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Vision Rehabilitation Training With Multimodal Feedback in Central Vision Loss

5 mai 2026 mis à jour par: New England College of Optometry

Central vision loss from macular degeneration creates blind spots that impair reading, face recognition, and navigation. Individuals must learn to use peripheral vision, requiring retraining of eye movements. Our preliminary research using high-speed eye tracking demonstrated that people with larger scotomas have impaired eye movement control, and that single-session visual feedback training showed limited immediate benefit, though combining feedback types showed promise.

This study will evaluate whether extended binocular training (5 weekly sessions) with multimodal feedback improves eye movement control in 8-15 participants with bilateral central vision loss. Unlike conventional monocular rehabilitation systems, our approach trains both eyes simultaneously using real-time visual and auditory feedback during saccadic and smooth pursuit tasks. Participants will receive gaze-contingent scotoma awareness feedback, preferred retinal locus feedback, and auditory cues while performing eye tracking exercises.

Primary outcomes include saccadic accuracy (latency, landing error, amplitude) and smooth pursuit parameters (gain, tracking accuracy). Secondary outcomes include contrast sensitivity and self-reported visual function. Success could establish an evidence base for accessible home-based training using virtual reality technology, potentially benefiting millions with macular degeneration.

Aperçu de l'étude

Type d'étude

Interventionnel

Inscription (Estimé)

12

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Coordonnées de l'étude

  • Nom: Nicole C Ross, OD
  • Numéro de téléphone: 6175875626
  • E-mail: rossn@neco.edu

Sauvegarde des contacts de l'étude

Lieux d'étude

    • Massachusetts
      • Boston, Massachusetts, États-Unis, 02115
        • Recrutement
        • New England College of Optometry
        • Contact:
          • Nicole C Ross, OD, MSc.
          • Numéro de téléphone: 617-587-5626
          • E-mail: rossn@neco.edu
        • Contact:

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

  • Enfant
  • Adulte
  • Adulte plus âgé

Accepte les volontaires sains

Non

La description

Inclusion Criteria:

Bilateral central scotomas confirmed via computerized tangent screen Visual acuity between 20/60 and 20/200 (0.5 - 1.00 logMAR) in either eye Stable central vision loss (no change in visual acuity >0.2 logMAR in past 6 months) Age 14 years or older, with diagnosis of macular disease Normal cognitive function (Mini-Mental State Examination score ≥24) Ability to provide informed consent and complete study visits No major hearing loss Fluent in English

Exclusion Criteria:

Unstable ocular disease (e.g., ongoing treatments and/or injections) Peripheral vision loss of less than 40 degrees Conditions affecting oculomotor control independent of CVL

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Autre
  • Répartition: N / A
  • Modèle interventionnel: Affectation à un seul groupe
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: Feedback Training
All participants will receive binocular oculomotor training with multimodal feedback. Participants will complete 5 weekly training sessions (approximately 60 minutes each) performing saccadic and smooth pursuit eye movement exercises. Training incorporates three types of feedback presented systematically across sessions: (1) scotoma awareness feedback via gaze-contingent black circle overlay representing the blind spot, (2) preferred retinal locus (PRL) feedback via dynamic gaze-contingent ring showing real-time fixation location, and (3) auditory feedback with tone modulation indicating fixation stability, PRL accuracy, and target acquisition. Eye movements are recorded using binocular eye tracking at 2000Hz. Contrast sensitivity is assessed intermittently during training using adaptive Gabor presentations. Outcomes are measured at baseline (Week 0) and post-training (Week 6).

Participants will complete 5 weekly training sessions (approximately 60 minutes each) performing eye movement exercises while receiving real-time multimodal feedback. Training includes:

Saccadic Training: Visually-guided saccades to targets appearing at randomized locations with instructions to use peripheral (inferior) retinal locus. Targets shift horizontally, vertically, and obliquely to train all saccadic directions.

Smooth Pursuit Training: Circular pursuit of moving targets at 2.6°/s in randomized directions with instructions to maintain peripheral gaze above the target.

Feedback Modalities (systematically varied across sessions):Scotoma Awareness: Gaze-contingent black circle overlay representing participant's blind spot; Preferred Retinal Locus (PRL) Feedback: Dynamic gaze-contingent ring showing real-time fixation location; Auditory Feedback: Tone modulation indicating fixation stability, PRL accuracy, and target acquisition success; Combined multimodal feedback

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Change in Saccadic Accuracy (Landing Error)
Délai: At First study visit - Baseline, At each training visit (week 1, week 2, week 3, week 4, week 5, and post training (week 11 )
Mean distance in degrees between saccade landing position and target location, measured using binocular eye tracking during visually-guided saccade tasks. Lower values indicate better accuracy.
At First study visit - Baseline, At each training visit (week 1, week 2, week 3, week 4, week 5, and post training (week 11 )

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Change in Saccadic Latency
Délai: At First study visit - Baseline, At each training visit (week 1, week 2, week 3, week 4, week 5, and post training (week 11 )
Time in milliseconds from target appearance to saccade initiation, measured using binocular eye tracking. Faster latencies indicate improved oculomotor response.
At First study visit - Baseline, At each training visit (week 1, week 2, week 3, week 4, week 5, and post training (week 11 )
Change in Smooth Pursuit Gain
Délai: At First study visit - Baseline, At each training visit (week 1, week 2, week 3, week 4, week 5, and post training (week 11 )
Ratio of eye velocity to target velocity during smooth pursuit tasks (optimal gain = 1.0). Higher gain values indicate better pursuit tracking accuracy.
At First study visit - Baseline, At each training visit (week 1, week 2, week 3, week 4, week 5, and post training (week 11 )
Change in Number of Catch-up Saccades During Pursuit
Délai: At First study visit - Baseline, At each training visit (week 1, week 2, week 3, week 4, week 5, and post training (week 11 )
Mean number of corrective saccades per trial during smooth pursuit tasks. Fewer catch-up saccades indicate smoother, more accurate pursuit performance.
At First study visit - Baseline, At each training visit (week 1, week 2, week 3, week 4, week 5, and post training (week 11 )
Change in Contrast Sensitivity Function
Délai: Baseline, Post-training (Week 6)
Area under the log contrast sensitivity function (AULCSF) measured using adaptive Gabor presentations during eye movement tasks. Higher values indicate better contrast sensitivity.
Baseline, Post-training (Week 6)
Change in Fixation Stability
Délai: Baseline, Post-training (Week 6)
Area of the bivariate contour ellipse at 95% confidence interval of fixation positions during stationary target fixation tasks, measured in square degrees. Smaller ellipse area indicates more stable fixation.
Baseline, Post-training (Week 6)
Change in Vision Related Quality of Life
Délai: At First study visit - Baseline, at last training session - week 5, and post training (week 11 )
Baseline, Post-training (Week 6)
At First study visit - Baseline, at last training session - week 5, and post training (week 11 )

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Liens utiles

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

31 janvier 2026

Achèvement primaire (Estimé)

1 décembre 2026

Achèvement de l'étude (Estimé)

1 décembre 2026

Dates d'inscription aux études

Première soumission

30 janvier 2026

Première soumission répondant aux critères de contrôle qualité

5 mai 2026

Première publication (Réel)

11 mai 2026

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

11 mai 2026

Dernière mise à jour soumise répondant aux critères de contrôle qualité

5 mai 2026

Dernière vérification

1 mai 2026

Plus d'information

Termes liés à cette étude

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INDÉCIS

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

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