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 trial tests a new training method called reminder-cue scanning training to help people with visual field loss improve their scanning skills while driving. The research aims to determine if reminder cues can help these individuals navigate roads safely. Participants will undergo this training in a driving simulator. Individuals with visual field loss affecting half of their vision for at least three months and decent vision in both eyes might be suitable candidates, especially if they have previous driving experience. As an unphased trial, this study provides a unique opportunity to contribute to innovative research that could enhance driving safety for individuals with visual field loss.

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.

What prior data suggests that this training method is safe for people with visual field loss?

Research has shown that reminder-cue scanning training is generally safe. Studies have found that this training, which helps individuals use their eyes to search for objects, can benefit those with vision problems. It has been used to assist people with vision loss on one side, known as homonymous hemianopia.

In these studies, the training did not cause serious side effects. Participants improved their scanning ability without major issues, suggesting that reminder-cue scanning training is well-tolerated. However, as with any new method, participants should report any problems they experience during the trial. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about reminder-cue scanning training for visual field loss because it offers a novel approach to rehabilitation. Unlike traditional therapies that might focus on compensatory strategies or optical aids, this method uses a driving simulator to provide real-world, practical training. This immersive technique aims to improve the way individuals naturally scan their environment, potentially enhancing their ability to navigate daily life more effectively. By harnessing the power of simulation, this training could offer a more engaging and directly applicable way to help those with visual field loss regain confidence and independence.

What evidence suggests that reminder-cue scanning training is effective for visual field loss?

Research has shown that scanning training, included in the reminder-cue scanning training for participants in this trial, can greatly enhance visual search and reading skills. This training aids individuals with visual field loss by teaching them to scan their surroundings more effectively. Previous studies have demonstrated that this training can improve scanning habits, potentially increasing safety and confidence while driving. Although evidence remains limited, early results are promising for helping people with visual field loss navigate their environment more effectively. ^{1 2 3 4 5}

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

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]

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]

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]

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]

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]

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]

Citations

1. clinicaltrials.gov clinicaltrials.gov/study/NCT06136169

Reminder-cue Scanning Training for Homonymous Visual ... Reminder-cue Scanning Training for Homonymous Visual Field Loss ... Homonymous visual field loss is the loss of vision on the same side in both eyes.

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12446690/

A randomized controlled trial of Scanning Eye trAining as a ... Visual field loss ... However, there is limited evidence that compensatory visual search training is effective at improving search scanning outcomes.

3. withpower.com withpower.com/trial/phase-hemianopsia-2024-4e713

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 ...

4. centerwatch.com centerwatch.com/clinical-trials/listings/NCT06136169/reminder-cue-scanning-training-for-homonymous-visual-field-loss

Reminder-cue Scanning Training for Homonymous Visual ... This study will evaluate a new approach to training people with visual field loss to scan when driving.

5. tandfonline.com tandfonline.com/doi/full/10.1080/09638288.2023.2243590

A systematic review on visual scanning behaviour in ... Compensatory scanning training can induce performance-enhancing scanning behaviour. Keywords: Hemianopia · scanning · eye movements · mobility · reading ...