ClinicalTrials.gg
RecruitingNCT04762368Updated Jan 22, 2026

Learning Study: Improving Vision in Adults With Macular Degeneration

An interventional study of Active anodal tDCS and Sham anodal tDCS in Macular Degeneration, sponsored by University of Waterloo. Recruiting at 2 sites in 2 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-01-22.

Sponsored by University of Waterloo · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started Feb 2021; still recruiting 5 years 8 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
30
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of this study is to test whether a kind of brain stimulation called anodal transcranial direct current stimulation (a-tDCS) can be combined with perceptual learning to improve the ability of people with age-related macular degeneration (AMD) or juvenile macular degeneration (JMD) to read words presented to them on a computer screen better than if perceptual learning alone were used.

In addition, secondary measures of visual acuity will also be examined to determine whether brain stimulation can allow patients to resolve finer details of an image. The proposed treatment is the application of a-tDCS onto the participant's head, with brain stimulation aimed at Primary Visual Cortex toward the occipital pole, while patients undergo six separate sessions of training. The investigators will test the ability of participants to read words before the start of the training sessions (pre test) and after the completion of all training sessions (post test). This is a between-subjects design, and half of the participants will receive true stimulation, and the other half will receive sham stimulation. The difference between the pre and post tests when receiving active stimulation will be compared to the difference when receiving sham stimulation, because the sham stimulation is not expected to influence reading beyond a placebo. The aim of the study is to examine the potential of concurrent brain stimulation and perceptual learning as an effective treatment for macular degeneration that may be used in conjunction with more traditional eye-based interventions. The investigators hypothesize that the brain stimulation will enable higher performance in the reading task after and secondary measures after perceptual training due to an increase in the cortical excitability of the stimulated brain cells.

Read the detailed description

This study will be carried out in Ontario, Canada (University of Waterloo) and Hong Kong (The Hong Kong Polytechnic University). There are two conditions: Active brain stimulation + perceptual training and sham/placebo brain stimulation + perceptual training. This study uses a between-subjects design, such that half of all participants will be placed in the active stimulation group and half will be placed in the sham group.

Participants will be recruited from university-affiliated clinics and local clinical practices. Following full informed consent, participants will complete baseline testing and clinical testing to confirm that they meet eligibility criteria including: a diagnosis of macular degeneration without any additional eye disease, impaired vision but with enough visual acuity that the computer monitor can still present readable word, and no contraindications for brain stimulation interventions. Eligible participants will then be randomized to either receiving the active stimulation during perceptual training or the placebo stimulation during perceptual training.

The primary outcome measure is verbal reading accuracy for sentences presented on a computer screen following a Rapid Serial Visual Presentation (RSVP) task in which a single word is presented on the screen at a time. Participants will freely observe the words and will indicate the words on the screen verbally. The secondary outcome measures are contrast sensitivity and crowded and uncrowded visual acuity as measured by Freiburg Visual Acuity \& Contrast Test (FrACT) using the Landolt C stimulus. The "C"'s gap will be oriented randomly, and the participant will indicate the orientation of the stimulus. Crowded visual acuity will be assessed with Landolt C surrounded by a solid ring, while uncrowded visual acuity will be assessed with the Landolt C alone. The Test of contrast sensitivity will measure the amount of contrast required relative to the background to identify the orientation of the "C". The Hong Kong Polytechnic University has an additional set of secondary outcome measures of temporal and spatial visual span. Temporal visual span will be assessed using Chinese trigrams presented horizontally or vertically at the centre for a range of presentation times. Spatial visual span will be assessed using Chinese trigrams presented horizontally or vertically at different character positions for a fixed presentation time. Participants will be asked to recognize all three characters in a correct order.

The study consists of 9 sessions plus 1 additional session particularly for Hong Kong Polytechnic University

Session 0: This session only applies for The Hong Kong Polytechnic university, that horizontal and vertical temporal and spatial visual span will be collected.

Session 1: The first session will include the clinical evaluation. In addition, the pre tests of all outcome measures will be collected (RSVP performance, crowded and uncrowded visual acuity, contrast sensitivity).

Sessions 2-7: Brain stimulation sessions. Participants will undergo roughly 1 hour of perceptual training, performing the RSVP task. The first 25 minutes of this training will include either sham or active brain stimulation. A given participant will receive the same kind of stimulation for all 6 training sessions.

Session 8: No brain stimulation will occur. Post test outcome measures will be collected (RSVP performance, crowded and uncrowded visual acuity, contrast sensitivity, horizontal and vertical temporal and spatial visual span).

Session 9: 30 day follow up. 30 days after the final training session, participants will again perform the outcome measures without brain stimulation to determine the long term benefit of the perceptual training + brain stimulation.

02

Conditions studied

  • Macular Degeneration

Keywords

  • Macular Degeneration
  • Brain Stimulation
  • Psychophysics
  • Reading
  • tDCS
  • RSVP
  • Visual Acuity
  • Uncrowded Visual Acuity
  • Crowded Visual Acuity
  • Contrast Sensitivity
03

In context

Macular Degeneration

1,459 studies on the registry are indexed under Macular Degeneration; 238 are open to participants now.

This study's planned enrollment of 30 is below the median of 56 across 985 interventional studies indexed under Macular Degeneration.

Browse Macular Degeneration studies →

Lead sponsor

University of Waterloo is the lead sponsor of 90 studies on the registry; 7 are open to participants now.

Of its 12 completed or terminated interventional studies of FDA-regulated products, 9 (75%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Diagnosis of AMD (age 60+) or JMD (current age 18+).
  2. Visual acuity (VA); between 6/9-6/96 in the better eye
  3. Best-corrected near visual acuity of 4.0M at 40 cm or better in the better eye
  4. Stable vision in previous 3 months (patient report)
  5. Central vision loss

Exclusion criteria

Exclusion Criteria:

  1. Diagnosed dementia.
  2. Not fluent in reading English (Waterloo) or Chinese characters (Hong Kong).
  3. Any ocular surgery (including anti-vegF injections) within the duration of the study, except for: A. Chronic and continuous injections for at least 1 year. B. Injections stopped at least 2 months before participation. C. Injections in the untested eye
  4. Ocular pathology other than JMD or AMD that can significantly reduce central vision. Example: mild cataract of grade 2 or below is acceptable
  5. Severe hearing impairment.
  6. for brain stimulation
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
30 participants (estimated)

Study arms

  • Active comparator
    Active + Training

    Participants in this arm will be exposed to active stimulation for the first 25 minutes of a roughly hour - long perceptual training procedure in which participants must verbally read sentences presented at various speeds and sizes.

    Device: Active anodal tDCS

  • Sham comparator
    Sham + Training

    Participants in this arm will be exposed to sham stimulation for the first 25 minutes of a roughly hour - long perceptual training procedure in which participants must verbally read sentences presented at various speeds and sizes.

    Device: Sham anodal tDCS

Interventions

  • DeviceActive anodal tDCS

    a weak electric current is applied to the head through electrodes to affect the cortical excitability of the targeted cells in the brain.

  • DeviceSham anodal tDCS

    The tDCS machine will be used as in active stimulation, except the electrical current will not be applied.

06

What researchers measure

Primary outcomes

  1. Change in Rapid Serial Visual Presentation (RSVP) Reading performance before and right after training.

    Behavioral Measure - Participants will verbally read words presented on a computer. A variety of speeds and sizes will be presented, so that an accurate measure of the maximum reading speed, and the smallest text size readable at the maximum reading speed can be calculated. The maximum reading speed and smallest text size will be measured before and after training. The outcome measures are the change in these reading measurements from pre test to post test.

    Time frame: The pre test and post test will take roughly 1 hour to complete, and they will be roughly 4-7 weeks apart.

  2. Change in Rapid Serial Visual Presentation (RSVP) Reading performance 30 days after training

    Behavioral Measure - Participants will verbally read words presented on a computer. A variety of speeds and sizes will be presented, so that an accurate measure of the maximum reading speed, and the smallest text size readable at the maximum reading speed can be calculated. The maximum reading speed and smallest text size will be measured before and after training. The outcome measures are the change in these reading measurements from pre test to the 30 day follow up.

    Time frame: The test will take roughly 1 hour to complete, and they will be roughly 7-10 weeks apart.

Secondary outcomes

  1. Change in Uncrowded Visual Acuity before and just after training

    Visual acuity as measured by participants indicating the orientation of the gap present in a Landolt C stimulus using the freely available FrACT software https://michaelbach.de/fract/index.html . The outcome measure is the change in performance from pre test to the post test

    Time frame: The pre test and post test will take roughly 5 minutes to complete, and they will be roughly 4-7 weeks apart.

  2. Change in Uncrowded Visual Acuity before and 30 days after training

    Visual acuity as measured by participants indicating the orientation of the gap present in a Landolt C stimulus using the freely available FrACT software https://michaelbach.de/fract/index.html . The outcome measure is the change in performance from pre test to the 30 day follow up.

    Time frame: The pre test and post test will take roughly 5 minutes to complete, and they will be roughly 7 to 10 weeks apart.

  3. Change in Crowded Visual Acuity before and just after training

    Visual acuity as measured by participants indicating the orientation of the gap present in a Crowded (Ring) Landolt C stimulus using the freely available FrACT software https://michaelbach.de/fract/index.html . The outcome measure is the change in performance from pre test to post test.

    Time frame: The tests will take roughly 5 minutes to complete, and they will be roughly 4 - 7 weeks apart.

  4. Change in Crowded Visual Acuity before and 30 days after training

    Visual acuity as measured by participants indicating the orientation of the gap present in a Crowded (Ring) Landolt C stimulus using the freely available FrACT software https://michaelbach.de/fract/index.html . The outcome measure is the change in performance from pre test to the 30 day follow up.

    Time frame: The tests will take roughly 5 minutes to complete, and they will be roughly 7 - 10 weeks apart.

  5. Change in Contrast Sensitivity before and just after training

    Contrast sensitivity as measured by participants indicating the orientation of the gap present in a Landolt C stimulus using the freely available FrACT software https://michaelbach.de/fract/index.html . The outcome measure is the change in performance from pre test to the post test.

    Time frame: The tests will take roughly 5 minutes to complete, and they will be roughly 4 - 7 weeks apart.

  6. Change in Contrast Sensitivity before and 30 days after training

    Contrast sensitivity as measured by participants indicating the orientation of the gap present in a Landolt C stimulus using the freely available FrACT software https://michaelbach.de/fract/index.html . The outcome measure is the change in performance from pre test to the 30 day follow up.

    Time frame: The tests will take roughly 5 minutes to complete, and they will be roughly 7-10 weeks apart.

  7. Change in Temporal Visual Span before and just after training

    Three unrelated Chinese characters will appear at the centre of a monitor for a range of exposure times. Participants will be asked to recognize all three characters in a correct order. Both horizontal and vertical presentation will be assessed. The outcome measures are the changes in time for recognizing the characters from pre test to the post test.

    Time frame: The test will take roughly 1.5 hours to complete, and they will be roughly 5-8 weeks apart

  8. Change in Spatial Visual Span before and just after training

    Three unrelated Chinese character will appear at different character positions for a fixed exposure time, while participants will be asked to keep fixation at the centre but recognize all three characters in a correct order. Both horizontal and vertical presentation will be assessed. The outcome measures are the changes in the size of the spatial visual span from pre test to the post.

    Time frame: The test will take roughly 1.5 hours to complete, and they will be roughly 5-8 weeks apart.

07

Study locations

2 of 2 sites recruiting
08

References and documents

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: Yes — IDP that underlie results in a publication will be available after deidentification upon reasonable request to the research team.

Supporting information: Analytic code

Time frame: IDP will be available upon a publication, and no more than 9 months after the publication.

Access criteria: IDP will be shared to researchers who provide a methodologically sound proposal.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Feb 2021 (actual). Primary completion is estimated for Dec 2026, 70 months after the start.

Of 104 non-industry interventional studies with no phase under Macular Degeneration, half reached primary completion within 41 months of starting (the median), counting those still running; a quarter within 17 and three quarters within 56. This study's planned 70 months is above that.

Counting every sponsor, half of 132 studies reached it within 37 months; a quarter within 17 and three quarters within 60.

How these figures are worked out, and which studies are left out of them.

Registered
Feb 13, 2021
First posted
Feb 21, 2021
StartActual
Feb 13, 2021
Primary completionEst.
Dec 2026
CompletionEst.
Dec 2026
Last update
Jan 22, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jan 22, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04762368
Lead sponsor
University of Waterloo
Responsible party
Ben Thompson (Professor; Associate Director for Research, University of Waterloo) — Principal investigator
First posted
Feb 21, 2021
Start date
Feb 13, 2021
Primary completion
Dec 2026 (estimated)
Completion
Dec 2026 (estimated)
Last update
Jan 22, 2026

Study contacts

Ben Thompson, PhD
Contact
ben.thompson@uwaterloo.ca
15198884567 ext. 39398
Andrew E Silva, PhD
Contact
a8silva@uwaterloo.ca
Ben Thompson, PhD
principal investigator · University of Waterloo

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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