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Br J Ophthalmol 2002;86:915-919 doi:10.1136/bjo.86.8.915
  • Original Article
    • Clinical science

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

  1. C E Stewart1,
  2. A R Fielder1,
  3. D A Stephens2,
  4. M J Moseley1
  1. 1Department of Ophthalmology, Imperial College of Science, Technology and Medicine, London, UK
  2. 2Department of Mathematics, Imperial College of Science, Technology and Medicine, London, UK
  1. 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
  • Accepted 14 January 2002

Abstract

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.

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