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Binocular Vision, Amblyopia, and Refractive Development

Award Number: R01EY022313
ORGANIZATION: NATIONAL EYE INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 05/01/2012
PERIOD OF PERFORMANCE END DATE: 01/31/2028

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Binocular Vision, Amblyopia, and Refractive Development - Amblyopia is a common disorder of neurodevelopment resulting from discordant binocular visual experience during the first years of life, affecting 2-3% of children. Randomized clinical trials (RCTs) show that current approaches to amblyopia treatment, most often patching the fellow eye, are effective in improving visual acuity. However, full recovery occurs in less than 50% of children. Standard-of-care patching treatment of amblyopia is effective but suffers from poor adherence, exhibits significant individual differences in response even when adherence is good, and fails to address the binocular dysfunction that is fundamental to amblyopia. There is a need for an alternative approach to occlusion therapy that improves adherence to maximize visual outcomes. Aim 1 will evaluate a novel, patch-free approach to occlusion therapy and determine whether it results in better adherence and visual acuity outcomes compared with patching in an RCT. Our patch-free treatment provides access to a variety of engaging activities for the child during occlusion time. Our hypothesis is that patch-free occlusion will lead to better adherence and better visual acuity improvement than standard-of-care patching. However, even excellent patching adherence does not ensure a good outcome; objectively monitored patching for200 hours resulted in visual acuity improvements ranging from 0.15-0.8 logMAR. Clearly, poor adherence is not the only factor influencing visual acuity outcome—other unidentified factors must contribute to individual differences. This argues for a personalized approach to amblyopia treatment, choosing among a variety of effective approaches to determine which works best for each child. In Aim 2, we propose to evaluate an alternative treatment approach based on spike-timing dependent plasticity (STDP) to shift the modification threshold for long-term potentiation (LTP). This neuroplasticity-based approach, prioritized in the NEI Strategic Plan, is targeted to strengthen amblyopic eye input to binocular neurons and improve not only visual acuity but also binocular function. In an RCT, we will determine whether this treatment results in better visual acuity and binocular outcomes compared with standard-of-care patching. Ourproposed clinical trials include anumber of technological innovations. Our conceptual approach is novel in that we not only evaluate vision outcomes, but also look at the effects of treatment on the whole child, including motor skills, self-perception, and quality of life.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $496,873 )
2025	2025	RETINA FOUNDATION OF THE SOUTHWEST	9600 N CENTRAL EXPY STE 200	DALLAS	TX	75231	DALLAS	USA	Vision Research	001	12	2/14/2025	NON-COMPETING CONTINUATION	$496,873
2025	2022	RETINA FOUNDATION OF THE SOUTHWEST	9600 N CENTRAL EXPY STE 200	DALLAS	TX	75231	DALLAS	USA	Vision Research	000	10	1/15/2025	NON-COMPETING CONTINUATION	$0
														Subtotal = $496,873

Issue Date FY: 2024 ( Subtotal = $506,265 )
2024	2024	RETINA FOUNDATION OF THE SOUTHWEST	9600 N CENTRAL EXPY STE 200	DALLAS	TX	75231	DALLAS	USA	Vision Research	000	11	1/31/2024	COMPETING CONTINUATION	$506,265
														Subtotal = $506,265

Issue Date FY: 2023 ( Subtotal = $202,167 )
2023	2023	RETINA FOUNDATION OF THE SOUTHWEST	9600 N CENTRAL EXPY	DALLAS	TX	75231	DALLAS	USA	Vision Research	000	10	3/8/2023	SUPPLEMENT FOR EXPANSION	$202,167
														Subtotal = $202,167

Issue Date FY: 2022 ( Subtotal = $533,817 )
2022	2022	RETINA FOUNDATION OF THE SOUTHWEST	9600 N CENTRAL EXPY STE 200	DALLAS	TX	75231	DALLAS	USA	Vision Research	000	10	1/27/2022	NON-COMPETING CONTINUATION	$533,817
														Subtotal = $533,817

Issue Date FY: 2021 ( Subtotal = $533,819 )
2021	2021	RETINA FOUNDATION OF THE SOUTHWEST	9600 N CENTRAL EXPY STE 200	DALLAS	TX	75231	DALLAS	USA	Vision Research	000	9	2/18/2021	NON-COMPETING CONTINUATION	$533,819
														Subtotal = $533,819

Issue Date FY: 2020 ( Subtotal = $550,329 )
2020	2020	RETINA FOUNDATION OF THE SOUTHWEST	9600 N CENTRAL EXPY STE 200	DALLAS	TX	75231	DALLAS	USA	Vision Research	000	8	1/23/2020	NON-COMPETING CONTINUATION	$550,329
														Subtotal = $550,329

Issue Date FY: 2019 ( Subtotal = $550,329 )
2019	2019	RETINA FOUNDATION OF THE SOUTHWEST	9600 N CENTRAL EXPY STE 200	DALLAS	TX	75231	DALLAS	USA	Vision Research	002	7	1/21/2019	NON-COMPETING CONTINUATION	$550,329
2019	2016	RETINA FOUNDATION OF THE SOUTHWEST	9600 N CENTRAL EXPY STE 200	DALLAS	TX	75231	DALLAS	USA	Vision Research	001	5	1/16/2019	EXTENSION WITH OR WITHOUT FUNDS	$0
2019	2015	RETINA FOUNDATION OF THE SOUTHWEST	9600 N CENTRAL EXPY STE 200	DALLAS	TX	75231	DALLAS	USA	Vision Research	000	4	1/16/2019	NON-COMPETING CONTINUATION	$0
														Subtotal = $550,329

Issue Date FY: 2018 ( Subtotal = $550,329 )
2018	2018	RETINA FOUNDATION OF THE SOUTHWEST	9600 N CENTRAL EXPY STE 200	DALLAS	TX	75231	DALLAS	USA	Vision Research	001	6	2/1/2018	COMPETING CONTINUATION	$550,329
2018	2016	RETINA FOUNDATION OF THE SOUTHWEST	9600 N CENTRAL EXPY STE 200	DALLAS	TX	75231	DALLAS	USA	Vision Research	000	5	1/29/2018	EXTENSION WITH OR WITHOUT FUNDS	$0
														Subtotal = $550,329

Issue Date FY: 2016 ( Subtotal = $503,475 )
2016	2016	RETINA FOUNDATION OF THE SOUTHWEST	9900 N CENTRAL EXPRESSWAY #400	DALLAS	TX	75231	DALLAS	USA	Vision Research	000	5	4/15/2016	EXTENSION WITH OR WITHOUT FUNDS	$503,475
														Subtotal = $503,475

Issue Date FY: 2015 ( Subtotal = $547,999 )
2015	2015	RETINA FOUNDATION OF THE SOUTHWEST	9900 N CENTRAL EXPRESSWAY #400	DALLAS	TX	75231	DALLAS	USA	Vision Research	000	4	4/29/2015	NON-COMPETING CONTINUATION	$547,999
														Subtotal = $547,999

Issue Date FY: 2014 ( Subtotal = $549,114 )
2014	2014	RETINA FOUNDATION OF THE SOUTHWEST	9900 N CENTRAL EXPRESSWAY #400	DALLAS	TX	75231	DALLAS	USA	Vision Research	001	3	5/2/2014	SUPPLEMENT FOR EXPANSION	$55,709
2014	2014	RETINA FOUNDATION OF THE SOUTHWEST	9900 N CENTRAL EXPRESSWAY #400	DALLAS	TX	75231	DALLAS	USA	Vision Research	000	3	4/28/2014	NON-COMPETING CONTINUATION	$493,405
														Subtotal = $549,114

Issue Date FY: 2013 ( Subtotal = $478,301 )
2013	2013	RETINA FOUNDATION OF THE SOUTHWEST	9900 N CENTRAL EXPRESSWAY #400	DALLAS	TX	75231	DALLAS	USA	Vision Research	001	2	6/25/2013	NON-COMPETING CONTINUATION	$25,174
2013	2013	RETINA FOUNDATION OF THE SOUTHWEST	9900 N CENTRAL EXPRESSWAY #400	DALLAS	TX	75231	DALLAS	USA	Vision Research	000	2	4/24/2013	NON-COMPETING CONTINUATION	$453,127
														Subtotal = $478,301

Issue Date FY: 2012 ( Subtotal = $528,797 )
2012	2012	RETINA FOUNDATION OF THE SOUTHWEST	9900 N CENTRAL EXPRESSWAY #400	DALLAS	TX	75231	DALLAS	USA	Vision Research	000	1	4/20/2012	NEW	$528,797
														Subtotal = $528,797

Grand Total All Awards = $6,531,614

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Binocular Vision, Amblyopia, and Refractive Development

Award Number: R01EY022313

ORGANIZATION: NATIONAL EYE INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 05/01/2012

PERIOD OF PERFORMANCE END DATE: 01/31/2028

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