Remapping the Visual Field to Aid Reading With Central Scotomas
Trial Snapshot
- Phase
- Not Applicable
- Status
- Recruiting
- Sponsor
- University of Minnesota
- Enrollment
- 108
- Locations
- 1
- Primary Endpoint
- Reading Speed for Natural Text Samples
Study Overview
Brief Summary
Reading performance in patients with Central Vision Loss and age matched controls with artificial scotomas will be measured with and without different kinds of remapping of missing text to different parts of the visual field.
Detailed Description
Following initial characterization of their visual field loss, the participant's performance in reading tasks will be measured with and without remapping. Tasks will include reading groups of random letters, words, simple sentences, and "natural" text from the environment (taken from phone apps, signage, etc). Different kinds of remappings will be used by participants, including traditional and personalized remapping. For control observers, differently shaped artificial scotomas will be used.
Participants interested in the study will be brought in for an initial visit. All participants will be administered the MMSE. Observers who pass the criteria for the study will then have the remainder of the procedures described to them verbally prior to undergoing the remainder of the consent process (see below). Participants will then undergo a standard exam at the UMN eye clinic, if they have not had one within the last month.
Participants will then have their scotomas mapped using a microperimeter housed in the psychology department to give size and shape information. Additional perimetry may also be conducted using either of the two displays (either HMD or desk mounted computer monitor) we have developed. Here, patients will be asked to fixate at a spot on screen and identify visual stimuli presented at different regions of the screen. The size and locations of visual stimuli patients were unable to identify will provide the size and location of the scotoma. Another additional manual perimetry protocol may be conducted as well. This would involve asking subjects to fixate at the center of a tangent screen, and asking them to identify dots temporarily presented on the screen by the researcher using a laser pointer. The locations of dots that patients are unable to identify will provide the size and location of the scotoma. The location and extent of each eye's scotoma and PRL will be used as software inputs on either device. Perimetry using one or all of the methods above will be performed until acceptable information about the scotoma extent and location is obtained.
In a second visit, participants will perform the visual tasks that are used as the basis of their personalized remapping, letter perimetry. Participants will first view and report three randomly selected horizontally arranged letters placed at different locations in the visual field. This letter perimetry task will take about 40 min and will cover a large part of the visual field.
Participants will then read single words whose letters have been displaced from horizontal in various ways that comprise candidate remappings generated on the basis of the letter perimetry results. This personalization test will take about 40 minutes, and will find a good remapping strategy for the individual. Subjects will then be introduced to the reading tasks that comprise the remainder of the study
Study Design
- Study Type
- Interventional
- Allocation
- Non Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 16 Years to — (Child, Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •16 years or older
- •Central vision loss of at least 5 deg diameter, including the fovea, from bilateral central scotomas
- •Stable fixation (+/- 1 deg) using their PRL.
- •No cognitive impairment as indicated by a Mini-Mental State Examination (MMSE).
- •Satisfactory calibration achievable using eye tracker
Exclusion Criteria
- •Central vision loss of less than 5 deg diameter; scotomas that do not cover the fovea; unilateral scotomas
- •Poor fixation (worse than+/- 1 deg) using their PRL.
- •Cognitive impairment as indicated by a Mini-Mental State Examination (MMSE).
- •Satisfactory calibration not achievable using eye tracker
Arms & Interventions
Normally sighted with artificial scotoma
No remapping (control condition), traditional remapping, personalized remapping
Intervention: Traditional Remapping (Behavioral)
Normally sighted with artificial scotoma
No remapping (control condition), traditional remapping, personalized remapping
Intervention: Personalized Remapping (Behavioral)
Patients with scotoma
No remapping (control condition), traditional remapping, personalized remapping
Intervention: Traditional Remapping (Behavioral)
Patients with scotoma
No remapping (control condition), traditional remapping, personalized remapping
Intervention: Personalized Remapping (Behavioral)
Outcomes
Primary Outcomes
Reading Speed for Natural Text Samples
Time Frame: Measured during fifth visit; each visit is one day only and this measure refers to data gathered during a < 1 hr long reading session during that day
How quickly participants can correctly read displayed text
Reading error rate for Individual Words
Time Frame: Measured during third visit; each visit is one day only and this measure refers to data gathered during a < 1 hr long reading session during that day
How many mistakes participants make
Reading Speed for Individual Words
Time Frame: Measured during third visit- each visit is one day only and this measure refers to data gathered during a < 1 hr long reading session during that day
How quickly participants can correctly read displayed text
Reading Speed for Sentences
Time Frame: Measured during fourth visit- each visit is one day only and this measure refers to data gathered during a < 1 hr long reading session during that day
How quickly participants can correctly read displayed text
Reading error rate for Sentences
Time Frame: Measured during fourth visit; each visit is one day only and this measure refers to data gathered during a < 1 hr long reading session during that day
How many mistakes participants make
Reading error rate for Natural Text Samples
Time Frame: Measured during fifth visit; each visit is one day only and this measure refers to data gathered during a < 1 hr long reading session during that day
How many mistakes participants make
Secondary Outcomes
- Eye movement quality for sentences(Measured during fourth visit)
- Eye fixation quality for natural text samples(Measured during fifth visit; each visit is one day only and this measure refers to data gathered during a < 1 hr long reading session during that day)
- Eye fixation quality for words(Measured during third visit; each visit is one day only and this measure refers to data gathered during a < 1 hr long reading session during that day)
- Eye fixation quality for sentences(Measured during fourth visit; each visit is one day only and this measure refers to data gathered during a < 1 hr long reading session during that day)
- Eye movement quality for natural text samples(Measured during fifth visit; each visit is one day only and this measure refers to data gathered during a < 1 hr long reading session during that day)
