Virtual Reality Obstacle Detection for Visual Field Loss

Overseen By Eli Peli, OD, MSc

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Massachusetts Eye and Ear Infirmary

Disqualifiers: Cognitive dysfunction, Balance problems, Seizures, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

Duration: 4 months

15 Participants Needed

Trial Summary

Do I have to stop taking my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the idea that Virtual Reality Obstacle Detection for Visual Field Loss is an effective treatment?

The available research shows that Virtual Reality (VR) headsets for visual field testing are as effective, if not better, than traditional methods. They are more comfortable for patients, especially those with limited mobility, and are more cost-effective. This suggests that VR Obstacle Detection is a promising treatment for visual field loss. ^{1 2 3 4 5}

What data supports the effectiveness of the treatment Virtual Reality Obstacle Detection for Visual Field Loss?

Research shows that virtual reality headsets for visual field testing perform as well as or better than traditional methods, are more comfortable for patients, and are more accessible, especially for those with limited mobility. Additionally, vision rehabilitation devices using head-mounted displays have been developed and evaluated, showing potential benefits for people with visual field loss. ^{1 2 3 4 5}

What safety data is available for the Virtual Reality Obstacle Detection treatment?

The safety data for the Virtual Reality Obstacle Detection treatment includes a laser safety analysis of a retinal scanning display system, which indicates that the Virtual Retinal Display (VRD) is safe in both normal operating mode and in failure modes. Additionally, the development of a VR walking collision detection test on a head-mounted display addressed safety concerns such as physical collision and visual perception mismatches, showing promising potential as clinical outcome measures. ^{2 6 7 8 9}

Is the Virtual Reality Obstacle Detection System safe for humans?

Research indicates that virtual reality systems, including those using head-mounted displays (HMDs), are generally safe for human use. A study on a similar system, the Virtual Retinal Display, found it safe in both normal and failure modes, suggesting that these technologies are designed with safety in mind. ^{2 6 7 8 9}

Is the treatment 'Field expansion view' a promising treatment for visual field loss?

Yes, the 'Field expansion view' treatment using virtual reality is promising because it offers a new way to help people with visual field loss detect obstacles. It uses VR technology to expand the field of view, which can improve safety and awareness for those with vision impairments. ^{2 9 10 11 12}

How is the Virtual Reality Obstacle Detection System treatment different from other treatments for visual field loss?

The Virtual Reality Obstacle Detection System is unique because it uses a VR headset to help people with visual field loss detect obstacles, offering a novel approach compared to traditional methods like prism glasses. This system provides a virtual environment to simulate real-world scenarios, potentially improving hazard detection and navigation skills. ^{2 9 10 11 12}

What is the purpose of this trial?

This trial uses a VR headset to help people with visual field loss practice detecting and avoiding virtual pedestrians. The headset shows 3D images of people walking towards the user while they walk in a real-world setting. This helps improve their ability to avoid collisions in a safe environment.

Research Team

Eli Peli, OD, MSc

Principal Investigator

Senior Scientist

Eligibility Criteria

This trial is for people with visual field loss, such as hemianopia or tunnel vision. Participants must have binocular vision within normal limits, at least partial peripheral vision, and a visual acuity of no worse than 20/100 in the weaker eye. They should be over 14 years old, healthy enough for sessions up to 3 hours, understand English, consent voluntarily, and move independently.

Inclusion Criteria

I can walk by myself for short distances.

I can complete activities lasting 2-3 hours without significant difficulty.

I have lost vision in either half or the outer parts of my field of vision.

Exclusion Criteria

Any person with a self-reported medical history (such as pacemaker use or photosensitive epilepsy) or physical condition listed on the device manual of the Oculus / HMD system used for the experiment as a contraindication

I have had a seizure in the past 6 months.

I do not have any physical or mental disabilities that would affect my participation.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo pedestrian hazard detection tests using VR head-mounted displays with and without field expansion information

4 months

1 to 4 visits (each 2 to 4 hours)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• Field expansion view

Trial Overview The study is testing a new virtual reality (VR) system designed to help individuals with visual field loss detect obstacles while walking. It involves wearing a VR headset that simulates real-world environments and oncoming pedestrians in three dimensions.

Participant Groups

Group I: Field expansion view Experimental Treatment 1 Intervention

Various configurations of field expansion views will be additionally displayed on HMD

Who Is Running the Clinical Trial?

Massachusetts Eye and Ear Infirmary

Lead Sponsor

Trials

115

Recruited

15,000+

National Eye Institute (NEI)

Collaborator

Trials

572

Recruited

1,320,000+

Findings from Research

Virtual reality (VR) headsets for visual field testing have been shown to perform comparably or even better than traditional automated perimetry, based on a systematic review of 64 studies involving 36 different VR devices.

These VR devices are more cost-effective and better tolerated by patients, especially those with limited mobility, making them a promising alternative for visual field assessments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Virtual reality headsets for perimetry testing: a systematic review. Selvan, K., Mina, M., Abdelmeguid, H., et al.[2023]

A new visual field examination method using virtual reality glasses was tested on 10 patients, showing a high correlation (r=0.808) with traditional Humphrey perimeter results, indicating its reliability.

The study suggests that this virtual reality method could be a suitable alternative for clinical use in assessing visual fields, particularly for patients in glaucoma care.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Visual field examination method using virtual reality glasses compared with the Humphrey perimeter. Tsapakis, S., Papaconstantinou, D., Diagourtas, A., et al.[2022]

The research developed various vision rehabilitation devices, including a head-mounted display for tunnel vision and a device for enhancing central vision, aimed at helping individuals with different types of visual impairments.

Evaluation studies were conducted with patients to assess the effectiveness of these devices, focusing on their advantages and limitations in improving visual search capabilities in controlled indoor settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development and evaluation of vision rehabilitation devices. Luo, G., Peli, E.[2021]

A new Virtual Reality application has been developed to simulate various visual impairments, such as age-related macular degeneration and glaucoma, allowing users to experience the challenges faced by individuals with these conditions.

This application serves multiple purposes, including patient education and training for healthcare practitioners and eye care specialists, enhancing understanding of both normal and pathological eye anatomy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Simulation of eye disease in virtual reality. Jin, B., Ai, Z., Rasmussen, M.[2020]

The C3 field analyzer (CFA) demonstrated a higher reliability in visual field testing for neuro-ophthalmic patients, with 81.4% of tests being reliable compared to 59.3% for the traditional automated field analyzer (HFA).

CFA showed a strong correlation with HFA in detecting classic neurological field defects, such as hemianopia, with an 87.5% correlation, suggesting it could be a useful alternative for patients who struggle with standard perimetry.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparison of a New Head Mount Virtual Reality Perimeter (C3 Field Analyzer) With Automated Field Analyzer in Neuro-Ophthalmic Disorders. Odayappan, A., Sivakumar, P., Kotawala, S., et al.[2023]

The Virtual Retinal Display (VRD) uses laser light to project images directly onto the retina, and safety assessments show it operates within safe power levels for normal viewing and potential failure modes.

Maximum permissible exposure (MPE) calculations confirm that the VRD is safe for users, indicating that it does not pose a risk to eye health during regular use or in case of malfunctions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Laser safety analysis of a retinal scanning display system. Viirre, E., Johnston, R., Pryor, H., et al.[2019]

A new virtual reality (VR) walking collision detection test was developed using the Meta Quest 2 headset, allowing subjects to physically walk in a simulated busy shopping mall environment to assess their ability to detect and avoid collisions.

This VR platform addresses safety and consistency issues found in real-world obstacle courses, making it a promising tool for evaluating clinical interventions related to mobility and collision avoidance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development of Virtual Reality Walking Collision Detection Test on Head-mounted display. Hwang, AD., Peli, E., Jung, JH.[2023]

The Iowa Head-Mounted Display (HMD) Open-Source Perimeter shows comparable repeatability and accuracy in detecting visual field defects when tested against the Octopus 900 perimeter in both healthy individuals and glaucoma patients, with repeatability coefficients indicating similar performance.

This new HMD system is a more portable and cost-effective alternative to traditional perimeters, potentially increasing access to visual field testing for patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Validation of the Iowa Head-Mounted Open-Source Perimeter. Heinzman, Z., Linton, E., Marín-Franch, I., et al.[2023]

A new portable visual field testing system using a VR headset (Oculus Quest 2) was developed and tested on 21 healthy subjects, showing strong agreement with traditional visual field analyzers, indicating its potential efficacy.

The VR kinetic perimetry system demonstrated good reproducibility and could provide a more accessible and portable alternative to conventional kinetic perimetry methods, which may improve patient screening in clinical settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Kinetic Perimetry on Virtual Reality Headset. Terracciano, R., Mascolo, A., Venturo, L., et al.[2023]

A new virtual reality (VR) software was developed to evaluate detection abilities in the human field of regard (FOR), revealing that detection times were faster in the field of view (FOV) compared to FOR conditions, with a notable left-side attention bias observed in the FOR condition.

The study's findings suggest that understanding the unique characteristics of human perception in the FOR can inform the design of interactive 3D user interfaces, potentially benefiting individuals with FOR-related handicaps.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Human field of regard, field of view, and attention bias. Jang, W., Shin, JH., Kim, M., et al.[2017]

The base-in multiplexing prism (MxP) glasses significantly improved the ability of patients with acquired monocular vision (AMV) to detect pedestrians approaching from their blind side, providing a true field expansion of about 25°.

In a virtual reality walking environment, participants with simulated AMV showed better pedestrian detection rates when using the MxP, indicating that these glasses could help reduce collision risks for individuals with AMV.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Field Expansion with Multiplexing Prism Glasses Improves Pedestrian Detection for Acquired Monocular Vision. Jung, JH., Castle, R., Kurukuti, NM., et al.[2023]

Current VR headsets have a minimum angular resolution of 0.41 logMAR on average, which is inadequate for reliable visual acuity testing and may not be suitable for treating conditions like amblyopia.

The average field of view for VR headsets is about 50.2°, which is significantly lower than manufacturer claims, but it may still be sufficient for certain visual field tests, although concerns exist for vergence testing due to varying eye-to-screen distances.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Measuring Virtual Reality Headset Resolution and Field of View: Implications for Vision Care Applications. Lynn, MH., Luo, G., Tomasi, M., et al.[2021]

References

1. England pubmed.ncbi.nlm.nih.gov

Virtual reality headsets for perimetry testing: a systematic review. [2023]

2. New Zealand pubmed.ncbi.nlm.nih.gov

Visual field examination method using virtual reality glasses compared with the Humphrey perimeter. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Development and evaluation of vision rehabilitation devices. [2021]

4. United States pubmed.ncbi.nlm.nih.gov

Simulation of eye disease in virtual reality. [2020]

5. United States pubmed.ncbi.nlm.nih.gov

Comparison of a New Head Mount Virtual Reality Perimeter (C3 Field Analyzer) With Automated Field Analyzer in Neuro-Ophthalmic Disorders. [2023]

6. United States pubmed.ncbi.nlm.nih.gov

Laser safety analysis of a retinal scanning display system. [2019]

7. United States pubmed.ncbi.nlm.nih.gov

Development of Virtual Reality Walking Collision Detection Test on Head-mounted display. [2023]

8. United States pubmed.ncbi.nlm.nih.gov

Validation of the Iowa Head-Mounted Open-Source Perimeter. [2023]

9. United States pubmed.ncbi.nlm.nih.gov

Kinetic Perimetry on Virtual Reality Headset. [2023]

10. Ireland pubmed.ncbi.nlm.nih.gov

Human field of regard, field of view, and attention bias. [2017]

11. United States pubmed.ncbi.nlm.nih.gov

Field Expansion with Multiplexing Prism Glasses Improves Pedestrian Detection for Acquired Monocular Vision. [2023]

12. United States pubmed.ncbi.nlm.nih.gov

Measuring Virtual Reality Headset Resolution and Field of View: Implications for Vision Care Applications. [2021]