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Virtual Reality-based Perceptual Learning Therapy for Visually Impaired Population

4. september 2026 oppdatert av: Centre for Eye and Vision Research

Virtual Reality-based Perceptual Learning Therapy for Visually Impaired Population: Study Protocol for a Randomized Clinical Trial

Visual impairments significantly impact individuals' activities of daily living (ADL) and quality of life (QoL). While perceptual learning (PL) has shown promise in vision rehabilitation, traditional PL usually involves a protracted training process, and its training effects may sometimes lack ecological validity. This study protocol outlines a two-arm, single-blind, randomized controlled trial to evaluate the efficacy of an innovative virtual reality (VR)-based PL therapy integrated with machine learning algorithms. Twenty participants with visual field deficits will be recruited and randomized in a 1:1 ratio into either the VR training group or a no-intervention control group. The intervention consists of six visits (1-7 days apart), each involving two training tasks (20 - 30 minutes per task). The VR training task is an Ecological Multiple Object Tracking task and a Dual task. Training stimuli are personalized to target each participant's transition zone (1~20 dB) based on the result of clinical visual field test. A Deep Reinforcement Learning (DRL) framework, specifically the Proximal Policy Optimization (PPO) algorithm, is utilized as an adaptive controller to dynamically modulate task difficulty and maintain participants in an optimal cognitive "flow state". The primary outcome is visual field area improvement (measured by Humphrey Field Analyzer). Secondary outcomes include pre- and post-intervention assessments of visual search, balance ability, fear of falling, ADL, and QoL. It is hypothesized that participants in the VR training group will obtain improvements in primary and secondary outcomes.

Studieoversikt

Status

Har ikke rekruttert ennå

Forhold

Intervensjon / Behandling

Studietype

Intervensjonell

Registrering (Antatt)

20

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiekontakt

Studiesteder

      • Hong Kong, Hong Kong
        • Units 901-903, 9/F, Building 17W, 17 Science Park West Avenue, Hong Kong Science Park, Pak Shek Kok, Shatin
        • Ta kontakt med:

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen
  • Eldre voksen

Tar imot friske frivillige

Nei

Beskrivelse

Inclusion Criteria:

  • Humphrey visual field analyzer (HFA) visual field loss (mean deviation of ≤-6 dB)

Exclusion Criteria:

  • Comprehension disorder that does not allow understanding of tests or training (e.g., in severe aphasia)
  • Currently under other PL treatment

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Dobbelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Virtual Reality-based Perceptual Learning Training

Prior to the training session, participants' visual fields will be assessed using standard automated perimetry (e.g., Humphrey Field Analyzer, 30-2 or 24-2 grid). Based on the decibel (dB) sensitivity maps from the clinical results, each participant's visual field will be classified into three functional zones: the intact zone (normal sensitivity), the absolute blind zone (<0 dB), and the transition zone or "gray area" (1~20 dB; relative scotoma characterized by reduced but present sensitivity).

One training session will be 20 ~30 minutes for each task. Participants will be asked to complete a total of 6 training sessions. In each training session, the participant will be asked to complete two tasks (i.e., ecological multiple object tracking task and dual task) which will take approximately one hour. Training sessions will be spaced at intervals of 1~7 days.

Ingen inngripen: No-intervention Control

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Visual Area Improvement
Tidsramme: Within one week after the training ends
Primary outcome is the visual area measured using the HVF (24-2, SITA-standard), where sensitivity increased by 6 dB or more relative to baseline in the defective hemifield or whole field.
Within one week after the training ends

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Pre/post-intervention assessments of visual search
Tidsramme: Within one week after the training ends
Visual search: Perceptual processing efficiency will be assessed using a visual search task - spatial configuration search task (Wolfe et al., 2010). In this task, participants were instructed to fixate on the centre of the screen and to locate a target. Each trial began with a short tone, followed after 500 ms by a search display. Participants pressed a key to report whether the target was present (in 50% of trials) or absent, responding as quickly and accurately as possible. Feedback-indicating response correctness-appeared for 500 ms after each trial. Trials were separated by a 1000-ms inter-trial interval. Set size was systematically varied across two conditions-6 items (1 target + 5 distractors) and 18 items (1 target + 17 distractors)-to quantify search efficiency. For each participant, reaction time (RT) was regressed on set size, and the resulting slope served as the primary index of perceptual processing efficiency: shallower slopes indicate higher efficiency.
Within one week after the training ends
Pre/post-intervention assessments of balance ability
Tidsramme: Within one week after the training ends
Balance: The Bertec Balance Advantage™ system is used to assess participants' balance before and after training. During the test, participants are asked to stand under different challenging conditions. Balance-challenging conditions include (1) standing on a firm or foam surface (Fi/Fo); (2) standing surface with backward or forward translation (BT/FT); and (3) standing with their eyes close (EC). Outcome measures, including root mean square sway of the center of pressure in the anterior - posterior and medial -lateral directions (mm/s), total sway path length (mm), and maximum CoP displacement in the AP and ML directions (mm)
Within one week after the training ends
Pre/post-intervention assessments of fear of fall
Tidsramme: Within one week after the training ends
Fear of fall: The English & Chinese version of the Falls Efficacy Scale-International (FES-I) is a validated and reliable questionnaire used to assess fear of falling in everyday life. The FES-I total score ranges from 16 to 64. Higher scores indicate greater concern about falling and therefore a worse outcome.
Within one week after the training ends
Pre/post-intervention assessments of quality of life (a)
Tidsramme: Within one week after the training ends
The National Eye Institute 25-Item Visual Function Questionnaire (NEI-VFQ-25), English and Chinese versions. The NEI VFQ-25 scores range from 0 to 100. Higher scores indicate better visual functioning and better vision-related quality of life and therefore represent a better outcome.
Within one week after the training ends
Pre/post-intervention assessments of quality of life (b)
Tidsramme: Within one week after the training ends
The Chinese version of the Low Vision Quality of Life Questionnaire (CLVQOL) is used to assess vision-related quality of life. The CLVQOL contains 25 items, each scored from 0 to 5, resulting in a theoretical total score ranging from 0 to 125. Higher scores indicate fewer vision-related difficulties and better vision-related quality of life and therefore represent a better outcome.
Within one week after the training ends

Samarbeidspartnere og etterforskere

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Sponsor

Samarbeidspartnere

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Antatt)

1. oktober 2026

Primær fullføring (Antatt)

1. oktober 2028

Studiet fullført (Antatt)

1. januar 2029

Datoer for studieregistrering

Først innsendt

31. august 2026

Først innsendt som oppfylte QC-kriteriene

4. september 2026

Først lagt ut (Faktiske)

9. september 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

9. september 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

4. september 2026

Sist bekreftet

1. september 2026

Mer informasjon

Begreper knyttet til denne studien

Andre studie-ID-numre

  • CEVR-PL-20260831

Plan for individuelle deltakerdata (IPD)

Planlegger du å dele individuelle deltakerdata (IPD)?

JA

IPD-delingstidsramme

After the publication of the study results, for an indefinite period.

Tilgangskriterier for IPD-deling

Upon reasonable request and with approval from the study's principal investigator.

IPD-deling Støtteinformasjonstype

  • STUDY_PROTOCOL
  • SEVJE

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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