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Trial registered on ANZCTR
Registration number
ACTRN12611000669998
Ethics application status
Approved
Date submitted
29/06/2011
Date registered
4/07/2011
Date last updated
23/11/2015
Type of registration
Prospectively registered
Titles & IDs
Public title
Combining selective serotonin reuptake inhibitors and patching to improve visual function in adult amblyopia (“Lazy Eye”)
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Scientific title
In adult patients with amblyopia, is citalopram combined with part time monocular occlusion more effective than monocular occlusion alone in improving visual acuity in the amblyopic eye?
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Secondary ID [1]
262531
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Nil
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Universal Trial Number (UTN)
U1111-1122-4973
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Amblyopia
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Condition category
Condition code
Eye
268327
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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
Citalopram, 20mg per day for 2 weeks combined with monocular occlusion of the amblyopic eye, 2 hours per day for 2 weeks. Monocular occlusion involves wearing an opaque eye patch over the non-amblyopic eye. Citalopram will be administered in oral tablet form. This study will adopt a cross-over design with placebo and drug arms separated by a 2-week washout period.
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Intervention code [1]
266876
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Treatment: Drugs
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Comparator / control treatment
Placebo combined with monocular occlusion of the amblyopic eye, 2 hours per day for 2 weeks. This study will adopt a cross-over design with placebo and drug arms separated by a 2-week washout period. The placebo wil be made of methlycellulose in a gelatin capsule.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Visual acuity in the amblyopic eye measured using a LogMAR eye chart
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Assessment method [1]
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Timepoint [1]
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Baseline measurements upon participant recruitment, directly before the first 2 weeks of occlusion, directly after the first 2weeks of occlusion, at the end of the 2 week washout period which is also directly before the second 2 weeks of occlusion, directly after the second 2 weeks of occlusion and 2 weeks after the second 2 weeks of occlusion (second washout period).
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Secondary outcome [1]
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Amplitude and/or latency of the amblyopic eye pattern reversal visual evoked potential
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Assessment method [1]
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Timepoint [1]
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Baseline measurements upon participant recruitment, directly before the first 2 weeks of occlusion, directly after the first 2weeks of occlusion, at the end of the 2 week washout period which is also directly before the second 2 weeks of occlusion, directly after the second 2 weeks of occlusion and 2 weeks after the second 2 weeks of occlusion (second washout period).
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Secondary outcome [2]
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Amplitude and/or latency of the amblyopic eye multifocal electroretinogram
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Assessment method [2]
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Timepoint [2]
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Baseline measurements upon participant recruitment, directly before the first 2 weeks of occlusion, directly after the first 2weeks of occlusion, at the end of the 2 week washout period which is also directly before the second 2 weeks of occlusion, directly after the second 2 weeks of occlusion and 2 weeks after the second 2 weeks of occlusion (second washout period).
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Secondary outcome [3]
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Stereoscopic depth perception measured using the Randot Test, the Frisby test and the TNO test (TNO is the official name of this test rather than an abbreviation).
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Assessment method [3]
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Timepoint [3]
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Baseline measurements upon participant recruitment, directly before the first 2 weeks of occlusion, directly after the first 2weeks of occlusion, at the end of the 2 week washout period which is also directly before the second 2 weeks of occlusion, directly after the second 2 weeks of occlusion and 2 weeks after the second 2 weeks of occlusion (second washout period).
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Secondary outcome [4]
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Suppression measured using the Worth 4 Lights test and the Bagolini Striated Lenses test
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Assessment method [4]
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Timepoint [4]
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Baseline measurements upon participant recruitment, directly before the first 2 weeks of occlusion, directly after the first 2weeks of occlusion, at the end of the 2 week washout period which is also directly before the second 2 weeks of occlusion, directly after the second 2 weeks of occlusion and 2 weeks after the second 2 weeks of occlusion (second washout period).
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Secondary outcome [5]
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Motor cortex excitability measured using transcranial magnetic stimulation and motor evoked potentials
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Assessment method [5]
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Timepoint [5]
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Baseline measurements upon participant recruitment, directly before the first 2 weeks of occlusion, directly after the first 2weeks of occlusion, at the end of the 2 week washout period which is also directly before the second 2 weeks of occlusion, directly after the second 2 weeks of occlusion and 2 weeks after the second 2 weeks of occlusion (second washout period).
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Secondary outcome [6]
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Motor cortex plasticity measured using the paired associative stimulation technique that involves transcranial magnetic stimulation, electrical nerve stimulation and motor evoked potentials
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Assessment method [6]
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Timepoint [6]
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Baseline measurements upon participant recruitment, directly before the first 2 weeks of occlusion, directly after the first 2weeks of occlusion, at the end of the 2 week washout period which is also directly before the second 2 weeks of occlusion, directly after the second 2 weeks of occlusion and 2 weeks after the second 2 weeks of occlusion (second washout period).
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Secondary outcome [7]
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Heart rate variability. Heart rate will be measured using a standard Polar chest strap and watch. This chest strap is a heart rate monitor that is fitted around the participant's chest, so that it is in contact with their skin. The watch is worn by the researcher and is connected with the polar chest strap, displaying the participant's heart rate and recording the hart rate data. The participant's heart rate data will be downloaded to a computer for subsequent calculation and analysis of heart rate variability (HRV). The analysis of HRV will utilise a method called frequency domain analysis, which is based on the theory that the parasympathetic and sympathetic systems of the autonomic nervious system modulate heart rate intervals at specific frequencies. Essentially, the parasympathetic activity is linked to a fast, high frequency range while sympathetic activity is associated with a low frequency range. HRV information can be gained by analysing the fluctuations in frequency.
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Assessment method [7]
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Timepoint [7]
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Baseline measurements upon participant recruitment, directly before the first 2 weeks of occlusion, directly after the first 2weeks of occlusion, at the end of the 2 week washout period which is also directly before the second 2 weeks of occlusion, directly after the second 2 weeks of occlusion and 2 weeks after the second 2 weeks of occlusion (second washout period).
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Secondary outcome [8]
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Blood tests for brain derived neurotrophic factor genotype and 5-HT transporter genotype as well as blood levels of citalopram
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Assessment method [8]
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Timepoint [8]
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Directly after each 2 week session of monocular occlusion
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Eligibility
Key inclusion criteria
Monocular amblyopia
No ocular pathology
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
A personal history, or family history, of mood disorder such as depression or bipolar disorder, diabetes, a history of drug, alcohol or nicotine addiction, taking medications or supplements known to alter moods such as St John’s Wort, taking medications which affect SSRIs, such as codeine (coughing, pain killer medication), being a postgraduate student supervised by one of the researchers involved in this study.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Potential participants will self-identify, by responding to advertisements, posters, flyers, newspaper advertisements and web-based recruitment (such as getparticipants.com). Participants may also be provided with a participant information sheet or given the contact details of the researchers by their optometrist. If screening indicates that the participant is eligible all researchers who have responsibility for data collection will be blinded to whether the participant receives placebo tablets in the first or second 2-week periods of monocular occlusion. The tablets are prepared and supplied in unmarked blister packs by a pharmacist involved in the study who has no contact with the participants. Allocation will be by concealment using central randomization by computer.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Custom computer software will be used to randomize participants into the drug first or drug second groups. This software takes into account the ages and genders of participants already allocated to each group before making an allocation.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Crossover
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Other design features
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Phase
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/10/2011
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Actual
16/09/2011
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Date of last participant enrolment
Anticipated
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Actual
2/12/2013
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
20
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Accrual to date
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Final
7
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Recruitment outside Australia
Country [1]
3680
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New Zealand
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State/province [1]
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Auckland
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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The Marsden Fund
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Address [1]
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Marsden Fund
The Royal Society of New Zealand
Level 11, Freyberg House
20 Aitken Street
Thorndon 6001
Wellington
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Country [1]
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New Zealand
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Primary sponsor type
University
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Name
The University of Auckland
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Address
The University of Auckland
Private Bag 90210
Auckland
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
266414
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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The Northern X Regional Ethics Commitee
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Ethics committee address [1]
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3rd floor, Unisys building 650 Great South Rd Penrose Private Bag 92-522, Wellesley St Auckland
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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Approval date [1]
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14/06/2011
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Ethics approval number [1]
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NTX/11/06/044
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Summary
Brief summary
Amblyopia, or ‘lazy eye’, is a developmental disorder of the visual cortex. An effective treatment for amblyopia in children is patching the healthy eye to encourage use of the amblyopic eye; however this treatment is not effective in adults because the adult brain does not have sufficient capacity for change, a property known as neural plasticity. Neural plasticity is the process by which connections between neurons in the brain are formed and strengthened by new experiences, and is an essential component of learning and memory. Recent studies have shown that anti-depressant drugs are capable of reinstating plasticity in the adult brain. This study will determine whether the anti-depressant drug Citalopram will restore sufficient plasticity within the adult brain to allow for short-term patching (2 hours per day for two weeks) to improve visual function in adults with amblyopia.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Benjamin Thompson
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Address
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Department of Optometry and Vision Science
University of Auckland
Auckland
New Zealand
1142
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Country
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New Zealand
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Phone
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+64 9 5236020
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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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Benjamin Thompson
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Address
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Department of Optometry and Vision Science
University of Auckland
Private Bag 92019
Auckland
1142
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Country
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New Zealand
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Phone
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+64 9 923 6020
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Benjamin Thompson
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Address
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Department of Optometry and Vision Science
University of Auckland
Private Bag 92019
Auckland
1142
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Country
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New Zealand
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Phone
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+64 9 923 6020
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Fax
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Email
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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
Source
Title
Year of Publication
DOI
Embase
Advances in Amblyopia Treatment: Paradigm Shifts and Future Directions.
2017
https://dx.doi.org/10.1097/IIO.0000000000000184
Embase
The effect of combined patching and citalopram on visual acuity in adults with amblyopia: A randomized, crossover, placebo-controlled trial.
2019
https://dx.doi.org/10.1155/2019/5857243
N.B. These documents automatically identified may not have been verified by the study sponsor.
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