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Trial registered on ANZCTR
Registration number
ACTRN12617000338369
Ethics application status
Approved
Date submitted
28/02/2017
Date registered
3/03/2017
Date last updated
8/02/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Using eye movements to measure vision in children
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Scientific title
Objective Assessment of Visual Performance Using Optokinetic Nystagmus in Young Children
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Secondary ID [1]
290610
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None
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Universal Trial Number (UTN)
U1111-1190-2839
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Trial acronym
OKN (optokinetic nystagmus) study
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Amblyopia
301102
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Anisometropia
301103
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Significant refractive error
301104
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Visual impairment
301105
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Strabismus
301106
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Condition category
Condition code
Eye
300873
300873
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0
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Normal eye development and function
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Eye
300874
300874
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0
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Diseases / disorders of the eye
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention is a clinical device designed by Dr. Jason Turuwhenua, and consists of multiple components: a stimulus display unit, infrared (IR) camera for optokinetic nystagmus (OKN) video recording, IR illumination, and a computer. Data collection will be done with a prototype device by Objective Acuity Ltd, a UniServices (University of Auckland) start-up company co-founded by Lead investigator, Dr. Jason Turuwhenua, and A/Prof. Ben Thompson. The overall aim of this study is to accurately test visual acuity in young children to allow for the early detection and treatment of vision problems. The OKN device assesses visual acuity by inducing and measuring an involuntary, reflexive eye movement known as OKN. This eye movement only occurs when a moving target is visible. The intervention will be done one eye at a time, and the eye not being tested is covered by an eye patch.
The intervention will be delivered by optometrist(s), orthoptist(s), ophthalmologist(s), and vision researcher(s) with minimum 2 years' clinical/clinical research experience. The mode of delivery is face to face, one participant at a time, in an optometry/ophthalmology clinic or a clinic in vision research institution..
Children will undergo the intervention once, but in the event of technical difficulties or child unable to cooperate, we will invite children and their parents to reschedule for a second attempt. The duration of intervention is approximately 10 minutes (5 minutes per eye).
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Intervention code [1]
297337
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Early detection / Screening
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Comparator / control treatment
The sensitivity and specificity of the OKN device will be compared against the clinical gold-standard crowded HOTV visual acuity test using the EVA (electronic visual acuity) system. Children will be shown letters on the EVA monitor one eye at a time, and asked to identify the letter verbally or by letter-matching. The eye not being tested is covered by an eye patch. All children enrolled in this trial will have their visual acuity measured using both the gold-standard and OKN device.
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Control group
Active
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Outcomes
Primary outcome [1]
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To assess the sensitivity and specificity of the OKN device for detecting uncorrected monocular visual acuity impairment caused by strabismic amblyopia, anisometropic amblyopia or refractive error in developmentally normal children from 3-6-years of age. The HOTV test delivered using the Electronic Visual Acuity (EVA) system will be used as the gold-standard comparison.
Uncorrected monocular visual acuity impairment will be defined using the ATS-HOTV test in the absence of refractive correction according to age-specific visual acuity cutoffs for vision screening provided by the American Association for Pediatric Ophthalmology and Strabismus (AAPOS, 2014): 36-47 months, >0.4 LogMAR; 49-59 months, >0.3 LogMAR; 60-83 months, >0.2 LogMAR.
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Assessment method [1]
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Timepoint [1]
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Data analysis will be conducted between March 19th to 31st 2018.
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Secondary outcome [1]
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Testability of the OKN device (proportion of completed measurements vs. attempts) compared to the ATS-HOTV test. A complete measurement is defined as a visual acuity measurement at the age-appropriate cut-off LogMAR level for each eye separately.
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Assessment method [1]
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Timepoint [1]
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The proposed timepoint for calculation and presentation of secondary outcome is January-March 2018.
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Secondary outcome [2]
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To assess the specificity and sensitivity of OKN in the detection of impaired visual acuity for pre-specified subgroups, if sufficient number of children can be recruited for each category:
* Study sites (Auckland vs Melbourne vs Texas)
* Age groups (36-47, 48-59, 60-83 months of age)
* Sex (Male, Female)
* Hyperopes vs. Myopes
* High astigmatism vs. low/no astigmatism
* Strabismic vs. non-strabismic
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Assessment method [2]
329656
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Timepoint [2]
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The proposed timepoint for calculation and presentation of secondary outcome is January-March 2018.
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Eligibility
Key inclusion criteria
* Aged 3-6 years old (36-83 months at the time of registration)
* Have parent(s)/guardian(s) willing to provide informed consent
* Had paediatric eye examination, including cycloplegic refraction within the past 6 months OR is a child for whom the parent consents to having a paediatric eye examination including cycloplegic refraction at the time of registration.
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Minimum age
36
Months
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Maximum age
83
Months
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
* Infantile nystagmus syndrome
* Eye muscle surgery within the past 6 months
* Current eye disease
* Developmental delay (known or suspected)
* Systemic disease or syndrome
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Study design
Purpose of the study
Diagnosis
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
Statistical analysis will be performed using SAS version 9.4 (SAS Institute Inc., Cary, NC, USA) and R version 3.3 (R Foundation for Statistical Computing). All statistical tests will be two-sided at 5% significance level. The STROBE statement will be used as the guidelines for reporting observational studies.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
3/03/2017
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Actual
3/03/2017
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Date of last participant enrolment
Anticipated
9/03/2018
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Actual
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Date of last data collection
Anticipated
9/03/2018
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Actual
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Sample size
Target
120
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Accrual to date
71
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment postcode(s) [1]
15480
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3010 - University Of Melbourne
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Recruitment outside Australia
Country [1]
8415
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New Zealand
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State/province [1]
8415
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Auckland
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Country [2]
8416
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United States of America
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State/province [2]
8416
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Texas
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Funding & Sponsors
Funding source category [1]
295056
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Government body
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Name [1]
295056
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Ministry of Business, Innovation and Employment
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Address [1]
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15 Stout Street, Wellington 6011
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Country [1]
295056
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New Zealand
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Funding source category [2]
298621
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Commercial sector/Industry
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Name [2]
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Objective Acuity Ltd (University of Auckland UniServices company)
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Address [2]
298621
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Objective Acuity Limited
c/o Lumberlink Ltd
P.O. Box 105193
Auckland City 1143
New Zealand
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Country [2]
298621
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New Zealand
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Primary sponsor type
University
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Name
University of Auckland
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Address
Auckland Bioengineering Institute
70 Symonds Street
Auckland 1010
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School of Optometry & Vision Science
85 Park Road
Auckland 1023
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Country
New Zealand
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Secondary sponsor category [1]
293870
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None
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Name [1]
293870
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Address [1]
293870
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Country [1]
293870
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Other collaborator category [1]
279322
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Individual
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Name [1]
279322
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Dr. Shuan Dai (Eye Doctors)
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Address [1]
279322
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Eye Doctors Ltd
Level 2, 90 Greenlane Rd East
Auckland, 1050
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Country [1]
279322
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New Zealand
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Other collaborator category [2]
279323
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Individual
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Name [2]
279323
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Prof. Eileen Birch (Retina Foundation of the Southwest)
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Address [2]
279323
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Retina Foundation of the Southwest
9600 N Central Expy #200, Dallas, TX 75231
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Country [2]
279323
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United States of America
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Other collaborator category [3]
279407
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Individual
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Name [3]
279407
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Ms Christine Nearchou (University of Melbourne Eye Care Clinic)
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Address [3]
279407
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University of Melbourne Eye Care Clinic
2/800 Swanston St
University of Melbourne
VIC 3010
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Country [3]
279407
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Australia
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Other collaborator category [4]
279931
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University
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Name [4]
279931
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A/Prof. Ben Thompson (University of Waterloo)
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Address [4]
279931
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School of Optometry and Vision Science
University of Waterloo
200 University Avenue West
Waterloo, Ontario, Canada
N2L 3G1
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Country [4]
279931
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Canada
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
296402
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The University of Auckland Human Participants Ethics Committee (UAHPEC)
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Ethics committee address [1]
296402
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The University of Auckland Research Office Level 10, Building 620 49 Symonds Street Auckland 1010
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Ethics committee country [1]
296402
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New Zealand
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Date submitted for ethics approval [1]
296402
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08/11/2016
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Approval date [1]
296402
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04/01/2017
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Ethics approval number [1]
296402
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018420
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Summary
Brief summary
If eye problems occur in early childhood, they can affect the development of the brain areas that are responsible for sight and cause lifelong visual impairment. In addition, vision problems can affect the development of fine control over arm and hand movements and, in older children, impact on education. Many of the eye problems that affect young children can be treated effectively, however detecting these problems is challenging. Young children find it difficult to complete standard tests of vision because these tests require high levels of attention. Many tests also involve recognising shapes and letters and are therefore not suitable for young children. To address this problem we are developing a new computer-based vision test suitable for use with children as young as 2-years old. The test is simple and easy to use; carefully designed moving patterns are shown to the child that causes a reflexive, involuntary movement of the eyes if the child is able to see the pattern (which thereby yields a measure of visual performance). At the same time we record the movement of the eyes with a video camera attached to a computer and the software we are developing will identify whether the child is able to see the pattern or not. Finally, the visibility of the pattern will be varied to measure how well the child can see. In this project, we will develop and perform clinical validation tests in ophthalmology and optometry clinics in New Zealand and the USA. The overall aim of this research is to validate a device that we envisage could be used to rapidly and accurately test visual acuity in young children to allow for the early detection and treatment of vision problems. We propose here to conduct data collection of OKN eye movement using our prototype system developed from our own research to date. This study will involve three clinical sites: (1) the University of Auckland Optometry research clinic, (2) a private ophthalmology clinic (Eye Doctors, Ascot Hospital) led by co-investigator and ophthalmologist Dr Shuan Dai and his research assistant (orthoptist, Nia Stonex), and (3) the Retina Foundation of the Southwest (a non-profit eye research institute in Texas, USA) led by co-investigator Prof. Eileen Birch and her research team.
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Trial website
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Trial related presentations / publications
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Public notes
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Attachments [1]
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/AnzctrAttachments/371914-Outcome Approved with comment.pdf
(Ethics approval)
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Attachments [2]
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/AnzctrAttachments/371914-OKN protocol.pdf
(Protocol)
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Attachments [3]
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/AnzctrAttachments/371914-child_PIS CF_018420_ANZCTR.pdf
(Participant information/consent)
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Attachments [4]
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/AnzctrAttachments/371914-OKN protocol_version14thNovember2017_LC.pdf
(Protocol)
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Contacts
Principal investigator
Name
70714
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Dr Jason Turuwhenua
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Address
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Auckland Bioengineering Institute
The University of Auckland
Private Bag 92019
Auckland 1142
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Country
70714
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New Zealand
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Phone
70714
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+64 9 923 5807
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Lily Yu-Li Chang
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Address
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Auckland Bioengineering Institute
The University of Auckland
Private Bag 92019
Auckland 1142
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Country
70715
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New Zealand
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Phone
70715
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+64 9 923 1689
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Fax
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Email
70715
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[email protected]
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Contact person for scientific queries
Name
70716
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Jason Turuwhenua
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Address
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Auckland Bioengineering Institute
The University of Auckland
Private Bag 92019
Auckland 1142
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Country
70716
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New Zealand
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Phone
70716
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+64 9 923 5807
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Fax
70716
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Email
70716
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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