CLINICAL SCIENCE

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

C E Stewart¹, A R Fielder¹, D A Stephens² and M J Moseley¹

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

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

BJO at a glance

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

This article has been cited by other articles:

• Mitchell, D. E, Sengpiel, F. (2009). Neural mechanisms of recovery following early visual deprivation. Phil Trans R Soc B 364: 383-398 [Abstract] [Full Text]  
• Stewart, C. E, Stephens, D. A, Fielder, A. R, Moseley, M. J, ROTAS Cooperative, (2007). Objectively monitored patching regimens for treatment of amblyopia: randomised trial. BMJ 335: 707-707 [Abstract] [Full Text]  
• Stewart, C. E., Stephens, D. A., Fielder, A. R., Moseley, M. J., on behalf of the MOTAS Cooperative, (2007). Modeling Dose-Response in Amblyopia: Toward a Child-Specific Treatment Plan. IOVS 48: 2589-2594 [Abstract] [Full Text]  
• Stewart, C. E., Fielder, A. R., Stephens, D. A., Moseley, M. J., MOTAS Cooperative, (2005). Treatment of Unilateral Amblyopia: Factors Influencing Visual Outcome. IOVS 46: 3152-3160 [Abstract] [Full Text]  
• Arditi, A. (2005). Improving the Design of the Letter Contrast Sensitivity Test. IOVS 46: 2225-2229 [Abstract] [Full Text]  
• Awan, M., Proudlock, F. A, Gottlob, I. (2005). A Randomized Controlled Trial of Unilateral Strabismic and Mixed Amblyopia Using Occlusion Dose Monitors to Record Compliance. IOVS 46: 1435-1439 [Abstract] [Full Text]  
• Stewart, C E, Moseley, M J, Fielder, A R, Stephens, D A, and the MOTAS cooperative, (2004). Refractive adaptation in amblyopia: quantification of effect and implications for practice. Br. J. Ophthalmol. 88: 1552-1556 [Abstract] [Full Text]  
• Stewart, C. E., Moseley, M. J., Stephens, D. A., Fielder, A. R. (2004). Treatment Dose-Response in Amblyopia Therapy: The Monitored Occlusion Treatment of Amblyopia Study (MOTAS). IOVS 45: 3048-3054 [Abstract] [Full Text]  
• Sankari, P R, Henshall, V, O'Regan, K, Cobb, C J, Russell, K, Cox, A, MacEwen, C J (2003). "Compliance" with treatment in amblyopia is an important factor affecting the final visual outcome. Br. J. Ophthalmol. 87: 928-928 [Full Text]  
• Fleck, B W (2003). Amblyopia therapy. Br. J. Ophthalmol. 87: 255-256 [Full Text]