Homonymous Hemianopia, Homonymous Quadrantanopia
Conditions
Brief summary
This study will evaluate a new approach to training people with visual field loss to scan when driving
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.
Interventions
BEHAVIORALReminder-cue scanning training
Auditory reminders to scan when scanning to the side of the field loss is inadequate
Sponsors
Massachusetts Eye and Ear Infirmary
National Eye Institute (NEI)
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
16 Years to No maximum
Healthy volunteers
No
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of Early Large Head Scans to the Side of the Field Loss | Pre-training, post-training (1 week) | Percentage of intersections at which an early large head scan was made to the side of the field loss |
| Detection Rate for Hazards on the Side of the Field Loss | Pre-training, Post-training (1 week) | Percentage of hazards detected out of the total number of hazards on the side of the field loss |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of Head Scans to the Side of the Field Loss | Pre-training, Post-training (1 week) | 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 |
| Magnitude of Head Scans to the Side of the Field Loss | Pre-training, Post-training (1 week) | 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 |
| Response Times to Hazards on the Side of the Field Loss | Pre-training, Post-training (1 week) | Mean time (in seconds) between the hazard appearing and the horn-press response |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORAlex Bowers, PhD
Schepens Eye Research Institute of Mass Eye and Ear
Participant flow
Recruitment details
Participants were recruited from local ophthalmology outpatient clinics
Baseline characteristics
| Characteristic | — |
|---|---|
| Age, Continuous | 52.5 years |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 1 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) White | 15 Participants |
| Sex: Female, Male Female | 7 Participants |
| Sex: Female, Male Male | 9 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 16 |
| other Total, other adverse events | 0 / 16 |
| serious Total, serious adverse events | 0 / 16 |
Outcome results
None listed