Visual Field Defects

Visual impairments significantly impact individuals' activities of daily living (ADL) and quality of life (QoL). While perceptual learning (PL) has shown promise in vision rehabilitation, traditional PL usually involves a protracted training process, and its training effects may sometimes lack ecological validity. This study protocol outlines a two-arm, single-blind, randomized controlled trial to evaluate the efficacy of an innovative virtual reality (VR)-based PL therapy integrated with machine learning algorithms. Twenty participants with visual field deficits will be recruited and randomized in a 1:1 ratio into either the VR training group or a no-intervention control group. The intervention consists of six visits (1-7 days apart), each involving two training tasks (20 - 30 minutes per task). The VR training task is an Ecological Multiple Object Tracking task and a Dual task. Training stimuli are personalized to target each participant's transition zone (1\~20 dB) based on the result of clinical visual field test. A Deep Reinforcement Learning (DRL) framework, specifically the Proximal Policy Optimization (PPO) algorithm, is utilized as an adaptive controller to dynamically modulate task difficulty and maintain participants in an optimal cognitive "flow state". The primary outcome is visual field area improvement (measured by Humphrey Field Analyzer). Secondary outcomes include pre- and post-intervention assessments of visual search, balance ability, fear of falling, ADL, and QoL. It is hypothesized that participants in the VR training group will obtain improvements in primary and secondary outcomes.

The goal of this clinical trial is to learn if visual restoration therapy (VRT) (a type of treatment that aims to improve vision) works to the visual rehabilitation of patients with visual field defects. It will also learn about the safety of VRT. The main questions it aims to answer are: * Can visual reconstruction therapy help expand the visual field in patients with visual field defects? * What medical problems do patients with visual field defects experience during the procedure of VRT? Researchers will look at how patients with visual field defects who use a visual aid in combination with VRT and those who use a visual aid only, compare the visual field expansion at three months to see how well visual reconstruction therapy works. Participants will: * will undergo a specialized visual function assessment and be provided with a pair of appropriate vision aids. * Visit the clinic at one month and three months after enrolment for review of visual function and completion of a Chinese-version Low Vision Quality of Life (CLVQOL) questionnaire. * Participants receiving VRT will additionally undergo 30 minutes of VRT three times per week for 3 months. * Keep a diary for their symptoms and severity and frequency of occurrence during treatment.