Visual Restoration for Hemianopia

NCT ID: NCT03350919

Last Updated: 2020-12-24

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

48 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-03-15

Study Completion Date

2019-12-03

Brief Summary

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The purpose of this research is to assess the efficacy of a visual training task on reducing the size of a visual field deficit caused by brain damage in adults, and its ability to improve visual functions in this patient population.

Detailed Description

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Conditions

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Stroke Induced Vision Loss Hemianopia Quadrantanopia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Training in the blind field

Training in the blind field using software

Group Type EXPERIMENTAL

Training in the blind field

Intervention Type DEVICE

A computer software and chin-rest necessary to perform visual training will be loaned to each patient to use at home. They will perform one to two daily training sessions in their home, consisting of 200-300 trials each. The visual task performed repetitively will involve discriminating the direction of motion of a small cloud of dots located at a pre-determined location in the blind field. The computer program will automatically create a record of patient performance during each home training session. They will train daily (about 40-60 minutes total), 5 to 7 days per week, for at least 24 weeks.

Training in the intact field

Training in the intact field using software

Group Type EXPERIMENTAL

Training in the intact field

Intervention Type DEVICE

A computer software and chin-rest necessary to perform visual training will be loaned to each patient to use at home. They will perform one to two daily training sessions in their home, consisting of 200-300 trials each. The visual task performed repetitively will involve discriminating the direction of motion of a small cloud of dots located at a pre-determined location in the intact field of vision. The computer program will automatically create a record of patient performance during each home training session. They will train daily (about 40-60 minutes total), 5 to 7 days per week, for at least 24 weeks.

Interventions

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Training in the blind field

A computer software and chin-rest necessary to perform visual training will be loaned to each patient to use at home. They will perform one to two daily training sessions in their home, consisting of 200-300 trials each. The visual task performed repetitively will involve discriminating the direction of motion of a small cloud of dots located at a pre-determined location in the blind field. The computer program will automatically create a record of patient performance during each home training session. They will train daily (about 40-60 minutes total), 5 to 7 days per week, for at least 24 weeks.

Intervention Type DEVICE

Training in the intact field

A computer software and chin-rest necessary to perform visual training will be loaned to each patient to use at home. They will perform one to two daily training sessions in their home, consisting of 200-300 trials each. The visual task performed repetitively will involve discriminating the direction of motion of a small cloud of dots located at a pre-determined location in the intact field of vision. The computer program will automatically create a record of patient performance during each home training session. They will train daily (about 40-60 minutes total), 5 to 7 days per week, for at least 24 weeks.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Ages 21-75 years old
* Ability and willingness to sign informed consent
* Willingness to participate in both the training and evaluation sessions
* MRI or CT scan demonstrating lesion in the occipital lobe of the brain and/or affecting white matter tracts that provide visual input to the occipital lobe of the brain
* Brain injury due to ischemic or hemorrhagic causes that occurs after age 18 and at least 90 days prior to screening visit
* At least two reliable HVF's demonstrating good fixation and a stable homonymous incomplete (e.g., quadrantanopia or relative defect) or complete hemianopia
* Reliable HVFs with repeat HVFs if randomization takes place more than 4 weeks after screening visit
* A homonymous, contiguous visual deficit measured by the 24-2 HVF to be a minimum of two testing locations high and two testing locations wide, where impaired locations are any that measure a threshold of less than 15 dB.
* Demonstration of good fixation on visual training task - able to fixate the small targets presented as fixation letters reliably for 1000ms with jitter over less than 1 degree of visual angle in any direction away from target edge

Exclusion Criteria

* Physical, neurological or mental disability that would interfere with study intervention
* Concurrent participation in "vision therapy" other than standard occupational or physical therapy
* Unreliable visual fields on prior testing, indicated by greater than 20% fixation losses, false positives, or false negatives.
* Inability to discontinue medications judged to affect training and/or assessment (e.g., Ritalin, amphetamines, dopamines, or chemotherapeutic agents)
* Physical condition likely to preclude completion of the clinical trial (e.g. end-stage or uncontrolled cancer, uncontrolled epilepsy, or end-stage heart disease)
* Ocular or neurological condition that would interfere with training or assessment (e.g. damage to the optic nerves or lateral geniculate nucleus, any degenerative ocular condition)
* Best corrected vision worse than 20/40
* Impaired foveal Humphrey sensitivity as indicated by the HVF tests.
* Presence of vision loss resulting from ocular disease or disorder
* Presence of bilateral visual acuity loss from any source
* Inability to demonstrate fixation stability on eye movement monitored testing
* Inability to follow training instructions
Minimum Eligible Age

21 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Envision Solutions, LLC

OTHER_GOV

Sponsor Role collaborator

University of Rochester

OTHER

Sponsor Role lead

Responsible Party

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Steven Feldon

Professor and Chair of Ophthalmology

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Bascom Palmer Eye Institute, University of Miami Health Services

Miami, Florida, United States

Site Status

Flaum Eye Institute, University of Rochester Medical Center

Rochester, New York, United States

Site Status

Scheie Eye Institute

Philadelphia, Pennsylvania, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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69879

Identifier Type: -

Identifier Source: org_study_id