Visual Restoration for Hemianopia

Not Applicable

Completed

Brief Summary: 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.

Recruitment & Eligibility

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

Primary Outcome Measures

Name	Time	Method
24-2 Humphrey PMD Change From Baseline to 6-month Post-training Timepoint	6 months	Change in the perimetric mean deviation (PMD) generated by standard Humphrey automated perimetry using a 24-2 testing pattern between baseline and post-training after a 6-month training interval.

Secondary Outcome Measures

Name	Time	Method

Locations (3): Bascom Palmer Eye Institute, University of Miami Health Services
🇺🇸
Miami, Florida, United States
Flaum Eye Institute, University of Rochester Medical Center
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Rochester, New York, United States
Scheie Eye Institute
🇺🇸
Philadelphia, Pennsylvania, United States
Bascom Palmer Eye Institute, University of Miami Health Services
🇺🇸Miami, Florida, United States