Remapping Text in Sentence and Word Tasks to Aid Reading With Central Vision Loss

University of Minnesota (UMN)

Status: Begins enrollment in 3 months

Conditions: Central Visual Impairment; Macular Degeneration

Treatments: Behavioral: Personalised Remapping Training; Behavioral: Reading text in the wild with remapping; Behavioral: RSVP personalized remappi

Study type: Interventional

Funder types: Other

Identifiers

NCT07216924

Remapping in reading tasks

Details and patient eligibility

About

Reading performance in patients with Central Vision Loss will be measured with and without missing text being remapped to different parts of the visual field in a variety of different reading tasks.

Full description

Following initial characterization of their visual field loss, the participant's performance in various reading tasks will be measured with and without remapping. Tasks will include reading simple sentences, reading popular fiction, reading text with one word presented at a time (rapid serial visual presentation, RSVP), and reading text in simulated real-world environments in virtual reality (e.g. subway station, school, city street). Different remapping strategies, e.g. mainly shifting the text horizontally, or vertically, will be tested.

Participants interested in the study will be brought in for an initial visit where they will first be consented. Participants will then undergo a standard exam at the UMN eye clinic, if they have not had one within the last month. Participants will then have their scotomas mapped using a microperimeter housed in the Ophthalmology department to give size and shape information. Participants will perform visual tasks that are used as the basis of their personalized remapping, letter perimetry. Participants will first view and report three randomly selected horizontally arranged letters placed at different locations in the visual field. This letter perimetry task will take about 40 min and will cover a large part of the visual field. Participants will then read single words whose letters have been displaced from horizontal in various ways that comprise candidate remappings generated on the basis of the letter perimetry results. This personalization test will take about 40 minutes, and will find a good remapping strategy for the individual. Subjects will then be introduced to the reading tasks that comprise the remainder of the study The study then branches into three arms. In one arm, participants will be given repeated practice reading sentences with remappings. In XX additional sessions, participants will perform a single sentence reading tasks for remapped and non-remapped text: One sentence at a time will be displayed on the screen, and the task is simply to read aloud what was presented. Following blocks of this task with and without remapping, participants will be given extended practice reading with remapping. Participants read multiple sentences from a longer text (popular fiction) in multiple 10 minute blocks. Each sentence will be presented individually, and participants will continuously read one sentence after another taken from the fiction text.

In a second arm, participants will read sentences with one word at a time presented in rapid succession. This form of reading is called rapid serial visual presentation or RSVP. In an initial block of sentences, different word rates will be tested to determine the fastest rate where participants are accurate, with and without remapping. Then individual sentences and longer passages will be read as in the other arm, but with this different presentation method. Different remappings and no remapping will again be tested.

In a third arm, participants will read single words presented in naturalistic scenes viewed in a virtual reality environment and presented on a head mounted display. Words will be read with and without remapping. Several different environments will be tested (e.g. subway station, school, city street). The words will be natural text that could be found in these environments, e.g. subway station names, messages on a chalkboard, storefront shop names, etc.

In all sessions in all arms, the eye tracker will be calibrated to participants' individual head and eye position. This will involve fixating at different points on the device screen (HMD or desk-mounted) as the eye is imaged by the eye trackers. Throughout all testing, patients will be asked if they feel any discomfort, and will be able to take a break or quit testing at any point. Reading responses will be verbal and will scored for accuracy by a research assistant.

Including the initial visit, testing for any given patient is anticipated to last no more than 16 sessions over sixteen weeks. Enrolling participants, testing, and data analysis for all participants is anticipated to take five years from the date of enrollment of the first participant.

Enrollment: 100 estimated patients

Sex: All

Ages: 16+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Dense bilateral scotomas of at least 2 deg diameter in each eye covering the fovea
• Bivariate contour ellipse area (BCEA) of less than 10^2 is obtained in a simple fixation task

Exclusion criteria

• Neovascular AMD
• Any history of visual disorders other than that causing the central vision loss.

Trial design

Primary purpose: Basic Science

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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100 participants in 3 patient groups

Perceptual Learning

Experimental group

Description:

Participants will practice reading with remapping over many sessions on different days.

Treatment:

Behavioral: Personalised Remapping Training

Rapid Serial Visual Presentation

Experimental group

Description:

Participants will read words presented one at a time in rapid succession near fixation.

Treatment:

Behavioral: RSVP personalized remappi

Reading in The Wild

Experimental group

Description:

Participants will view scenes in virtual reality showing natural settings and read a single word at a time within those scenes- e.g. a name on a street sign or shop in a city scene.

Treatment:

Behavioral: Reading text in the wild with remapping