Delaying the Onset of Nearsightedness Until Treatment (DONUT) Clinical Trial

Purpose

The aims of this clinical trial will test whether or not the onset of nearsightedness is delayed in a group of children randomized to nightly drops in 0.05% atropine in both eyes, in comparison to children who receiving nightly placebo drops in both eyes. The primary outcome is the two-year cumulative incidence of nearsightedness. The second aim of this project will determine whether atropine is associated with slower eye growth in children receiving nightly drops of atropine versus placebo.

Condition

  • Myopia

Eligibility

Eligible Ages
Between 6 Years and 11 Years
Eligible Sex
All
Accepts Healthy Volunteers
Yes

Inclusion Criteria

  • Refractive Error (cycloplegic autorefraction, spherical equivalent, at least one eye, inclusive) 6 years: -0.74 D to +0.75 D 7 and 8 years: -0.74 D to +0.50 D 9 and 10 years: -0.74 D to +0.25 D 11 years: -0.74 D to plano - Neither eye has -0.75 D or more myopia, spherical component - Anisometropia: Less than 1.50 D difference between OD and OS, cycloplegic autorefraction, spherical equivalent - Astigmatism: Less than 1.50 DC in both eyes by cycloplegic autorefraction - Successfully complete run-in period: take at least 90% of unit dose artificial tears for 2 to 4 weeks (# of unit-dose vials used divided by # nights since baseline visit must equal 0.90 or greater)

Exclusion Criteria

  • If Visit 2 (randomization visit) is not completed within 4 weeks of the baseline, eligibility visit. - Presence of strabismus (intermittent or constant) based on unilateral cover test at distance and near - Known allergy to atropine - Systemic issues that may affect accommodation or convergence (e.g., multiple sclerosis, myasthenia gravis, Graves ophthalmopathy, diabetes mellitus, Parkinson's disease, Down syndrome, etc.) - Ocular disease (e.g., congenital glaucoma, retinal disease, nystagmus, amblyopia, etc.) - Ocular surgery (e.g., cataracts, strabismus) - Any previous myopia prevention/control therapy (e.g., atropine, soft contact lenses, orthokeratology, myopia control spectacles, etc.) for more than one month - Pregnancy by self-report

Study Design

Phase
Phase 3
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Intervention Model Description
Placebo-controlled randomized clinical trial
Primary Purpose
Prevention
Masking
Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Masking Description
Bottles to be distributed are masked at the pharmacy. Only pharmacy personnel and data coordinating center personnel have access to the assigned treatment groups.

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
0.05% Atropine
0.05% atropine instilled in each eye nightly at bedtime
  • Drug: Atropine Sulfate 0.05% Oph Soln
    Atropine Sulfate 0.05% Oph Soln compounded at the pharmacy
Placebo Comparator
Placebo
Placebo drops instilled in each eye nightly at bedtime
  • Drug: Placebo
    Placebo drop with same formulation as treatment minus the atropine

Recruiting Locations

The Ohio State University College of Optometry
Columbus, Ohio 43210
Contact:
Heather Anderson, OD PhD
614-247-5825
anderson.3881@osu.edu

More Details

Status
Recruiting
Sponsor
Ohio State University

Study Contact

Lisa A Jordan, PhD
614-247-7321
jordan.646@osu.edu

Detailed Description

The "Delaying the Onset of Nearsightedness (DONUT) Study - Data Coordinating Center" is a randomized clinical trial designed to compare the effectiveness 0.05% atropine and a placebo in delaying the onset of nearsightedness. It is a multicenter (14 clinic centers) randomized clinical trial of 606 children (recruited over two years) ages 6 to 11 years who are determine to be at high risk of myopia onset, as measured by cycloplegic autorefraction and age. The primary outcome is the two-year cumulative incidence of myopia. The second aim of this project will determine whether atropine is associated with slower axial elongation in children receiving nightly drops of atropine versus placebo. Participants will be seen every six months for at least two years to determine the onset of myopia.