An interventional study of Reminder-cue scanning training in Homonymous Hemianopia and Homonymous Quadrantanopia, sponsored by Massachusetts Eye and Ear Infirmary. Completed at 1 site in United States. Open to participants aged 16 Years and older. Per ClinicalTrials.gov, last updated 2026-09-18.
Sponsored by Massachusetts Eye and Ear Infirmary · Not applicable, Interventional, and Other
This study will evaluate a new approach to training people with visual field loss to scan when driving
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.
Exclusion Criteria:
Participants will receive reminder-cue scanning training in a driving simulator.
Behavioral: Reminder-cue scanning training
Auditory reminders to scan when scanning to the side of the field loss is inadequate
Rate of Early Large Head Scans to the Side of the Field Loss
Percentage of intersections at which an early large head scan was made to the side of the field loss
Time frame: Pre-training, post-training (1 week)
Detection Rate for Hazards on the Side of the Field Loss
Percentage of hazards detected out of the total number of hazards on the side of the field loss
Time frame: Pre-training, Post-training (1 week)
Number of Head Scans to the Side of the Field Loss
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
Time frame: Pre-training, Post-training (1 week)
Magnitude of Head Scans to the Side of the Field Loss
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
Time frame: Pre-training, Post-training (1 week)
Response Times to Hazards on the Side of the Field Loss
Mean time (in seconds) between the hazard appearing and the horn-press response
Time frame: Pre-training, Post-training (1 week)
Participants were recruited from local ophthalmology outpatient clinics
| Milestone | Intervention |
|---|---|
| Started | 16 |
| Completed | 16 |
| Not completed | 0 |
| Milestone | Intervention |
|---|---|
| Started | 16 |
| Completed | 16 |
| Not completed | 0 |
Percentage of intersections at which an early large head scan was made to the side of the field loss
| Percentage of intersections | Intervention |
|---|---|
| Pre-training | 18 (9 to 26) |
| 1-week post-training | 84 (77 to 91) |
Percentage of hazards detected out of the total number of hazards on the side of the field loss
| Percentage of hazards | Intervention |
|---|---|
| Pre-training | 56 (41 to 70) |
| 1-week post-training | 86 (76 to 95) |
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
| Number of head scans per intersection | Intervention |
|---|---|
| Pre-training | 2.2 (1.8 to 2.7) |
| 1-week post-training | 3.5 (3.1 to 4.0) |
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
| Degrees | Intervention |
|---|---|
| Pre-training | 23.9 (20.3 to 27.5) |
| 1-week post-training | 27.5 (23.8 to 31.2) |
Mean time (in seconds) between the hazard appearing and the horn-press response
| Seconds | Intervention |
|---|---|
| Pre-training | 2.7 (2.4 to 3.0) |
| 1-week post-training | 1.9 (1.6 to 2.1) |
Collected over From start of training until end of follow-up, up to 4 weeks. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Intervention | 0/16 (0%) | 0/16 (0%) | 0/16 (0%) |
| Age, Continuous(years) | Intervention |
|---|---|
| Median | 52.5 (17 to 75) |
| Sex: Female, Male(Participants) | Intervention |
|---|---|
| Female | 7 |
| Male | 9 |
| Race (NIH/OMB)(Participants) | Intervention |
|---|---|
| American Indian or Alaska Native | 0 |
| Asian | 1 |
| Native Hawaiian or Other Pacific Islander | 0 |
| Black or African American | 0 |
| White | 15 |
| More than one race | 0 |
| Unknown or Not Reported | 0 |
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Massachusetts Eye and Ear Infirmary