction:
- Spherical equivalent must be within 0.50 D of fully correcting the anisometropia.
- Hypermetropia of 3.00D or more must be corrected.
- Hypermetropia must not be under corrected by more than 1.50 D spherical equivalent, and reduction in plus sphere must be symmetric in the two eyes.
- Cylinder power in both eyes must be within 0.50 D of fully correcting the astigmatism.
- Cylinder axis in both eyes is within 6 degrees of the axis in the spectacles when cylinder power is ≥1.00 D.
- Myopia of amblyopic eye greater than 0.50 D by spherical equivalent must be corrected, and the glasses must not under correct the myopia by more than 0.25 D or overcorrect it by more than 0.50 D.
- Spectacles meeting above criteria must be worn :until visual acuity in amblyopic eye is stable (defined as 2 consecutive visual acuity measurements by the same testing method at least 4 weeks apart with no improvement of one line (5 letters) or more.
- Eye examination within 6 months prior to enrollment
- Parent available for at least one year of follow-up, has access to phone), and willing to be contacted by clinical site and Jaeb Center staff
- In the investigator's judgment, the subject is likely to comply with prescribed treatment (e.g., no history of poor compliance with patching treatment) and unlikely to continue to improve by using 2 hours of patching per day alone.
Who cannot join
- Myopia more than -6.00 D (spherical equivalent) in either eye.
- Current vision therapy or orthoptics
- Ocular cause for reduced visual acuity
- nystagmus per se does not exclude the subject if the above visual acuity criteria are met
- Prior intraocular or refractive surgery
- History of narrow-angle glaucoma
Show all 22Show fewer
- Bronchial asthma or severe pulmonary disease
- Strabismus surgery planned within 26 weeks
- Known allergy to levodopa or carbidopa
- History of dystonic reactions
- Current use of oral iron supplements including multivitamins containing iron during treatment with levodopa-carbidopa
- Current use of antihypertensive, anti-depressant medications, phenothiazines, butyrophenones, risperidone and isoniazid, non-specific monoamine oxidase inhibitors, or medication for the treatment of attention deficit hyperactivity disorder
- Known liver disease
- History of melanoma
- Known psychological problems
- Known skin reactions to patch or bandage adhesives
- Prior levodopa treatment
- Treatment with topical ophthalmic atropine within the past 12 weeks
- A physician-prescribed diet high in protein
- Females who are pregnant, lactating, or intend to become pregnant within the next 34 weeks.
- A negative urine pregnancy test will be required for all females who have experienced menarche.
- Requirements regarding pregnancy testing prior to enrollment may be further defined by each individual Institutional Review Board.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: A Randomized Trial of Levodopa as Treatment for Residual Amblyopia (ATS 17)
The purpose of this study is to evaluate the efficacy and safety of oral levodopa and patching versus oral placebo and patching as treatment for residual amblyopia in children 7 to <13 years old with visual acuity of 20/50 to 20/400 in the amblyopic eye.
Read the detailed description
Amblyopia is the most common cause of monocular visual impairment in both children and young and middle-aged adults. Both patching and atropine are accepted treatment modalities for the management of moderate amblyopia in children. Despite best efforts with conventional amblyopia treatment, many older children and teenagers with amblyopia fail to achieve normal visual acuity in the amblyopic eye. In a previous PEDIG study where children 7 to 12 years old were treated with atropine and patching, only 36% of the children with moderate amblyopia and only 23% of the children with severe amblyopia achieved 20/40 or better acuity.
Many clinicians have recognized that conventional therapies with patching and atropine have not been universally successful and have sought alternatives. PEDIG has discussed for several years the problem of residual amblyopia and how the remaining visual acuity deficit could be reduced. A number of research groups have evaluated the short term use of oral levodopa-carbidopa as an adjunct to patching therapy for older children.
- Conditions
- Amblyopia
- Being tested
- Levodopa/Carbidopa, Placebo, Patching
- Keywords
- amblyopia, levodopa
- Medical subject headings
- Amblyopia
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Levodopa/CarbidopaDrug
Oral levodopa 0.76 mg/kg tid with carbidopa 0.17 mg/kg tid
PlaceboDrug
Oral placebo tid
PatchingOther
Two hours of daily patching
| Study group | Role | What they receive |
|---|---|---|
| Levodopa/Carbidopa | Active comparator | Levodopa 0.76 mg/kg with Carbidopa 0.17 mg/kg tid Receives: Drug: Levodopa/Carbidopa; Other: Patching |
| Placebo | Placebo comparator | Oral placebo tid Receives: Drug: Placebo; Other: Patching |
What is being measured
The primary outcome is the main question the study is designed to answer.
Distribution of Amblyopic Eye Visual Acuity Change From Baseline
The primary outcome is the amblyopic eye visual acuity letter score measured at the 18-week primary outcome visit following a rapid taper of study medicine beginning at week 16. The primary analytic approach will be a treatment group comparison of the mean amblyopic eye visual acuity adjusted for baseline acuity.
Visual acuity was measured in each eye (right eye first) by a study-certified VA tester using the Electronic Early Treatment of Diabetic Retinopathy Study (E-ETDRS©) visual acuity protocol. Five letters is equivalent to one logMAR line.
Measured: 18 weeks after enrollment
Mean Amblyopic Eye Visual Acuity Change From Baseline
The primary outcome is the amblyopic eye visual acuity letter score measured at the 18-week primary outcome visit following a rapid taper of study medicine beginning at week 16. The primary analytic approach will be a treatment group comparison of the mean amblyopic eye visual acuity adjusted for baseline acuity.
Visual acuity was measured in each eye (right eye first) by a study-certified VA tester using the Electronic Early Treatment of Diabetic Retinopathy Study (E-ETDRS©) visual acuity protocol. Five letters is equivalent to one logMAR line.
Measured: 18 weeks after enrollment
Secondary outcomes (41)
Amblyopic Eye Visual Acuity Improvement Treatment Group Comparison at 18 Weeks
Treatment group comparisons of the proportion of subjects who have improved from baseline by 10 or more letters.
Measured: 18 weeks after enrollment
Distribution of Amblyopic Eye Visual Acuity at 18 Weeks
Measured: 18 weeks after enrollment
Mean Amblyopic Eye Visual Acuity at 18 Weeks
Visual acuity was measured in each eye (right eye first) by a study-certified VA tester using the Electronic Early Treatment of Diabetic Retinopathy Study (E-ETDRS©) visual acuity protocol. Five letters is equivalent to one logMAR line.
Measured: 18 weeks after enrollment
Amblyopic Eye Visual Acuity Improvement Treatment Group Comparison at 4 Weeks
Treatment group comparisons adjusted for baseline acuity scores using logistic regression of the proportion of subjects who have improved from baseline by 10 or more letters.
Measured: 4 weeks after enrollment
Amblyopic Eye Visual Acuity Improvement Treatment Group Comparison at 10 Weeks
Treatment group comparisons of the proportion of subjects who have improved from baseline by 10 or more letters.
Measured: 10 weeks after enrollment
Amblyopic Eye Visual Acuity Improvement Treatment Group Comparison at 16 Weeks
Treatment group comparisons of the proportion of subjects who have improved from baseline by 10 or more letters.
Measured: 16 weeks after enrollment
Amblyopic Eye Visual Acuity Improvement Treatment Group Comparison at 26 Weeks
Treatment group comparisons adjusted for baseline acuity scores using logistic regression of the proportion of subjects who have improved from baseline by 10 or more letters.
Measured: 26 weeks after enrollment
Amblyopia Resolutionat 4 Weeks
Treatment group comparisons adjusted for baseline acuity scores using logistic regression of the proportion of subjects with 20/25 or better visual acuity.
Measured: 4 weeks after enrollment
Amblyopia Resolution at 10 Weeks
Treatment group comparisons adjusted for baseline acuity scores using logistic regression of the proportion of subjects with 20/25 or better visual acuity.
Measured: 10 weeks after enrollment
Amblyopia Resolution at 16 Weeks
Treatment group comparisons adjusted for baseline acuity scores using logistic regression of the proportion of subjects with 20/25 or better visual acuity.
Measured: 16 weeks after enrollment
Amblyopia Resolution at 18 Weeks
Treatment group comparisons adjusted for baseline acuity scores using logistic regression of the proportion of subjects with 20/25 or better visual acuity.
Measured: 18 weeks after enrollment
Amblyopia Resolution at 26 Weeks
Treatment group comparisons adjusted for baseline acuity scores using logistic regression of the proportion of subjects with 20/25 or better visual acuity.
Measured: 26 weeks after enrollment
Distribution of Amblyopic Eye Visual Acuity Change From Baseline at 4 Weeks
Visual acuity was measured in each eye (right eye first) by a study-certified VA tester using the Electronic Early Treatment of Diabetic Retinopathy Study (E-ETDRS©) visual acuity protocol. Five letters is equivalent to one logMAR line.
Measured: 4 weeks after enrollment
Mean Change in Amblyopic Eye Visual Acuity From Baseline at 4 Weeks
A treatment group comparison of the mean amblyopic eye visual acuity at 4 weeks after enrollment, adjusted for baseline acuity.
Measured: 4 weeks after enrollment
Distribution of Amblyopic Eye Visual Acuity Change From Baseline at 10 Weeks
Visual acuity was measured in each eye (right eye first) by a study-certified VA tester using the Electronic Early Treatment of Diabetic Retinopathy Study (E-ETDRS©) visual acuity protocol. Five letters is equivalent to one logMAR line.
Measured: 10 weeks after enrollment
Mean Change in Amblyopic Eye Visual Acuity From Baseline at 10 Weeks
A treatment group comparison of the mean amblyopic eye visual acuity at 10 weeks after enrollment, adjusted for baseline acuity. Visual acuity was measured in each eye (right eye first) by a study-certified VA tester using the Electronic Early Treatment of Diabetic Retinopathy Study (E-ETDRS©) visual acuity protocol. Five letters is equivalent to one logMAR line.
Measured: 10 weeks after enrollment
Distribution of Amblyopic Eye Visual Acuity Change From Baseline at 16 Weeks
Visual acuity was measured in each eye (right eye first) by a study-certified VA tester using the Electronic Early Treatment of Diabetic Retinopathy Study (E-ETDRS©) visual acuity protocol. Five letters is equivalent to one logMAR line.
Measured: 16 weeks after enrollment
Mean Change in Amblyopic Eye Visual Acuity From Baseline at 16 Weeks
A treatment group comparison of the mean amblyopic eye visual acuity at 16 weeks after enrollment, adjusted for baseline acuity. Visual acuity was measured in each eye (right eye first) by a study-certified VA tester using the Electronic Early Treatment of Diabetic Retinopathy Study (E-ETDRS©) visual acuity protocol. Five letters is equivalent to one logMAR line.
Measured: 16 weeks after enrollment
Distribution of Amblyopic Eye Visual Acuity Change From Baseline at 26 Weeks
Visual acuity was measured in each eye (right eye first) by a study-certified VA tester using the Electronic Early Treatment of Diabetic Retinopathy Study (E-ETDRS©) visual acuity protocol. Five letters is equivalent to one logMAR line.
Measured: 26 weeks after enrollment
Mean Change in Amblyopic Eye Visual Acuity From Baseline at 26 Weeks
A treatment group comparison of the mean amblyopic eye visual acuity at 26 weeks after enrollment, adjusted for baseline acuity. Visual acuity was measured in each eye (right eye first) by a study-certified VA tester using the Electronic Early Treatment of Diabetic Retinopathy Study (E-ETDRS©) visual acuity protocol. Five letters is equivalent to one logMAR line.
Measured: 26 weeks after enrollment
Distribution of Fellow Eye Visual Acuity at 18 Weeks
Similar to the analysis for the amblyopic eye, the fellow eye visual acuity will be evaluated to determine if study treatment had an adverse effect on the occluded eye. The analysis will be a treatment group comparison of the mean fellow eye visual acuity at 18 weeks after enrollment, adjusted for baseline acuity.
Measured: 18 weeks after enrollment
Mean Fellow Eye Visual Acuity at 18 Weeks
Visual acuity was measured in each eye (right eye first) by a study-certified VA tester using the Electronic Early Treatment of Diabetic Retinopathy Study (E-ETDRS©) visual acuity protocol. Five letters is equivalent to one logMAR line.
Measured: 18 weeks after enrollment
Distribution of Fellow Eye Visual Acuity Change From Baseline at 18 Weeks
Visual acuity was measured in each eye (right eye first) by a study-certified VA tester using the Electronic Early Treatment of Diabetic Retinopathy Study (E-ETDRS©) visual acuity protocol. Five letters is equivalent to one logMAR line.
Measured: 18 weeks after enrollment
Mean Fellow Eye Visual Acuity Change From Baseline at 18 Weeks
Visual acuity was measured in each eye (right eye first) by a study-certified VA tester using the Electronic Early Treatment of Diabetic Retinopathy Study (E-ETDRS©) visual acuity protocol. Five letters is equivalent to one logMAR line.
Measured: 18 weeks after enrollment
Mean Child Symptom Survey Score at Enrollment
A treatment group comparison of symptom survey scores at enrollment. The average of the overall item responses will be calculated and compared by treatment group with a t-test for difference in means. A higher number reflects a more negative response (5=always, 4=often, 3=sometimes, 2=rarely, 1=never).
Measured: At enrollment
Mean Child Symptom Survey Score at 4 Weeks
A treatment group comparison of symptom survey scores at the 4 week visit. The average of the overall item responses will be calculated and compared by treatment group with a t-test for difference in means. A higher number reflects a more negative response (5=always, 4=often, 3=sometimes, 2=rarely, 1=never).
Measured: 4 weeks after enrollment
Mean Child Symptom Survey Score at 10 Weeks
A treatment group comparison of symptom survey scores at the 10 week visit. The average of the overall item responses will be calculated and compared by treatment group with a t-test for difference in means. A higher number reflects a more negative response (5=always, 4=often, 3=sometimes, 2=rarely, 1=never).
Measured: 10 weeks after enrollment
Mean Child Symptom Survey Score at 16 Weeks
A treatment group comparison of symptom survey scores at the 16 week visit. The average of the overall item responses will be calculated and compared by treatment group with a t-test for difference in means. A higher number reflects a more negative response (5=always, 4=often, 3=sometimes, 2=rarely, 1=never).
Measured: 16 weeks after enrollment
Mean Child Symptom Survey Score at 18 Weeks
A treatment group comparison of symptom survey scores at the primary outcome (18 week) visit. The average of the overall item responses will be calculated and compared by treatment group with a t-test for difference in means. A higher number reflects a more negative response (5=always, 4=often, 3=sometimes, 2=rarely, 1=never).
Measured: 18 weeks after enrollment
Mean Child Symptom Survey Score at 26 Weeks
A treatment group comparison of symptom survey scores at the 26 week visit. The average of the overall item responses will be calculated and compared by treatment group with a t-test for difference in means. A higher number reflects a more negative response (5=always, 4=often, 3=sometimes, 2=rarely, 1=never).
Measured: 26 weeks after enrollment
Mean Parent Symptom Survey Score at Enrollment
A treatment group comparison of symptom survey scores at enrollment. The average of the overall item responses will be calculated and compared by treatment group with a t-test for difference in means. A higher number reflects a more negative response (5=always, 4=often, 3=sometimes, 2=rarely, 1=never).
Measured: At enrollment
Mean Parent Symptom Survey Score at 4 Weeks
A treatment group comparison of symptom survey scores at the 4 week visit. The average of the overall item responses will be calculated and compared by treatment group with a t-test for difference in means. A higher number reflects a more negative response (5=always, 4=often, 3=sometimes, 2=rarely, 1=never).
Measured: 4 weeks after enrollment
Mean Parent Symptom Survey Score at 10 Weeks
A treatment group comparison of symptom survey scores at the 10 week visit. The average of the overall item responses will be calculated and compared by treatment group with a t-test for difference in means. A higher number reflects a more negative response (5=always, 4=often, 3=sometimes, 2=rarely, 1=never).
Measured: 10 weeks after enrollment
Mean Parent Symptom Survey Score at 16 Weeks
A treatment group comparison of symptom survey scores at the 16 week visit. The average of the overall item responses will be calculated and compared by treatment group with a t-test for difference in means. A higher number reflects a more negative response (5=always, 4=often, 3=sometimes, 2=rarely, 1=never).
Measured: 16 weeks after enrollment
Mean Parent Symptom Survey Score at 18 Weeks
A treatment group comparison of symptom survey scores at the primary outcome (18 week) visit. The average of the overall item responses will be calculated and compared by treatment group with a t-test for difference in means. A higher number reflects a more negative response (5=always, 4=often, 3=sometimes, 2=rarely, 1=never).
Measured: 18 weeks after enrollment
Mean Parent Symptom Survey Score at 26 Weeks
A treatment group comparison of symptom survey scores at the 26 week visit. The average of the overall item responses will be calculated and compared by treatment group with a t-test for difference in means. A higher number reflects a more negative response (5=always, 4=often, 3=sometimes, 2=rarely, 1=never).
Measured: 26 weeks after enrollment
Mean Systemic Adverse Events
Measured: Enrollment through 26 weeks
Distribution of Fellow Eye Visual Acuity at 26 Weeks
Similar to the analysis for the amblyopic eye, the fellow eye visual acuity will be evaluated to determine if study treatment had an adverse effect on the occluded eye. The analysis will be a treatment group comparison of the mean fellow eye visual acuity at 26 weeks after enrollment, adjusted for baseline acuity.
Measured: 26 weeks after enrollment
Mean Fellow Eye Visual Acuity at 26 Weeks
Visual acuity was measured in each eye (right eye first) by a study-certified VA tester using the Electronic Early Treatment of Diabetic Retinopathy Study (E-ETDRS©) visual acuity protocol. Five letters is equivalent to one logMAR line.
Measured: 26 weeks after enrollment
Distribution of Fellow Eye Visual Acuity Change From Baseline at 26 Weeks
Visual acuity was measured in each eye (right eye first) by a study-certified VA tester using the Electronic Early Treatment of Diabetic Retinopathy Study (E-ETDRS©) visual acuity protocol. Five letters is equivalent to one logMAR line.
Measured: 26 weeks after enrollment
Mean Fellow Eye Visual Acuity Change From Baseline at 26 Weeks
Visual acuity was measured in each eye (right eye first) by a study-certified VA tester using the Electronic Early Treatment of Diabetic Retinopathy Study (E-ETDRS©) visual acuity protocol. Five letters is equivalent to one logMAR line.
Measured: 26 weeks after enrollment
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted30 Aug 2010 (estimated)
- Study startSep 2010
- Primary completionJan 2014
- Study completionApr 2014
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- 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
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 139 participants (actual)
Sponsor and investigators
- Lead sponsor
- Jaeb Center for Health Research
- Sponsor type
- University, hospital or other
- Collaborators
- National Eye Institute (NEI)
- Responsible party
- Sponsor
- Investigators
- Michael X Repka, MD, Study chair, Jaeb Center for Health Research
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01190813
- Sponsor's protocol ID
- ATS 17
- Other IDs
- 2U10EY011751
- Acronym
- ATS17
- Status last verified
- May 2016
- First submitted
- 17 Aug 2010
- Last updated
- 2 Jun 2016
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- Individual data sharing
- Yes: A de-identified dataset is available on the PEDIG public website at http://pedig.jaeb.org/Studies.aspx?RecID=196
Publications
Pediatric Eye Disease Investigator Group; Repka MX, Kraker RT, Dean TW, Beck RW, Siatkowski RM, Holmes JM, Beauchamp CL, Golden RP, Miller AM, Verderber LC, Wallace DK. A randomized trial of levodopa as treatment for residual amblyopia in older children. Ophthalmology. 2015 May;122(5):874-81. doi: 10.1016/j.ophtha.2015.01.002. Epub 2015 Feb 9.
PubMed 25676904
Study at a glance
From the registry record, last updated by the sponsor on 2 Jun 2016. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized Trial of Levodopa as Treatment for Residual Amblyopia (ATS 17)
- ClinicalTrials.gov ID
- NCT01190813
- Acronym / sponsor ID
- ATS17 / ATS 17
- Conditions
- Amblyopia
- Keywords
- amblyopia, levodopa
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 139 participants (actual)
- Lead sponsor
- Jaeb Center for Health ResearchUniversity, hospital or other
- Collaborators
- National Eye Institute (NEI)
- Study start
- Sep 2010
- Primary completion
- Jan 2014 (actual)
- Study completion
- Apr 2014 (actual)
- First posted
- 30 Aug 2010 (estimated)
- Results
- Posted 13 Feb 2015
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to evaluate the efficacy and safety of oral levodopa and patching versus oral placebo and patching as treatment for residual amblyopia in children 7 to <13 years old with visual acuity of 20/50 to 20/400 in the amblyopic eye.
Detailed description
Amblyopia is the most common cause of monocular visual impairment in both children and young and middle-aged adults. Both patching and atropine are accepted treatment modalities for the management of moderate amblyopia in children. Despite best efforts with conventional amblyopia treatment, many older children and teenagers with amblyopia fail to achieve normal visual acuity in the amblyopic eye. In a previous PEDIG study where children 7 to 12 years old were treated with atropine and patching, only 36% of the children with moderate amblyopia and only 23% of the children with severe amblyopia achieved 20/40 or better acuity.
Many clinicians have recognized that conventional therapies with patching and atropine have not been universally successful and have sought alternatives. PEDIG has discussed for several years the problem of residual amblyopia and how the remaining visual acuity deficit could be reduced. A number of research groups have evaluated the short term use of oral levodopa-carbidopa as an adjunct to patching therapy for older children.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Levodopa/Carbidopa | Active comparator | Drug: Levodopa/Carbidopa, Other: PatchingLevodopa 0.76 mg/kg with Carbidopa 0.17 mg/kg tid |
| Placebo | Placebo comparator | Drug: Placebo, Other: PatchingOral placebo tid |
Who may qualify
- Ages
- 7 to 12 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
Key inclusion criteria (24 listed)
- Age 7 to 12
- Amblyopia associated with strabismus, anisometropia, or both
- Visual acuity, measured in each eye (amblyopic eye without cycloplegia) within 7 days prior to enrollment using the E-ETDRS protocol by a study certified visual acuity tester as follows:
- Current amblyopia treatment (other than spectacles)
- Spectacle correction (if applicable) for measurement of enrollment visual acuity must meet the following criteria and be based on a cycloplegic refraction that is no more than 6 months old:
Key exclusion criteria (22 listed)
- Myopia more than -6.00 D (spherical equivalent) in either eye.
- Current vision therapy or orthoptics
- Ocular cause for reduced visual acuity
- Prior intraocular or refractive surgery
- History of narrow-angle glaucoma
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 |
|---|---|---|
| Levodopa/CarbidopaOral levodopa 0.76 mg/kg tid with carbidopa 0.17 mg/kg tid | Drug | Levodopa/Carbidopa |
| PlaceboOral placebo tid | Drug | Placebo |
| PatchingTwo hours of daily patching | Other | Levodopa/Carbidopa, Placebo |
Primary outcome
Distribution of Amblyopic Eye Visual Acuity Change From Baseline
Time frame: 18 weeks after enrollment
The primary outcome is the amblyopic eye visual acuity letter score measured at the 18-week primary outcome visit following a rapid taper of study medicine beginning at week 16. The primary analytic approach will be a treatment group comparison of the mean amblyopic eye visual acuity adjusted for baseline acuity. Visual acuity was measured in each eye (right eye first) by a study-certified VA tester using the Electronic Early Treatment of Diabetic Retinopathy Study (E-ETDRS©) visual acuity protocol. Five letters is equivalent to one logMAR line.
Mean Amblyopic Eye Visual Acuity Change From Baseline
Time frame: 18 weeks after enrollment
The primary outcome is the amblyopic eye visual acuity letter score measured at the 18-week primary outcome visit following a rapid taper of study medicine beginning at week 16. The primary analytic approach will be a treatment group comparison of the mean amblyopic eye visual acuity adjusted for baseline acuity. Visual acuity was measured in each eye (right eye first) by a study-certified VA tester using the Electronic Early Treatment of Diabetic Retinopathy Study (E-ETDRS©) visual acuity protocol. Five letters is equivalent to one logMAR line.
41 secondary outcomes
Amblyopic Eye Visual Acuity Improvement Treatment Group Comparison at 18 Weeks
Time frame: 18 weeks after enrollment
Distribution of Amblyopic Eye Visual Acuity at 18 Weeks
Time frame: 18 weeks after enrollment
Mean Amblyopic Eye Visual Acuity at 18 Weeks
Time frame: 18 weeks after enrollment
Amblyopic Eye Visual Acuity Improvement Treatment Group Comparison at 4 Weeks
Time frame: 4 weeks after enrollment
Amblyopic Eye Visual Acuity Improvement Treatment Group Comparison at 10 Weeks
Time frame: 10 weeks after enrollment
Amblyopic Eye Visual Acuity Improvement Treatment Group Comparison at 16 Weeks
Time frame: 16 weeks after enrollment
Amblyopic Eye Visual Acuity Improvement Treatment Group Comparison at 26 Weeks
Time frame: 26 weeks after enrollment
Amblyopia Resolutionat 4 Weeks
Time frame: 4 weeks after enrollment
Amblyopia Resolution at 10 Weeks
Time frame: 10 weeks after enrollment
Amblyopia Resolution at 16 Weeks
Time frame: 16 weeks after enrollment
Amblyopia Resolution at 18 Weeks
Time frame: 18 weeks after enrollment
Amblyopia Resolution at 26 Weeks
Time frame: 26 weeks after enrollment
Distribution of Amblyopic Eye Visual Acuity Change From Baseline at 4 Weeks
Time frame: 4 weeks after enrollment
Mean Change in Amblyopic Eye Visual Acuity From Baseline at 4 Weeks
Time frame: 4 weeks after enrollment
Distribution of Amblyopic Eye Visual Acuity Change From Baseline at 10 Weeks
Time frame: 10 weeks after enrollment
Mean Change in Amblyopic Eye Visual Acuity From Baseline at 10 Weeks
Time frame: 10 weeks after enrollment
Distribution of Amblyopic Eye Visual Acuity Change From Baseline at 16 Weeks
Time frame: 16 weeks after enrollment
Mean Change in Amblyopic Eye Visual Acuity From Baseline at 16 Weeks
Time frame: 16 weeks after enrollment
Distribution of Amblyopic Eye Visual Acuity Change From Baseline at 26 Weeks
Time frame: 26 weeks after enrollment
Mean Change in Amblyopic Eye Visual Acuity From Baseline at 26 Weeks
Time frame: 26 weeks after enrollment
Distribution of Fellow Eye Visual Acuity at 18 Weeks
Time frame: 18 weeks after enrollment
Mean Fellow Eye Visual Acuity at 18 Weeks
Time frame: 18 weeks after enrollment
Distribution of Fellow Eye Visual Acuity Change From Baseline at 18 Weeks
Time frame: 18 weeks after enrollment
Mean Fellow Eye Visual Acuity Change From Baseline at 18 Weeks
Time frame: 18 weeks after enrollment
Mean Child Symptom Survey Score at Enrollment
Time frame: At enrollment
Mean Child Symptom Survey Score at 4 Weeks
Time frame: 4 weeks after enrollment
Mean Child Symptom Survey Score at 10 Weeks
Time frame: 10 weeks after enrollment
Mean Child Symptom Survey Score at 16 Weeks
Time frame: 16 weeks after enrollment
Mean Child Symptom Survey Score at 18 Weeks
Time frame: 18 weeks after enrollment
Mean Child Symptom Survey Score at 26 Weeks
Time frame: 26 weeks after enrollment
Mean Parent Symptom Survey Score at Enrollment
Time frame: At enrollment
Mean Parent Symptom Survey Score at 4 Weeks
Time frame: 4 weeks after enrollment
Mean Parent Symptom Survey Score at 10 Weeks
Time frame: 10 weeks after enrollment
Mean Parent Symptom Survey Score at 16 Weeks
Time frame: 16 weeks after enrollment
Mean Parent Symptom Survey Score at 18 Weeks
Time frame: 18 weeks after enrollment
Mean Parent Symptom Survey Score at 26 Weeks
Time frame: 26 weeks after enrollment
Mean Systemic Adverse Events
Time frame: Enrollment through 26 weeks
Distribution of Fellow Eye Visual Acuity at 26 Weeks
Time frame: 26 weeks after enrollment
Mean Fellow Eye Visual Acuity at 26 Weeks
Time frame: 26 weeks after enrollment
Distribution of Fellow Eye Visual Acuity Change From Baseline at 26 Weeks
Time frame: 26 weeks after enrollment
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 2 Jun 2016.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Results publication: PubMed 25676904Pediatric Eye Disease Investigator Group; Repka MX, Kraker RT, Dean TW, Beck RW, Siatkowski RM, Holmes JM, Beauchamp CL, Golden RP, Miller AM, Verderber LC, Wallace DK. A randomized trial of levodopa as treatment for residual amblyopia in older children. Ophthalmology. 2015 May;122(5):874-81. doi: 10.1016/j.ophtha.2015.01.002. Epub 2015 Feb 9.
- PubMed abstractLink provided by the sponsor.
- PubMed Central HHS Public Access - Full TextLink provided by the sponsor.
- Individual participant dataSharing planned: Yes. A de-identified dataset is available on the PEDIG public website at http://pedig.jaeb.org/Studies.aspx?RecID=196
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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. This study is not recruiting at the moment.
Michael X Repka, MD study chair
Jaeb Center for Health Research
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Levodopa/Carbidopa and Patching in people with Amblyopia, run by Jaeb Center for Health Research at 1 site 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 24 inclusion and 22 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: finished, as of the sponsor's last update on 2 Jun 2016. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site 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. Some participants in this study may receive a placebo. 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?
Yes. Results are posted in the registry (first posted 13 Feb 2015). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Distribution of Amblyopic Eye Visual Acuity Change From Baseline (time frame: 18 weeks after enrollment). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01190813, which also lists 1 linked publication.
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 2 Jun 2016.