Virtual Reality Obstacle Detection for Visual Field Loss

Recruiting in Palo Alto (17 mi)

Overseen by Eli Peli, OD, MSc

Age: Any Age

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: Massachusetts Eye and Ear Infirmary

No Placebo Group

Trial Summary

What is the purpose of this trial?

This trial uses a VR headset to help people with visual field loss practice detecting and avoiding virtual pedestrians. The headset shows 3D images of people walking towards the user while they walk in a real-world setting. This helps improve their ability to avoid collisions in a safe environment.

Do I have to stop taking my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications.

What data supports the idea that Virtual Reality Obstacle Detection for Visual Field Loss is an effective treatment?

The available research shows that Virtual Reality (VR) headsets for visual field testing are as effective, if not better, than traditional methods. They are more comfortable for patients, especially those with limited mobility, and are more cost-effective. This suggests that VR Obstacle Detection is a promising treatment for visual field loss. ^{1 2 3 4 5}

What safety data is available for the Virtual Reality Obstacle Detection treatment?

The safety data for the Virtual Reality Obstacle Detection treatment includes a laser safety analysis of a retinal scanning display system, which indicates that the Virtual Retinal Display (VRD) is safe in both normal operating mode and in failure modes. Additionally, the development of a VR walking collision detection test on a head-mounted display addressed safety concerns such as physical collision and visual perception mismatches, showing promising potential as clinical outcome measures. ^{2 6 7 8 9}

Is the treatment 'Field expansion view' a promising treatment for visual field loss?

Yes, the 'Field expansion view' treatment using virtual reality is promising because it offers a new way to help people with visual field loss detect obstacles. It uses VR technology to expand the field of view, which can improve safety and awareness for those with vision impairments. ^{2 9 10 11 12}

Research Team

Eli Peli, OD, MSc

Principal Investigator

Senior Scientist

Eligibility Criteria

This trial is for people with visual field loss, such as hemianopia or tunnel vision. Participants must have binocular vision within normal limits, at least partial peripheral vision, and a visual acuity of no worse than 20/100 in the weaker eye. They should be over 14 years old, healthy enough for sessions up to 3 hours, understand English, consent voluntarily, and move independently.

Inclusion Criteria

I can walk by myself for short distances.

I can complete activities lasting 2-3 hours without significant difficulty.

I have lost vision in either half or the outer parts of my field of vision.

Exclusion Criteria

Any person with a self-reported medical history (such as pacemaker use or photosensitive epilepsy) or physical condition listed on the device manual of the Oculus / HMD system used for the experiment as a contraindication

I have had a seizure in the past 6 months.

I do not have any physical or mental disabilities that would affect my participation.

Treatment Details

Interventions

• Field expansion view (Behavioural Intervention)

Trial Overview The study is testing a new virtual reality (VR) system designed to help individuals with visual field loss detect obstacles while walking. It involves wearing a VR headset that simulates real-world environments and oncoming pedestrians in three dimensions.

Participant Groups

Group I: Field expansion view Experimental Treatment 1 Intervention

Various configurations of field expansion views will be additionally displayed on HMD

Who Is Running the Clinical Trial?

Massachusetts Eye and Ear Infirmary

Lead Sponsor

Trials

115

Recruited

15,000+

CarolAnn Williams

Massachusetts Eye and Ear Infirmary

Chief Executive Officer

MBA from Harvard Business School

Aalok Agarwala

Massachusetts Eye and Ear Infirmary

Chief Medical Officer since 2019

MD from University of California, Los Angeles

National Eye Institute (NEI)

Collaborator

Trials

572

Recruited

1,320,000+

Dr. Michael F. Chiang

National Eye Institute (NEI)

Chief Executive Officer since 2020

MD from Harvard Medical School

Dr. Richard Lee

National Eye Institute (NEI)

Chief Medical Officer since 2021

MD, PhD from Harvard Medical School

Findings from Research

The research developed various vision rehabilitation devices, including a head-mounted display for tunnel vision and a device for enhancing central vision, aimed at helping individuals with different types of visual impairments.

Evaluation studies were conducted with patients to assess the effectiveness of these devices, focusing on their advantages and limitations in improving visual search capabilities in controlled indoor settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development and evaluation of vision rehabilitation devices. Luo, G., Peli, E.[2021]

A new Virtual Reality application has been developed to simulate various visual impairments, such as age-related macular degeneration and glaucoma, allowing users to experience the challenges faced by individuals with these conditions.

This application serves multiple purposes, including patient education and training for healthcare practitioners and eye care specialists, enhancing understanding of both normal and pathological eye anatomy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Simulation of eye disease in virtual reality. Jin, B., Ai, Z., Rasmussen, M.[2020]

The C3 field analyzer (CFA) demonstrated a higher reliability in visual field testing for neuro-ophthalmic patients, with 81.4% of tests being reliable compared to 59.3% for the traditional automated field analyzer (HFA).

CFA showed a strong correlation with HFA in detecting classic neurological field defects, such as hemianopia, with an 87.5% correlation, suggesting it could be a useful alternative for patients who struggle with standard perimetry.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparison of a New Head Mount Virtual Reality Perimeter (C3 Field Analyzer) With Automated Field Analyzer in Neuro-Ophthalmic Disorders. Odayappan, A., Sivakumar, P., Kotawala, S., et al.[2023]

The Virtual Retinal Display (VRD) uses laser light to project images directly onto the retina, and safety assessments show it operates within safe power levels for normal viewing and potential failure modes.

Maximum permissible exposure (MPE) calculations confirm that the VRD is safe for users, indicating that it does not pose a risk to eye health during regular use or in case of malfunctions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Laser safety analysis of a retinal scanning display system. Viirre, E., Johnston, R., Pryor, H., et al.[2019]

A new virtual reality (VR) walking collision detection test was developed using the Meta Quest 2 headset, allowing subjects to physically walk in a simulated busy shopping mall environment to assess their ability to detect and avoid collisions.

This VR platform addresses safety and consistency issues found in real-world obstacle courses, making it a promising tool for evaluating clinical interventions related to mobility and collision avoidance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development of Virtual Reality Walking Collision Detection Test on Head-mounted display. Hwang, AD., Peli, E., Jung, JH.[2023]

A new portable visual field testing system using a VR headset (Oculus Quest 2) was developed and tested on 21 healthy subjects, showing strong agreement with traditional visual field analyzers, indicating its potential efficacy.

The VR kinetic perimetry system demonstrated good reproducibility and could provide a more accessible and portable alternative to conventional kinetic perimetry methods, which may improve patient screening in clinical settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Kinetic Perimetry on Virtual Reality Headset. Terracciano, R., Mascolo, A., Venturo, L., et al.[2023]

Current VR headsets have a minimum angular resolution of 0.41 logMAR on average, which is inadequate for reliable visual acuity testing and may not be suitable for treating conditions like amblyopia.

The average field of view for VR headsets is about 50.2°, which is significantly lower than manufacturer claims, but it may still be sufficient for certain visual field tests, although concerns exist for vergence testing due to varying eye-to-screen distances.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Measuring Virtual Reality Headset Resolution and Field of View: Implications for Vision Care Applications. Lynn, MH., Luo, G., Tomasi, M., et al.[2021]

References

1. England pubmed.ncbi.nlm.nih.gov

Virtual reality headsets for perimetry testing: a systematic review. [2023]

2. New Zealand pubmed.ncbi.nlm.nih.gov

Visual field examination method using virtual reality glasses compared with the Humphrey perimeter. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Development and evaluation of vision rehabilitation devices. [2021]

4. United States pubmed.ncbi.nlm.nih.gov

Simulation of eye disease in virtual reality. [2020]

5. United States pubmed.ncbi.nlm.nih.gov

Comparison of a New Head Mount Virtual Reality Perimeter (C3 Field Analyzer) With Automated Field Analyzer in Neuro-Ophthalmic Disorders. [2023]

6. United States pubmed.ncbi.nlm.nih.gov

Laser safety analysis of a retinal scanning display system. [2019]

7. United States pubmed.ncbi.nlm.nih.gov

Development of Virtual Reality Walking Collision Detection Test on Head-mounted display. [2023]

8. United States pubmed.ncbi.nlm.nih.gov

Validation of the Iowa Head-Mounted Open-Source Perimeter. [2023]

9. United States pubmed.ncbi.nlm.nih.gov

Kinetic Perimetry on Virtual Reality Headset. [2023]

10. Ireland pubmed.ncbi.nlm.nih.gov

Human field of regard, field of view, and attention bias. [2017]

11. United States pubmed.ncbi.nlm.nih.gov

Field Expansion with Multiplexing Prism Glasses Improves Pedestrian Detection for Acquired Monocular Vision. [2023]

12. United States pubmed.ncbi.nlm.nih.gov

Measuring Virtual Reality Headset Resolution and Field of View: Implications for Vision Care Applications. [2021]