Files and links (1)
Accepted (AM)Open Access (License Unspecified), Open
Journal article
A randomized trial comparing part-time patching with observation for children 3 to 10 years of age with intermittent exotropia
Ophthalmology (Rochester, Minn.), v 121(12), pp 2299-2310
01 Dec 2014
PMID: 25234012
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
To determine the effectiveness of prescribed part-time patching for treatment of intermittent exotropia (IXT) in children.
Multicenter, randomized clinical trial.
Three hundred fifty-eight children 3 to <11 years of age with previously untreated (except for refractive correction) IXT and near stereoacuity of 400 seconds of arc or better were enrolled. Intermittent exotropia met the following criteria: (1) IXT at distance OR constant exotropia at distance and either IXT or exophoria at near; (2) exodeviation (tropia or phoria) of at least 15 prism diopters (PD) at distance or near by prism and alternate cover test (PACT); and (3) exodeviation of at least 10 PD at distance by PACT.
Participants were assigned randomly either to observation (no treatment for 6 months) or to patching for 3 hours daily for 5 months, with a 1-month washout period of no patching before the 6-month primary outcome examination.
The primary outcome was deterioration at either the 3-month or the 6-month follow-up visit, defined as: (1) constant exotropia measuring at least 10 PD at distance and near by simultaneous prism and cover test, and/or (2) near stereoacuity decreased by at least 2 octaves from baseline, both assessed by a masked examiner and confirmed by a retest. Participants who were prescribed any nonrandomized treatment without first meeting either deterioration criteria also were counted as having deteriorated.
Of the 324 participants (91%) completing the 6-month primary outcome examination, deterioration occurred in 10 of the 165 participants (6.1%) in the observation group (3 of these 10 started treatment without meeting deterioration criteria) and in 1 of the 159 participants (0.6%) in the part-time patching group (difference, 5.4%; lower limit of 1-sided exact 95% confidence interval, 2.0%; P = 0.004, 1-sided hypothesis test).
Deterioration of previously untreated childhood IXT over a 6-month period is uncommon with or without patching treatment. Although there is a slightly lower deterioration rate with patching, both management approaches are reasonable for treating children 3 to 10 years of age with IXT.
Metrics
Details
- Title
- A randomized trial comparing part-time patching with observation for children 3 to 10 years of age with intermittent exotropia
- Creators
- Susan A Cotter - Marshall B. Ketchum UniversityBrian G Mohney - Mayo ClinicDanielle L Chandler - Jaeb Center for Health ResearchJonathan M Holmes - Mayo ClinicMichael X Repka - Johns Hopkins MedicineMichele Melia - Jaeb Center for Health ResearchDavid K Wallace - Duke Eye Center, Durham, North CarolinaRoy W Beck - Jaeb Center for Health ResearchEileen E Birch - Retina Foundation of the SouthwestRaymond T Kraker - Jaeb Center for Health ResearchSusanna M Tamkins - Bascom Palmer Eye Institute, Miami, FloridaAaron M Miller - Houston Eye AssociatesNicholas A Sala - Pediatric Ophthalmology of Erie, Erie, PennsylvaniaStephen R Glaser - Private Practice, Rockville, MarylandPediatric Eye Disease Investigator GroupMitchell Scheiman - Pennsylvania College of Optometry (PCO)
- Publication Details
- Ophthalmology (Rochester, Minn.), v 121(12), pp 2299-2310
- Publisher
- Elsevier
- Grant note
- U10 EY011751 / NEI NIH HHS EY011751 / NEI NIH HHS EY018810 / NEI NIH HHS UG1 EY011751 / NEI NIH HHS U10 EY023198 / NEI NIH HHS U10 EY018810 / NEI NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Pennsylvania College of Optometry (PCO)
- Web of Science ID
- WOS:000345509500011
- Scopus ID
- 2-s2.0-84961291125
- Other Identifier
- 991021900196004721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Ophthalmology