Scanning Training for Visual Field Loss

Recruiting at 1 trial location

Overseen By Alex Bowers, PhD

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Massachusetts Eye and Ear Infirmary

Disqualifiers: Physical health problems, others

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

Compensation: Varies

Number of Visits: 3

30 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This study will evaluate a new approach to training people with visual field loss to scan when driving

Do I need to stop my current medications for this trial?

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

Is scanning training for visual field loss safe for humans?

The studies reviewed did not report any safety concerns related to scanning training for visual field loss, suggesting it is generally safe for humans. ^{1 2 3 4 5}

How does Reminder-cue scanning training differ from other treatments for visual field loss?

Reminder-cue scanning training is unique because it focuses on improving eye movement strategies to help patients better scan their environment, which can lead to faster reading and better obstacle avoidance. Unlike other treatments that aim to restore vision, this training enhances compensatory techniques, making it more user-friendly and effective for daily activities. ^{1 2 3 4 6}

What data supports the effectiveness of the treatment Reminder-cue scanning training for visual field loss?

Research shows that scanning training, which is part of the Reminder-cue scanning training, can significantly improve visual search performance and reading speed in patients with visual field defects. Studies found that these improvements are stable over time and help patients better manage daily activities. ^{1 2 3 4 7}

Who Is on the Research Team?

Alex Bowers, PhD

Principal Investigator

Schepens Eye Research Institute of Mass Eye and Ear

Are You a Good Fit for This Trial?

This trial is for people who have experienced a type of visual field loss called homonymous hemianopia or quadrantanopia and have been living with it for at least 3 months. Participants should have prior driving experience, be able to attend multiple study visits, communicate in English, and have a binocular visual acuity of at least 20/40. Those with physical health problems affecting simulator use, hemi-spatial neglect, or significant cognitive impairment cannot join.

Inclusion Criteria

I can attend all required study visits.

Prior or current driving experience

Able to communicate in English sufficiently to understand the study procedures

Exclusion Criteria

Physical or general health problems that could impair the ability to operate the controls of the driving simulator or participate in the training

You have difficulty paying attention to one side of your body or surroundings.

I have significant memory or thinking problems.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Training

Participants receive reminder-cue scanning training in a driving simulator

2 weeks

3 sessions (in-person)

Evaluation

Participants complete an evaluation in the driving simulator before and after the training

Up to 8 weeks

Follow-up

Participants are monitored for changes in scanning behavior post-training

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Reminder-cue scanning training

Trial Overview The study is testing a new training method called reminder-cue scanning training designed to help individuals with visual field loss improve their scanning techniques while driving.

How Is the Trial Designed?

Group I: StudyArm Experimental Treatment 1 Intervention

Participants will receive reminder-cue scanning training in a driving simulator.

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+

Published Research Related to This Trial

A novel eye movement training therapy significantly improved visual search performance in patients with chronic homonymous visual field defects, as evidenced by faster reaction times in a visual search task after training.

The improvement was specific to the patient group and only for targets presented in their blind visual field, indicating that the therapy effectively enhances compensatory eye movements in affected individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Rapid compensation of visual search strategy in patients with chronic visual field defects. Jacquin-Courtois, S., Bays, PM., Salemme, R., et al.[2022]

Systematic visual training, particularly scanning compensatory therapy (SCT), has shown significant improvements in visual search field size and reading performance, with studies reporting up to a 30-degree increase in visual search field and enhanced reading speed.

While some studies indicated potential benefits from vision restoration therapy (VRT), the overall effectiveness remains unclear, and SCT is recommended as a more effective and user-friendly rehabilitation approach until further evidence on VRT is established.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of visual training for patients with visual field defects due to brain damage: a systematic review. Bouwmeester, L., Heutink, J., Lucas, C.[2022]

In a study of 97 patients with unilateral homonymous hemianopia, targeted eye-movement training significantly improved scanning performance by approximately 40% and reading performance by about 45%, with these benefits lasting for up to 5 years after training.

The training was effective regardless of the patients' age or co-morbid conditions, demonstrating that systematic eye-movement strategies can effectively reduce visual impairments associated with this condition.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Aging and the rehabilitation of homonymous hemianopia: The efficacy of compensatory eye-movement training techniques and a five-year follow up. Zihl, J., Kentridge, RW., Pargent, F., et al.[2023]

A pilot study involving 23 patients with stable homonymous visual field deficits showed that vision restoration therapy (VRT) led to significant improvements in visual field detection, with a 4.2% increase in stimulus detection and fewer misses in the central visual field.

The study found that using a double-stimulation approach did not enhance visual field enlargements compared to standard VRT, suggesting that improvements were more related to enhanced spatial attention and alertness rather than the type of stimulation used.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Vision restoration therapy does not benefit from costimulation: A pilot study. Kasten, E., Bunzenthal, U., Müller-Oehring, EM., et al.[2010]

A systematic training procedure for patients with postchiasmatic visual field disorders led to a significant and stable increase of over 20° in visual search fields during training, which remained stable at a follow-up of 22 months.

Patients with additional left-sided visual neglect required about 25% more therapy sessions to achieve similar improvements in visual search fields compared to those without neglect, indicating that neglect may complicate recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Rehabilitation of homonymous scotomata in patients with postgeniculate damage of the visual system: saccadic compensation training. Kerkhoff, G., Münßinger, U., Haaf, E., et al.[2022]

Visual Restorative Function Training (vRFT) can lead to increased eye movement behavior towards visual field defects in chronic stroke patients, indicating changes in oculomotor behavior after training.

In a study of 6 hemianopia patients who underwent 65 hours of vRFT, those with the largest cortical gains showed significantly more eye movements towards their visual field defects, suggesting that a certain level of cortical restoration is necessary for improved oculomotor function.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Oculomotor behavior of hemianopic chronic stroke patients in a driving simulator is modulated by vision training. Bergsma, DP., Leenders, MJ., Verster, JC., et al.[2016]

In a study involving 29 patients with homonymous visual field defects, 20 daily training sessions over 4 weeks led to significantly shorter reaction times and improved search efficiency when locating targets among distractors.

The training resulted in specific changes in eye movement strategies, such as directing more fixations towards the target's location and making fewer saccades, which were maintained even after the training period ended.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Compensatory strategies following visual search training in patients with homonymous hemianopia: an eye movement study. Mannan, SK., Pambakian, AL., Kennard, C.[2022]

Citations

1. Italy pubmed.ncbi.nlm.nih.gov

Rapid compensation of visual search strategy in patients with chronic visual field defects. [2022]

2. England pubmed.ncbi.nlm.nih.gov

The effect of visual training for patients with visual field defects due to brain damage: a systematic review. [2022]

3. Netherlands pubmed.ncbi.nlm.nih.gov

Aging and the rehabilitation of homonymous hemianopia: The efficacy of compensatory eye-movement training techniques and a five-year follow up. [2023]

4. England pubmed.ncbi.nlm.nih.gov

Vision restoration therapy does not benefit from costimulation: A pilot study. [2010]

5. Netherlands pubmed.ncbi.nlm.nih.gov

Rehabilitation of homonymous scotomata in patients with postgeniculate damage of the visual system: saccadic compensation training. [2022]

6. Netherlands pubmed.ncbi.nlm.nih.gov

Oculomotor behavior of hemianopic chronic stroke patients in a driving simulator is modulated by vision training. [2016]

7. Germany pubmed.ncbi.nlm.nih.gov

Compensatory strategies following visual search training in patients with homonymous hemianopia: an eye movement study. [2022]