Correction of Myopia Evaluation Trial 2 (COMET2)
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| ClinicalTrials.gov Identifier: NCT00320593 |
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Recruitment Status :
Completed
First Posted : May 3, 2006
Results First Posted : June 21, 2011
Last Update Posted : July 19, 2016
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| Condition or disease | Intervention/treatment | Phase |
|---|---|---|
| Myopia | Device: Progressive Addition Lenses (PALs) Device: Single Vision Lenses (SVLs) | Phase 3 |
Myopia is a significant public health problem that affects at least 34% of children in the United States and a much higher percentage in Asia. It is a predisposing factor for retinal detachment, myopic retinopathy, and glaucoma, thus contributing to loss of vision and blindness. As might be expected for such a prevalent condition, treatment costs are high. If interventions to retard myopia progression are successful, sight-threatening complications might be avoided and costs should be reduced.
The study has been designed as a simple trial that, other than the type of lenses being determined through the randomization process and the addition of accommodation testing using an autorefractor, largely approximates standard clinical practice.
Screening consists of non-cycloplegic procedures of subjective refraction, testing of oculomotor alignment, and testing of accommodative response using the Grand Seiko autorefractor.
Patients who appear to be eligible for the randomized trial will be tested with their eyes dilated to determine whether refractive error in each eye is within the eligibility range for the randomized trial. Patients will be randomized to either progressive addition lenses (PALs) with a +2.00 D addition or to single vision lenses (SVLs). Children will have three years of follow up, with visits every 6 months.
The primary outcome visit is timed 3 years from randomization, with the primary analysis being a comparison of the average change from baseline to 3 years in amount of myopia between children in the single-vision lens group and the children in the progressive-addition lens group. The primary outcome is change in spherical equivalent refractive error (SER) in diopters (D) as measured by cycloplegic autorefraction.
A separate ancillary study nested within the screening process will collect data on two additional methods of measuring accommodation, Monocular Estimate Method (MEM) retinoscopy and Nott retinoscopy. The aim of the ancillary study to help determine whether a simple, effective measure exists that can be easily used by clinicians to identify children with reduced accommodative response who, if they have low myopia and esophoria, might benefit from the treatment with PALs.
| Study Type : | Interventional (Clinical Trial) |
| Actual Enrollment : | 118 participants |
| Allocation: | Randomized |
| Intervention Model: | Parallel Assignment |
| Masking: | Triple (Participant, Care Provider, Investigator) |
| Primary Purpose: | Treatment |
| Official Title: | Correction of Myopia Evaluation Trial 2 (COMET2): A Randomized Trial of the Effect of Progressive Addition Lenses Versus Single Vision Lenses on Low Myopia Associated With Large Accommodative Lags and Near Esophoria in Children |
| Study Start Date : | April 2005 |
| Actual Primary Completion Date : | March 2010 |
| Actual Study Completion Date : | March 2010 |
| Arm | Intervention/treatment |
|---|---|
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Active Comparator: Progressive addition lenses (PALs)
Varilux Ellipse progressive addition lenses (PALs) with a +2.00 D addition
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Device: Progressive Addition Lenses (PALs)
Varilux Ellipse progressive addition lenses (PALs) with a +2.00 D addition |
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Active Comparator: Single vision lenses (SVLs)
Single vision lenses
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Device: Single Vision Lenses (SVLs)
Single vision lenses |
- Distribution of Change in Spherical Equivalent Refractive Error From Baseline to 3 Years [ Time Frame: Baseline to 3 years ]Measured in diopters (D) using cycloplegic refraction sphere (amount of myopia) and cylinder (amount of astigmatism at an angle (axis)). Spherical equivalent (SE) is the sphere plus 1/2 the cylinder. For baseline and each time point, a SE was calculated for each eye for each of the five trials of cycloplegic autorefraction; the median for each eye was averaged to obtain the SE used for analysis. Change was calculated as SE at baseline minus SE at 3 years. A negative value indicates that the myopia worsened; a positive value indicates that it improved.
- Mean Change in Spherical Equivalent Refractive Error From Baseline to 3 Years [ Time Frame: 3 years ]Measured in diopters (D) using cycloplegic refraction sphere (amount of myopia) and cylinder (amount of astigmatism at an angle (axis)). Spherical equivalent (SE) is defined as the sphere plus 1/2 the cylinder. For baseline and each time point, a SE was calculated for each eye for each of the five trials of cycloplegic autorefraction; the median for each eye was averaged to obtain the SE used for analysis. Change was calculated as SE at baseline minus SE at 3 years. A negative value indicates that the myopia worsened; a positive value indicates that it improved.
- Distribution of Spherical Equivalent Refractive Error at 3 Years [ Time Frame: 3 years ]Measured in diopters (D) using cycloplegic refraction sphere (amount of myopia) and cylinder (amount of astigmatism at an angle (axis)). Spherical equivalent (SE) is defined as the sphere plus 1/2 the cylinder. A SE was calculated for each eye for each of the five trials of cycloplegic autorefraction, and the median for each eye was averaged to obtain the SE used for analysis.
- Mean Spherical Equivalent Refractive Error at 3 Years [ Time Frame: 3 years ]Measured in diopters (D) using cycloplegic refraction sphere (amount of myopia) and cylinder (amount of astigmatism at an angle (axis)). Spherical equivalent (SE) is defined as the sphere plus 1/2 the cylinder. A SE was calculated for each eye for each of the five trials of cycloplegic autorefraction, and the median for each eye was averaged to obtain the SE used for analysis.
- Distribution of Change in Spherical Equivalent Refractive Error From Baseline to 3 Years According to Baseline Characteristics [ Time Frame: Baseline to 3 years ]Measured in diopters (D) using cycloplegic refraction sphere (amount of myopia) and cylinder (amount of astigmatism at an angle (axis)). Spherical equivalent (SE) is defined as the sphere plus 1/2 the cylinder. For baseline and 3 years, a SE was calculated for each eye for each of the five trials of cycloplegic autorefraction; the median for each eye was averaged to obtain the SE used for analysis. Change was calculated as SE at baseline minus SE at 3 years. A negative value indicates that the myopia worsened; a positive value indicates that it improved.
- Mean Change in Spherical Equivalent Refractive Error From Baseline to 3 Years According to Baseline Characteristics [ Time Frame: Baseline to 3 years ]Measured in diopters (D) using cycloplegic refraction sphere (amount of myopia) and cylinder (amount of astigmatism at an angle (axis)). Spherical equivalent (SE) is defined as the sphere plus 1/2 the cylinder. For baseline and 3 years, a SE was calculated for each eye for each of the five trials of cycloplegic autorefraction; the median for each eye was averaged to obtain the SE used for analysis. Change was calculated as SE at baseline minus SE at 3 years. A negative value indicates that the myopia worsened; a positive value indicates that it improved.
- Mean Change in Spherical Equivalent Refractive Error From Baseline to 1 Year [ Time Frame: Baseline to 1 year ]Measured in diopters (D) using cycloplegic refraction sphere (amount of myopia) and cylinder (amount of astigmatism at an angle (axis)). Spherical equivalent (SE) is defined as the sphere plus 1/2 the cylinder. For baseline and 1 year, a SE was calculated for each eye for each of the five trials of cycloplegic autorefraction; the median for each eye was averaged to obtain the SE used for analysis. Change was calculated as SE at baseline minus SE at 1 year. A negative value indicates that the myopia worsened; a positive value indicates that it improved.
- Mean Change in Spherical Equivalent Refractive Error From Baseline to 2 Years [ Time Frame: Baseline to 2 years ]Measured in diopters (D) using cycloplegic refraction sphere (amount of myopia) and cylinder (amount of astigmatism at an angle (axis)). Spherical equivalent (SE) is defined as the sphere plus 1/2 the cylinder. For baseline and 2 years, a SE was calculated for each eye for each of the five trials of cycloplegic autorefraction; the median for each eye was averaged to obtain the SE used for analysis. Change was calculated as SE at baseline minus SE at 2 years. A negative value indicates that the myopia worsened; a positive value indicates that it improved.
- Excellent Spectacle Compliance [ Time Frame: Baseline to 3 years ]Spectacle compliance was assessed on a five-point Likert scale: always, 5; often, 4; sometimes, 3; rarely, 2; and never, 1. Excellent compliance indicates that for the specified period (during school, after school, on weekends), spectacles were estimated at all visits to have been worn either always or often.
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| Ages Eligible for Study: | 8 Years to 11 Years (Child) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
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Refractive error determined by cycloplegic autorefraction which meets all of the following:
- Spherical equivalent: -0.50 to -3.00 D in both eyes
- Astigmatism <= 1.5 D in both eyes
- Anisometropia <= 1.00 D difference between eyes in spherical equivalent
- Visual acuity is at least 20/20 with best subjective refraction in both eyes
- Accommodative response at near (33 cm) is less than 2.0D by non-cycloplegic autorefraction
- Near esophoria (>= 2.0 PD) present by alternate prism and cover test (APCT) at near using best refractive correction determined from non-cycloplegic subjective refraction
Exclusion Criteria:
- Strabismus present by cover-uncover test at far, near, and/or near with +2.00D over best subjective refraction
- Current or prior use of PALs, bifocals, or contact lenses in either eye (prior or current use of SVLs is allowed)
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00320593
| United States, Alabama | |
| University of Alabama- Birmingham, School of Optometry | |
| Birmingham, Alabama, United States, 35294 | |
| United States, California | |
| Southern California College of Optometry | |
| Fullerton, California, United States, 92831-1699 | |
| United States, Indiana | |
| Indiana School of Optometry | |
| Bloomington, Indiana, United States, 47405 | |
| United States, Massachusetts | |
| New England College of Optometry | |
| Boston, Massachusetts, United States, 02215-3468 | |
| United States, Ohio | |
| Ohio State University College of Optometry | |
| Columbus, Ohio, United States, 43210-1280 | |
| United States, Pennsylvania | |
| Family Eye Group | |
| Lancaster, Pennsylvania, United States, 17601 | |
| Pennsylvania College of Optometry | |
| Philadelphia, Pennsylvania, United States, 19141 | |
| United States, Texas | |
| University of Houston College of Optometry | |
| Houston, Texas, United States, 77204-2020 | |
| Study Chair: | Jane E Gwiazda, Ph.D. | New England College of Optometry | |
| Principal Investigator: | Wendy L Marsh-Tootle | University of Alabama at Birmingham School of Optometry | |
| Principal Investigator: | Ruth E Manny | University of Houston College of Optometry | |
| Principal Investigator: | Erik M Weissberg | New England College of Optometry | |
| Principal Investigator: | David I Silbert | Family Eye Group | |
| Principal Investigator: | Don W Lyon | Indiana University School of Optometry | |
| Principal Investigator: | Mitchell M Scheiman | Pennsylvania College of Optometry | |
| Principal Investigator: | Marjean T Kulp | Ohio State University | |
| Principal Investigator: | Susan A Cotter | Southern California College of Optometry |
Publications of Results:
| Responsible Party: | Jaeb Center for Health Research |
| ClinicalTrials.gov Identifier: | NCT00320593 History of Changes |
| Other Study ID Numbers: |
NEI-123 2U10EY011751 ( U.S. NIH Grant/Contract ) 5U10EY011751 ( U.S. NIH Grant/Contract ) |
| First Posted: | May 3, 2006 Key Record Dates |
| Results First Posted: | June 21, 2011 |
| Last Update Posted: | July 19, 2016 |
| Last Verified: | July 2016 |
Keywords provided by Jaeb Center for Health Research:
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Myopia Progressive Addition Lenses (PALs) Single Vision Lenses (SVLs) |
Accommodative lags Near esophoria Refractive error |
Additional relevant MeSH terms:
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Myopia Refractive Errors Eye Diseases |