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Using Dichoptic Therapy to Treat Intermittent Exotropia

Not Applicable
Recruiting
Conditions
Exotropia Intermittent
Interventions
Device: Luminopia, a virtual reality headset
Other: Paper pre- survey
Other: Paper Survey
Registration Number
NCT06529016
Lead Sponsor
Virginia Commonwealth University
Brief Summary

Intermittent exotropia is difficult to treat. The mainstay of treatment involves surgery, and in one long-term study authors found that as many as 60% of IXT required at least one re-operation.Patching of the non-dominant eye has also been tested in a large, multi-center randomized control trial and was not found to have a large benefit. More non-surgical treatment modalities are critical to improve the care in this condition.

Detailed Description

Luminopia, a dichoptic therapy device, was approved by the FDA in 2021 for use in amblyopia in children aged 4-7 years. The device was shown to improve vision in the amblyopic eye by lines in three months of use. Patients with strabismic amblyopia were also enrolled in the trial and found to have similar gains in vision in the amblyopic eye.

Li et al. used an investigational dichoptic therapy device in patients with intermittent exotropia and had a statistically significant improvement in ocular alignment as measured in prism diopters.The dichoptic therapy this study used is not commercially available, therefore using Luminopia to study this population may result in an immediately available non-surgical treatment for intermittent exotropia patients.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
20
Inclusion Criteria
  • Diagnosed with IXT
  • one eye that is their preferred eye
  • ages 4-7
  • distance control scores of <= 4
Exclusion Criteria
  • distance control scores of 5
  • patients with visual acuity with vision that is worse in one eye by greater than two lines
  • no preferred eye
  • patients who would be unable to tolerate wearing the headset for 1 hour/day, 6 days/week, for 12 weeks.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Luminopia VR headset treatmentPaper pre- surveyUsing Dichoptic Therapy to Improve Intermittent Exotropia Control in children ages 4-7
Luminopia VR headset treatmentPaper SurveyUsing Dichoptic Therapy to Improve Intermittent Exotropia Control in children ages 4-7
Luminopia VR headset treatmentLuminopia, a virtual reality headsetUsing Dichoptic Therapy to Improve Intermittent Exotropia Control in children ages 4-7
Primary Outcome Measures
NameTimeMethod
Dichoptic therapy change of control of intermittent exotropia using the standard control score3 months for primary response, and 6 months after a washout period (3 months without the device)

Improvement of the control of IXT using the Exotropia control scale that runs from 0-5. 0 meaning No exotropia noted unless dissociated, recovers in \< 1 seconds (exophoria). A 5 means Constant exotropia during 30-second observation before dissociation.

Secondary Outcome Measures
NameTimeMethod
Change of amplitude of exotropia as measured by Alternating Prism Cover Test3 months for primary response, and 6 months after a washout period (3 months without the device)

The alternate prism cover test is similar to the alternate cover test, with the addition of a prism held over one eye to quantify the misalignment. The examiner performs the alternate cover test while changing the prism over the deviated eye until the misalignment is neutralized

Change of scores from the Pediatric Eye Disease Investigator Group (PEDIG) intermittent exotropia questionnaire3 months for primary response, and 6 months after a washout period (3 months without the device)

The Intermittent Exotropia Questionnaire (IXTQ) is a patient-derived, intermittent exotropia-specific instrument designed to evaluate health-related quality of life (HRQOL) in children with intermittent exotropia. The12-item assessment ivalues were converted to 0 (best) to 100 (worst)

Trial Locations

Locations (1)

Virginia Commonwealth University

🇺🇸

Richmond, Virginia, United States

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