Vision Training for Age-Related Macular Degeneration
(FLAP Trial)
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University of Alabama at Birmingham
Disqualifiers: Pacemaker, Claustrophobia, Hallucinations, Pregnancy, others
No Placebo Group
Trial Summary
What is the purpose of this trial?A greater understanding of plasticity after central vision loss can inform new therapies for treating low vision and has the potential to benefit millions of individuals suffering from low vision. The treatment of low vision is particularly relevant to the mission of the NEI to support research on visual disorders, mechanisms of visual function, and preservation of sight. The comparison of different training and outcome factors is in line with the NIMH RDOC framework and studies in an aging population are consistent with the mission of the NIA.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications.
What data supports the effectiveness of the treatment for Vision Training for Age-Related Macular Degeneration?
Research shows that low vision rehabilitation, which includes training with magnifying aids, can improve reading speed, emotional well-being, and quality of life for people with age-related macular degeneration.
12345Is vision training for age-related macular degeneration safe?
The studies reviewed do not specifically address the safety of vision training for age-related macular degeneration, but they do not report any safety concerns or adverse effects related to the training methods used.
26789How does the Vision Training treatment for Age-Related Macular Degeneration differ from other treatments?
The Vision Training treatment for Age-Related Macular Degeneration is unique because it focuses on improving visual skills through exercises like eye-movement training and biofeedback, rather than relying solely on magnification aids or medications. This approach aims to enhance reading speed, visual acuity, and quality of life by training the brain to use healthier parts of the retina more effectively.
28101112Eligibility Criteria
This trial is for adults aged 18-89 with severe vision impairment (20/100 or worse) due to Macular Degeneration, confirmed by an ophthalmologist. Participants must have had this condition for at least two years and live within 50 miles of the study site. Those with certain body measurements, metal implants, claustrophobia, hearing impairments, significant head injuries, mental health conditions like hallucinations/delusions, or specific tattoos near the head cannot join.Inclusion Criteria
My medical records show my condition has been severe for at least 2 years.
Reside within 50 miles of study site
I am between 18 and 89 years old.
+3 more
Exclusion Criteria
You weigh more than 300 pounds.
You have had a severe head injury in the past.
You have too many, or very colorful tattoos, especially near your head.
+8 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Training
Participants undergo perceptual learning training focusing on visual sensitivity, spatial integration, and attention and eye-movements.
7 weeks
Weekly sessions
Follow-up
Participants are monitored for changes in visual processing and brain plasticity after training completion.
3 weeks
2 visits (in-person)
Participant Groups
The study explores how different training methods can improve visual sensitivity in people suffering from low vision caused by Macular Degeneration. It aims to understand how the brain adapts and learns despite central vision loss which could lead to new treatments that help preserve sight.
2Treatment groups
Experimental Treatment
Group I: Training visual sensitivityExperimental Treatment1 Intervention
A standard Perceptual Learning approach to train early visual processes of discriminating the orientation of Gabor patches presented at threshold- level contrast. Preliminary data, using this method, in normally seeing and MD participants show both feasibility and preliminary evidence that this training gives rise to improvements in acuity.
Group II: Combination trainingExperimental Treatment1 Intervention
In combination training, investigators test the extent to which a combined training gives rise to the joint benefits of each training individually, or integrative benefits potentially surpassing benefits of the individual training alone. The visual sensitivity task will alternate across blocks with the spatial integration task, using the timing of targets and location switches from spatial attention training.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
UABBirmingham, AL
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Who Is Running the Clinical Trial?
University of Alabama at BirminghamLead Sponsor
University of California, RiversideCollaborator
References
Memory deficit associated with worse functional trajectories in older adults in low-vision rehabilitation for macular disease. [2021]To examine whether performance on a brief memory test is related to functional outcomes in older individuals undergoing low-vision rehabilitation (LVR) for macular disease.
Effects of home reading training on reading and quality of life in AMD-a randomized and controlled study. [2020]Age-related macular degeneration (AMD) causes reading impairment, reduced quality of life (QoL), and secondary depression. We have shown that support with magnifying aids improved reading speed (RS), emotional and cognitive status, and QoL. The present study investigates whether additional reading training (RT) (after adapting to appropriate visual aids) can further improve vision rehabilitation.
Vision rehabilitation of persons with age related macular degeneration. [2019]As the population of the United States ages, there is an increase in the number of persons with age related macular degeneration (ARMD). Even as new prevention and treatment techniques are developed, the vision loss associated with ARMD may lead to loss of independence and quality of life. Low vision is a rehabilitative process designed to improve visual function and restore independence. This paper is a review of the current research related to low vision in the areas of magnification, contrast and illumination, reading, training, driving and outcomes assessment.
The effectiveness of low-vision rehabilitation in 2 cohorts derived from the veterans affairs Low-Vision Intervention Trial. [2022]To evaluate the effectiveness of low-vision rehabilitation in 2 cohorts derived from the Veterans Affairs Low-Vision Intervention Trial.
Survey of optometric low vision rehabilitation training methods for the moderately visually impaired. [2015]The goal of this survey study is to determine the low vision rehabilitation training practices of optometrists who prescribe near magnifying devices for low vision patients who have moderate visual impairment from age-related macular degeneration.
Functional Outcomes of the Low Vision Depression Prevention Trial in Age-Related Macular Degeneration. [2018]To compare the efficacy of behavioral activation (BA) plus low vision rehabilitation with an occupational therapist (OT-LVR) with supportive therapy (ST) on visual function in patients with age-related macular degeneration (AMD).
Comorbid cognitive impairment and functional trajectories in low vision rehabilitation for macular disease. [2021]Comorbid cognitive impairment is common among visually impaired older adults. This study investigated whether baseline cognitive status predicts functional trajectories among older adults in low vision rehabilitation (LVR) for macular disease.
Efficacy of biofeedback rehabilitation based on visual evoked potentials analysis in patients with advanced age-related macular degeneration. [2021]Age-related macular degeneration (AMD) is a progressive and degenerative disorder of the macula. In advanced stages, it is characterized by the formation of areas of geographic atrophy or fibrous scars in the central macula, which determines irreversible loss of central vision. These patients can benefit from visual rehabilitation programmes with acoustic "biofeedback" mechanisms that can instruct the patient to move fixation from the central degenerated macular area to an adjacent healthy area, with a reorganization of the primary visual cortex. In this prospective, comparative, non-randomized study we evaluated the efficacy of visual rehabilitation with an innovative acoustic biofeedback training system based on visual evoked potentials (VEP) real-time examination (Retimax Vision Trainer, CSO, Florence), in a series of patients with advanced AMD compared to a control group. Patients undergoing training were subjected to ten consecutive visual training sessions of 10 min each, performed twice a week. Patients in the control group did not receive any training. VEP biofeedback rehabilitation seems to improve visual acuity, reading performances, contrast sensitivity, retinal fixation and sensitivity and quality of life in AMD patients.
Is there a standard of care for eccentric viewing training? [2019]A study was conducted to determine the current Department of Veterans Affairs (VA) standard of practice for eccentric viewing (EV) training. EV training is the process of teaching patients to realign the visual image away from a diseased foveal/macular region onto healthier retina. Optometrists and Visual Skills Instructors at all VA blind rehabilitation centers (BRCs) and VICTORS (vision impairment centers to optimize remaining sight) programs were asked to rate preference for EV prescription criteria, evaluation, and training techniques. Responses were received from 70% of BRCs and 67% of VICTORS. The respondents reported that all programs include EV training. The average minutes of training per patient varied from 20 minutes to nearly 24 hours, with instructors within a single center varying by as much as two orders of magnitude. Routinely, 82% of optometrists prescribe EV training, yet no consensus was found among these practitioners as to the criteria for selecting the best EV area. The results of this survey reveal an inconsistent standard of practice across VA centers and demonstrate the need for prospective studies of the efficacy, effectiveness, and cost-effectiveness of EV training.
Training to improve reading speed in patients with juvenile macular dystrophy: a randomized study comparing two training methods. [2019]In this study, we examined the clinical application of two training methods for optimizing reading ability in patients with juvenile macular dystrophy with established eccentric preferred retinal locus and optimal use of low-vision aids.
Rehabilitation of reading skills in patients with age-related macular degeneration. [2019]Reading is the most frequent clinical complaint and the primary goal for patients with macular degeneration seeking vision rehabilitation. The current prevalent methods for reading skills training across the globe are still magnification and basic scotoma awareness training. More recent studies showed that specific eccentric training, comprehension ability training, and specific oculomotor training are all beneficial to reading skills rehabilitation. In clinical practice, ophthalmologists should strive to implement reading skills methods that include assessment of cognitive skills, optimal eyewear, optimal reading material, PRL assessment, training of better oculomotor control, and efficient perceptual training.
Eye-movement training for reading in patients with age-related macular degeneration. [2006]To determine whether training oculomotor control, without direct practice in reading sentences, could increase reading speed in patients with age-related macular degeneration (AMD).