Computer-Assisted Rehabilitation Environment Training After Argus Retinal Prosthesis

Overview

The goal of the current project is to fill the unmet clinical needs around the objective assessment of visual function and develop outcome-oriented visual rehabilitation approach using the computer assisted rehabilitation environment (CAREN) system for Argus recipients.

Full Title of Study: “Comprehensive Visual and Mobility Training Using Computer-Assisted Rehabilitation Environment (CAREN) After Argus Retinal Prosthesis Surgery”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: N/A
    • Intervention Model: Single Group Assignment
    • Primary Purpose: Treatment
    • Masking: None (Open Label)
  • Study Primary Completion Date: June 20, 2018

Interventions

  • Device: CAREN system training
    • CAREN allows Argus users to be trained and enhance their device usage in a safe, controlled, and standardized environment.

Arms, Groups and Cohorts

  • Experimental: CAREN system training
    • CAREN training

Clinical Trial Outcome Measures

Primary Measures

  • Effects of CAREN Virtual Reality System on Obstacle Course Navigation
    • Time Frame: 6 wks
    • Obstacle course navigation – time (seconds) to complete an obstacle course (walking forward while navigating over a ramp and curb)
  • Time to Complete the Timed Up and Go Test Before and After CAREN Virtual Reality System Training
    • Time Frame: 6 wks
    • Timed Up and Go testing – functional mobility test that requires the individual to stand from a chair, ambulate three meters to a target, turn around, return to the chair, and sit down. Participants were asked to complete two trials was recorded, with a maximum time of 60 seconds per trial.
  • Effects of CAREN Virtual Reality System on Square Localization Visual Function Test
    • Time Frame: 6 wks
    • The square localization test presents a 2.75″ square (250 pixels) at a random location on a black background and the patient is instructed to try to touch the square. The test measures the patient’s ability to locate an object and results are calculated as a mean error (how far away in pixels from the square the patient touches the screen). A lower mean error (the distance from the square) indicates better patient performance.
  • Effects of CAREN Virtual Reality System on Direction of Motion Visual Function Test.
    • Time Frame: 6 wks
    • The direction of motion test assesses the patient’s ability to determine the direction an object is moving. The patient is presented with a white line (1.4” wide) that moves across the screen in a random series of directions and angles. Patients are instructed to trace their finger on the monitor in the direction they perceived the line moved. Results are calculated as a mean error (how far off, in degrees, was the patient from the direction of the moving line). The higher the mean error/score, the worse the outcome.
  • Effects of CAREN Virtual Reality System on Grating Visual Acuity Visual Function Test
    • Time Frame: 6 wks
    • The grating visual acuity test measures the patient’s visual acuity using the principles of acuity charts modified for ultra-low vision subjects. The patients are presented with black and white bars in one of four orientations (horizontal, vertical, diagonal to the left or diagonal to the right). The bars are present on the screen for 5 seconds during which the patient may scan the screen and then provide a verbal response as to which orientation they perceived the bars. The widths of the bars are varied to evaluate different levels of visual acuity. A lower score is associated with better outcomes with 2.9 being the worst possible score.
  • Effects of CAREN Virtual Reality System on Gait Assessment
    • Time Frame: 6 wks
    • Subject’s gait assessed by meters traveled while localizing objects on the CAREN system. The higher scores are associated with better outcomes (further distance walked).

Participating in This Clinical Trial

Inclusion Criteria

  • Recipient of the Argus II Retinal Prosthesis System – Ability to provide informed consent – Ability to follow two-step commands – Ability to ambulate 300+ feet with or without visual assistance – Able to tolerate Argus device turned on for >20 continuous minutes. Exclusion Criteria:

  • Dementia – Musculoskeletal contraindication to exercise or walking – Cardiopulmonary contraindication exercise (i.e. uncontrolled heart failure, cardiac arrhythmia, or pulmonary disease).

Gender Eligibility: All

Minimum Age: 25 Years

Maximum Age: 100 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • The Cleveland Clinic
  • Provider of Information About this Clinical Study
    • Principal Investigator: Aleksandra Rachitskaya, MD, Assistant Professor of Ophthalmology, Cleveland Clinic Lerner College of Medicine – The Cleveland Clinic
  • Overall Official(s)
    • Aleksandra Rachitskaya, MD, Principal Investigator, The Cleveland Clinic

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