A novel gaze-based visual search task for children with CVI:A twin study

Visual search is often impaired in children with cerebral visual impairment (CVI), but the current assessment of visual search performance is limited. This study aimed to investigate underlying visual search processes in detail by including gaze-based measurements. Twin brothers (age 11.8 years), one diagnosed with CVI and one with neurotypical development, underwent a newly developed conjunction visual search task while simultaneously their gaze was recorded. In addition to speed and accuracy, we analyzed additional timing and spatial parameters of the search process before and after their initial fixation in the target area. The twin with CVI had good visual sensory functions, but impaired search performance indicated by longer search time and larger search areas. Also, it was observed that in more difficult task conditions, he tended to miss the target, even when fixating on it. These results point towards higher-order visual deficits. This study gives insight into the visual search challenges of a child with CVI. Mapping the search process in detail provided new and distinctive information that can shape more tailored support. Coupling verbal and nonverbal gaze-based outcomes is a promising first step towards a more inclusive nonverbal and nonmotor assessment.</p

A novel gaze-based visual search task for children with CVI:A twin study

Visual search is often impaired in children with cerebral visual impairment (CVI), but the current assessment of visual search performance is limited. This study aimed to investigate underlying visual search processes in detail by including gaze-based measurements. Twin brothers (age 11.8 years), one diagnosed with CVI and one with neurotypical development, underwent a newly developed conjunction visual search task while simultaneously their gaze was recorded. In addition to speed and accuracy, we analyzed additional timing and spatial parameters of the search process before and after their initial fixation in the target area. The twin with CVI had good visual sensory functions, but impaired search performance indicated by longer search time and larger search areas. Also, it was observed that in more difficult task conditions, he tended to miss the target, even when fixating on it. These results point towards higher-order visual deficits. This study gives insight into the visual search challenges of a child with CVI. Mapping the search process in detail provided new and distinctive information that can shape more tailored support. Coupling verbal and nonverbal gaze-based outcomes is a promising first step towards a more inclusive nonverbal and nonmotor assessment.</p

Collision avoidance in persons with homonymous visual field defects under virtual reality conditions

AbstractThe aim of the present study was to examine the effect of homonymous visual field defects (HVFDs) on collision avoidance of dynamic obstacles at an intersection under virtual reality (VR) conditions. Overall performance was quantitatively assessed as the number of collisions at a virtual intersection at two difficulty levels. HVFDs were assessed by binocular semi-automated kinetic perimetry within the 90° visual field, stimulus III4e and the area of sparing within the affected hemifield (A-SPAR in deg2) was calculated. The effect of A-SPAR, age, gender, side of brain lesion, time since brain lesion and presence of macular sparing on the number of collisions, as well as performance over time were investigated. Thirty patients (10 female, 20 male, age range: 19–71years) with HVFDs due to unilateral vascular brain lesions and 30 group-age-matched subjects with normal visual fields were examined. The mean number of collisions was higher for patients and in the more difficult level they experienced more collisions with vehicles approaching from the blind side than the seeing side. Lower A-SPAR and increasing age were associated with decreasing performance. However, in agreement with previous studies, wide variability in performance among patients with identical visual field defects was observed and performance of some patients was similar to that of normal subjects. Both patients and healthy subjects displayed equal improvement of performance over time in the more difficult level. In conclusion, our results suggest that visual-field related parameters per se are inadequate in predicting successful collision avoidance. Individualized approaches which also consider compensatory strategies by means of eye and head movements should be introduced

Bilateral vestibulopathy causes selective deficits in recombining novel routes in real space

The differential impact of complete and incomplete bilateral vestibulopathy (BVP) on spatial orientation, visual exploration, and navigation-induced brain network activations is still under debate. In this study, 14 BVP patients (6 complete, 8 incomplete) and 14 age-matched healthy controls performed a navigation task requiring them to retrace familiar routes and recombine novel routes to find five items in real space. 18F-fluorodeoxyglucose-PET was used to determine navigation-induced brain activations. Participants wore a gaze-controlled, head-fixed camera that recorded their visual exploration behaviour. Patients performed worse, when recombining novel routes (p < 0.001), whereas retracing of familiar routes was normal (p = 0.82). These deficits correlated with the severity of BVP. Patients exhibited higher gait fluctuations, spent less time at crossroads, and used a possible shortcut less often (p < 0.05). The right hippocampus and entorhinal cortex were less active and the bilateral parahippocampal place area more active during navigation in patients. Complete BVP showed reduced activations in the pontine brainstem, anterior thalamus, posterior insular, and retrosplenial cortex compared to incomplete BVP. The navigation-induced brain activation pattern in BVP is compatible with deficits in creating a mental representation of a novel environment. Residual vestibular function allows recruitment of brain areas involved in head direction signalling to support navigation

Intelligent computational techniques and virtual environment for understanding cerebral visual impairment patients

Cerebral Visual Impairment (CVI) is a medical area that concerns the study of the effect of brain damages on the visual field (VF). People with CVI are not able to construct a perfect 3-Dimensional view of what they see through their eyes in their brain. Therefore, they have difficulties in their mobility and behaviours that others find hard to understand due to their visual impairment. A branch of Artificial Intelligence (AI) is the simulation of behaviour by building computational models that help to explain how people solve problems or why they behave in a certain way. This project describes a novel intelligent system that simulates the navigation problems faced by people with CVI. This will help relatives, friends, and ophthalmologists of CVI patients understand more about their difficulties in navigating their everyday environment. The navigation simulation system is implemented using the Unity3D game engine. Virtual scenes of different living environments are also created using the Unity modelling software. The vision of the avatar in the virtual environment is implemented using a camera provided by the 3D game engine. Given a visual field chart of a CVI patient with visual impairment, the system automatically creates a filter (mask) that mimics a visual defect and places it in front of the visual field of the avatar. The filters are created by extracting, classifying and converting the symbols of the defected areas in the visual field chart to numerical values and then converted to textures to mask the vision. Each numeric value represents a level of transparency and opacity according to the severity of the visual defect in that region. The filters represent the vision masks. Unity3D supports physical properties to facilitate the representation of the VF defects into a form of structures of rays. The length of each ray depends on the VF defect s numeric value. Such that, the greater values (means a greater percentage of opacity) represented by short rays in length. While the smaller values (means a greater percentage of transparency) represented by longer rays. The lengths of all rays are representing the vision map (how far the patient can see). Algorithms for navigation based on the generated rays have been developed to enable the avatar to move around in given virtual environments. The avatar depends on the generated vision map and will exhibit different behaviours to simulate the navigation problem of real patients. The avatar s behaviour of navigation differs from patient to another according to their different defects. An experiment of navigating virtual environments (scenes) using the HTC Oculus Vive Headset was conducted using different scenarios. The scenarios are designed to use different VF defects within different scenes. The experiment simulates the patient s navigation in virtual environments with static objects (rooms) and in virtual environments with moving objects. The behaviours of the experiment participants actions (avoid/bump) match the avatar s using the same scenario. This project has created a system that enables the CVI patient s parents and relatives to aid the understanding what the CVI patient encounter. Besides, it aids the specialists and educators to take into account all the difficulties that the patients experience. Then, is to design and develop appropriate educational programs that can help each individual patient