Reminder-cue Scanning Training for Homonymous Visual Field Loss

Reminder-cue Scanning Training for People With Homonymous Visual Field Loss

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

Study Overview

• Status: Active, not recruiting
• Conditions: Homonymous Hemianopia; Homonymous Quadrantanopia
• Intervention / Treatment: Behavioral: Reminder-cue scanning training

Detailed Description

Homonymous visual field loss is the loss of vision on the same side in both eyes. The most common types are hemianopia (the loss of one half of the field of vision) and quadrantanopia (the loss of one quarter of the field of vision). Hemianopia and quadrantanopia may cause difficulties in seeing objects on the side of the field loss. People with these types of field loss can compensate by scanning (looking) toward the side of the field loss. However, sometimes they might not scan sufficiently well resulting in delayed responses to hazards when driving. The purpose of this research study is to evaluate a new approach, "reminder-cue scanning training", to training people with homonymous visual field loss to scan when driving.

Participants will receive reminder-cue scanning training in the driving simulator.Typically there will be three training sessions within about a 2-week period. In addition, participants will complete an evaluation in the driving simulator before and after the training.

• Study Type: Interventional
• Enrollment (Actual): 16
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Massachusetts
    • Boston, Massachusetts, United States, 02114
      • Schepens Eye Research Institute of Mass Eye and Ear

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Homonymous hemianopia or homonymous quadrantanopia for at least 3 months
• Binocular visual acuity of at least 20/40
• Prior or current driving experience
• Able to attend multiple study visits
• 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

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: StudyArm; Participants will receive reminder-cue scanning training in a driving simulator.	Behavioral: Reminder-cue scanning training; Auditory reminders to scan when scanning to the side of the field loss is inadequate

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Rate of Early Large Head Scans to the Side of the Field Loss	Percentage of intersections at which an early large head scan was made to the side of the field loss	Pre-training, post-training (1 week)
Detection Rate for Hazards on the Side of the Field Loss	Percentage of hazards detected out of the total number of hazards on the side of the field loss	Pre-training, Post-training (1 week)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of Head Scans to the Side of the Field Loss	Number of head scans per intersection to the side of the field loss. A validated algorithm was used to detect head scans, defined as lateral rotations of the head away from the straight ahead position toward either the left or the right, which exceeded a predefined threshold based on the participant's distance to the intersection: ≥ 4° (100 to 50 m to intersection), ≥ 6° (50 to 20m), ≥ 10° (20 to 0m). Savage SW, Zhang L, Swan G, Bowers AR (2020) The effects of age on the contributions of head and eye movements to scanning behavior at intersections. Transp Res Part F Traffic Psychol Behav. 73:128-142. Swan G, Goldstein RB, Savage SW, Zhang L, Ahmadi A, Bowers AR (2021) Automatic processing of gaze movements to quantify gaze scanning behaviors in a driving simulator. Behav Res Methods. 53(2): 487-506	Pre-training, Post-training (1 week)
Magnitude of Head Scans to the Side of the Field Loss	Mean magnitude (in degrees) of head scans to the side of the field loss. A validated algorithm was used to detect head scans, defined as lateral rotations of the head away from the straight ahead position toward either the left or the right, which exceeded a predefined threshold based on the participant's distance to the intersection: ≥ 4° (100 to 50 m to intersection), ≥ 6° (50 to 20m), ≥ 10° (20 to 0m). The magnitude is the lateral angular extent of the scan measured from the straight-ahead position to the furthest lateral position to the left or right. Savage SW, Zhang L, Swan G, Bowers AR (2020) The effects of age on the contributions of head and eye movements to scanning behavior at intersections. Transp Res Part F Traffic Psychol Behav. 73:128-142. Swan G, Goldstein RB, Savage SW, Zhang L, Ahmadi A, Bowers AR (2021) Automatic processing of gaze movements to quantify gaze scanning behaviors in a driving simulator. Behav Res Methods. 53(2): 487-506	Pre-training, Post-training (1 week)
Response Times to Hazards on the Side of the Field Loss	Mean time (in seconds) between the hazard appearing and the horn-press response	Pre-training, Post-training (1 week)

Collaborators and Investigators

• Sponsor: Massachusetts Eye and Ear Infirmary
• Collaborators: National Eye Institute (NEI)
• Investigators: Principal Investigator: Alex Bowers, PhD, Schepens Eye Research Institute of Mass Eye and Ear

Study record dates

Study Major Dates

• Study Start (Actual): May 14, 2024
• Primary Completion (Actual): May 11, 2025
• Study Completion (Estimated): May 1, 2026

Study Registration Dates

• First Submitted: November 9, 2023
• First Submitted That Met QC Criteria: November 14, 2023
• First Posted (Actual): November 18, 2023

Study Record Updates

• Last Update Posted (Actual): May 12, 2026
• Last Update Submitted That Met QC Criteria: April 20, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Neurologic Manifestations; Nervous System Diseases; Eye Diseases; Vision Disorders; Sensation Disorders; Blindness; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Hemianopsia
• Other Study ID Numbers: HST_Pilot; R01EY025677 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No