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. 2002 Aug;86(8):915-9.
doi: 10.1136/bjo.86.8.915.

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

C E Stewart  1 , A R Fielder, D A Stephens, M J Moseley
Affiliations

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

C E Stewart et al. Br J Ophthalmol. 2002 Aug.

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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Figures

Figure 1
Figure 1
Child with occlusion dose monitor (ODM).
Figure 2
Figure 2
The traditional hierarchy of evidence (modified from Greenhalgh24).
Figure 3
Figure 3
An organisation flow chart indicating the path followed by subjects as they progress through the study. Typical progress of child is indicated by bold arrow.
See this image and copyright information in PMC

References

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