Validation of Standardized Test Protocols to Assess the Impact of Visual Pathologies in Daily Life Activities

Study Overview
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Brief Summary
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the incidence of the disease of retinal degenerations with loss of photoreceptors (related to old age or genetic) on patients' daily lives, is poorly characterize without standardized means of measurement (usually performed with functional vision or reading tasks). self-assessment by a quality of life questionnaire correlated with an assessment of emotional state and direct observation of patients during daily life tasks are the two ways used in a scientific framework to collect data on the difficulties encountered by patients in their daily life. The aim of this project is to determine the behavioral effects of retinitis pigmentosa (RP) by the effects of performance reductions related to adapting to darkness and visual field restriction. Those assessments will be in real conditions but also in virtual reality (VR). This tool can be used to measure a therapeutic benefit for new treatments (like gene therapy, retinal implants, intra vitreous injections …) for visual loss patients.

Detailed Description
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This prospective, longitudinal and non-randomized study will be conducted on 2 groups of people: retinitis pigmentosa's patients ( 1st and 2nd phases) and healthy volunteers patients (2nd phase). The first phase's aim (named pilot phase) is to determine the optimal parameters to achieve the locomotion test. Fifteen RP's eligible patients will be requiring to 4 sessions of 3 hours to perform tests (Two sessions on real conditions and the two others on virtual reality). The second phase's aim (named validation phase) is to validate tests to assess the impact of peripheral visual impairment on the sensory and motor performance of patients in their daily life. Firstly 15 RP's patients and 15 healthy volunteers will be included in this phase conducted according to a plan of Simon. 21 additional patients will be including on each group in view of the results on the first step in this 2nd phase. For each patient, the duration of participation will be of 3 months for the first phase and 14 months for the second phase. The study duration is expected to be 50 months.

Official Title
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Validation of Standardized Test Protocols to Assess the Impact of Visual Pathologies in Daily Life Activities

Conditions
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Retinitis Pigmentosa

Intervention / Treatment
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* Behavioral: performance of behavioral locomotion tasks phase 1
* Behavioral: performance of behavioral locomotion tasks phase 2


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Gender male or female Non-syndromic pigmentary retinopathy: diagnosis confirmed by a specialist (RP patients) Pigmentary retinopathy with different damage's levels of visual field, acuity and sensitivity to contrasts (RP patients) Visual acuity of both corrected eyes (glasses, lenses) greater than or equal to 8/10 (or ≤ 0.1 logMAR) (Healthy volounteers) Normal semi-automated kinetic visual field (Healthy volounteers) Not participating in any other clinical trial that may interfere with this study Sufficient knowledge of the French language to ensure understanding of the tasks to be performed and the instructions received Social insurance Consent signed after information by the investigator Exclusion Criteria: Pregnant woman Inability to give personal consent Cataract surgery in the 3 months before inclusion Amblyopia Inability to comply with the instructions for the study tasks or to complete the study visits MMSE score without visual item ≤ 20/25 for RP patients MMSE score with visual item ≤ 25/30 for healthy volunteers Drug treatment which may cause motor, visual or cognitive disorders (neuroleptics, etc.) or which may interfere with study evaluations

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Interventional Model Description: optimal Simon two-stage design
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Retinitis Pigmentosa patients<br>Patients with Retinitis Pigmentosa (RP) at different stages of impairment of the visual field, acuity and sensitivity to contrasts 15 patients will be included in phase 1 versus 36 in phase 2 (15 in step 1 and 21 in step 2). | Behavioral: performance of behavioral locomotion tasks phase 1<br>* The performance of behavioral locomotion tasks is performed on 4 visits on pilot phase (2 in real condition and 2 in virtual reality in D1 and M1)<br>Behavioral: performance of behavioral locomotion tasks phase 2<br>* The performance of behavioral locomotion tasks is performed on 6 visits on validation phase (3 in real condition and 2 in virtual reality in D1, M1 and M12)<br>|
| Other: healthy volunteers patients<br>36 patients will be included just in phase 2 (15 in step 1 and 21 in step 2). | Behavioral: performance of behavioral locomotion tasks phase 2<br>* The performance of behavioral locomotion tasks is performed on 6 visits on validation phase (3 in real condition and 2 in virtual reality in D1, M1 and M12)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pilot calibration phase in a real environment. | Defines the optimal parameters of complexity of standardized behavioral tasks thanks to a mobility test in variable light conditions carried out in a real environment. | Month 1 | 
| Pilot calibration phase in a virtual environment. | Defines the optimal parameters of complexity of standardized behavioral tasks thanks to a mobility test in variable light conditions carried out in a virtual environment. | Month 1 | 
| Validation phase on the motor performance | Validation of tests to assess the impact of peripheral visual impairment on the motor performance of patients in their daily life | Month 12 | 
| Validation phase on the sensory performance | Validation of tests to assess the impact of peripheral visual impairment on the sensory performance of patients in their daily life | Month 12 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Validation of a locomotion test in virtual reality | It is to validate the construction of the test and to determine its performance in discriminating nature, its reproducibility and its sensitivity to change | Day 1 - Month 1- Month 12 | 
| Quality of Life Assessment | Analyze the correlation between the results of patients' quality of life and the results of behavioral tests | Day1-Month 1- Month 12 | 
| Measures of the evolution of the postural parameters | Evolution of postural's study parameters is performed by an experimental behavioral study, carried out during the same sessions as the main task of locomotion. The participants' postural stability will be correlated with the patient's visual parameters (acuity, visual field). | Day1 - Month 1 - Month 12 | 
| Analyze the adverse events during the tasks' assessment | Analyze the adverse events that will be collected during the performance of this study | through study completion, an average of 1 year |