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Design of the Monitored Occlusion Treatment of Amblyopia Study (MOTAS)

¹ Department of Ophthalmology, Imperial College of Science, Technology and Medicine, London, UK
² Department of Mathematics, Imperial College of Science, Technology and Medicine, London, UK

Correspondence to:
Correspondence to:
Catherine E Stewart, Department of Ophthalmology, Imperial College of Science, Technology and Medicine, Western Eye Hospital, 171 Marylebone Road, London NW1 5QH, UK

Background/aims: The effectiveness of occlusion therapy for the treatment of amblyopia is a research priority. The authors describe the design of the Monitored Occlusion Treatment for Amblyopia Study (MOTAS) and its methodology. MOTAS will determine the dose-response relation for occlusion therapy as a function of age and category of amblyopia.

Methods: Subjects progress through up to three study phases: (1) Assessment and baseline phase: On confirmation of eligibility, and after parental consent, baseline visual functions are determined, and spectacles prescribed as necessary; (2) Refractive adaptation phase: Subjects wear spectacles full time and return to clinic at 6 weekly intervals until 18 weeks, by which time all improvement due to refractive correction is complete; (3) Occlusion phase: All subjects are prescribed 6 hours of occlusion per day. Daily occlusion is objectively monitored using an occlusion dose monitor (ODM). Outcome variables: visual acuity (logMAR charts), log contrast sensitivity (Pelli-Robson chart), and stereoacuity (Frisby) are assessed at 2 weekly intervals until gains in visual acuity cease to be statistically verifiable.

Conclusion: Four methodological issues have been addressed; firstly, baseline stability of visual function; secondly, differentiation of refractive adaptation from occlusion; thirdly, objective measurement of occlusion dose and concordance; fourthly, use of validated outcome measures.

Keywords: amblyopia; occlusion therapy; occlusion dose monitor; refractive adaptation; dose-response

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BJO at a glance

Creig Hoyt
Br. J. Ophthalmol. 2002 86: 835. [Extract] [Full Text] [PDF]

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