PAVE (Parallactic Visual-Field Enhancement) System for Treatment of Chronic Visual Field Loss Due to Stroke, Traumatic Brain Injury, or Brain Surgery

This clinical investigation will focus on patients with chronic visual field loss following a cerebrovascular accident (CVA), a traumatic brain injury (TBI), or surgery of the brain. The CVA and TBI and some surgeries of the brain may affect bilateral visual fields (homonymous hemianopia, quadrantanopia, or general constriction). While perimetric visual field improvements can occur spontaneously in the first few months after brain injury, after six months the condition is considered chronic and permanent .

This study will include patients at least 6 months after the brain injury event and up to ten years after onset. If available for the study, patients suffering field loss as a result of brain surgery may also be enrolled. All patients shall have a definitive diagnosis of homonymous hemianopia, quadrantanopia, or general constriction. The patients shall have the ability to wear the virtual reality head mounted display HMD for a 30-minute session performed in the clinic at least once per week. Patients will be between 21 and 80 years of age. The clinical study shall be comprised of a single arm with all subjects receiving therapy with the PAVE software on the HMD. The initial sample size will be a minimum of fifteen. Performance will be evaluated using a semiautomated kinetic perimeter (SKP) measurement derived from the Goldmann method.

The goal will be to determine the amount of statistically significant improvement of the visual field for the subjects. Additional endpoints will include the percentage of subjects showing improvement and subjective assessment of the subject's visual performance using the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ).

Inclusion criteria

• This study will include patients at least 6 months after the CVA or TBI or brain surgery event and up to ten (10) years after onset
• The patients shall have a definitive diagnosis of homonymous hemianopia or quadrantanopia or generalized constriction.

Exclusion criteria

• Presence of any physical, neurological, or mental disability that would interfere with receiving the therapy.
• Concurrent use of another visual therapy
• Concurrent use of medications judged to affect training (amphetamines, dopamine, etc.)
• Presence of ocular or neurological conditions that would interfere with training or cause a visual impairment including no residual vision, disorders of the eye, non-optic nerve heteronymous visual field defects
• Insufficient fixation ability
• Use of life supporting external medical device such as infusion pumps, ventricular assist devices, etc.
• Presence of active implantable medical device including but not limited to cardiac pacemakers, defibrillators, nerve stimulators, cochlear implants, etc.
• Subjects with known photosensitive epilepsy.
• Subjects with chronic active infections on the head and face should be excluded from the study
• Patients with known immune disorders for whom an infection could be life threatening should be excluded from the study.