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CataractContrastValNCT03169855

Validation of Mesopic and Photopic Contrast Vision Tests With Respect to Nighttime Driving Ability

An observational study of Cataract and Traffic Accident, run by Aalen University at 1 site in Germany.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

A) The main purposes of this study are (i) to develop a related virtual reality (VR) environment in order to judge the nighttime driving ability under mesopic and under glare conditions (ophthalmologically healthy subjects and patients with incipient to intermediate cataract, i.e. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Cataract, Traffic Accident, Vision Disorders
What is being tested?
Slit lamp (LOCS III Score)
How many people
54 participants
Where
1 siteGermany
Study dates
2 May 2017to 31 Dec 2018
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: Ophthalmologically healthy subjects and patients with incipient to intermediate cataract.

Who may be able to join

  • age ≥ 18 years (preferred: age, exceeding 50 yrs.)
  • Minimum distant visual acuity (with habitual correction) 0.8 (16/20, single optotypes, LANDOLT C chart for presentation of high contrast optotypes according to DIN 58220 - Part 3/ISO 10938 (Visus GmbH, Stuttgart/Germany)
  • ametropia maximum spherical ametropia sph ±8.00 dpt maximum maximum astigmatism cyl 2.00 dpt
  • normal (age-corrected) visual field
  • clear refractive media OR incipient to intermediate cataract
  • informed consent

Who cannot join

  • epilepsy / psychiatric disorders
  • drugs, interfering with reaction time and/or with visual acuity or with refractive status of the eye
  • deficient driving license
  • yearly mileage less than 3000 km/y (less than 1.864 miles/y)
  • ophthalmological exclusion criteria: all ophthalmological diseases or abnormalities, with the exception of those, listed in the above-mentioned inclusion criteria
  • amblyopia
Show all 21Show fewer
  • strabismus
  • ocular motility disorders
  • nystagmus
  • double vision
  • albinism
  • glaucoma / IOP exceeding 22 mmHg
  • shallow anterior chamber/risk of angle closure glaucoma (van HERICK grade less than 2)
  • macular diseases / maculopathy
  • diabetic retinopathy (blood sugar-related retinal disease)
  • status post severe eye injuries
  • eye surgery within the last three months (, related to the time point of recruitment)
  • Infectious diseases (conjunctivitis, corneal inflammation, uveitis)
  • very dry eyes (sicca symptoms)
  • drugs inducing miosis
  • any other eye disorders that affect the image quality

Trial locations and contacts

1 site in 1 country.

Germany1 site
  • University of Applied Sciences, Study Course Ophthalmic Optics

    Aalen, Baden-Wurttemberg, 73430

Other trials in Germany

About this study

Official title: Validation of Mesopic and Photopic Contrast Vision Tests With Respect to Nighttime Driving Ability (ContrastVal) - Influence of Dynamic Glare on (Aged) Motorist (With/Without Media Opacities)

  1. The main purposes of this study are (i) to develop a related virtual reality (VR) environment in order to judge the nighttime driving ability under mesopic and under glare conditions (ophthalmologically healthy subjects and patients with incipient to intermediate cataract, i.e. opacities of the human lens, will participate in this study), (ii) to validate the above-mentioned VR environment with respect to a related on-road driving scenario under mesopic and glare conditions, (iii) to validate clinical photopic and mesopic contrast vision tests and glare tests with respect to the prediction of nighttime driving ability, (iv) to assess the test retest reliability of clinical photopic and mesopic contrast vision tests
  2. Background:

An intact mesopic vision and a glare sensitivity within a normal range are essential pre-requisites for safe driving at nighttime (DOG \& BVA, 2011). Anderson \& Holiday (1995) have shown that (simulated) opacities of the refractive media (with only minor effects on daytime visual acuity) induce a pronounced impairment of contrast sensitivity under nighttime conditions. Especially under glare conditions by the headlights of traffic on the opposite lane or by stationary street illumination, an impairment of the mesopic vision may cause traffic hazards. The prevalence of impairments of the central visual acuity, the mesopic vision and the glare sensitivity is significantly higher for subjects being involved in nighttime traffic accidents (Lachenmayr, 1998). Furthermore, these impairments occur more frequently in aged drivers and are, among others, related to an increase of age-related media opacities (Aulhorn \& Harms, 1970, Babizhayev, 2003). Due to the demographic change, the relevance of nighttime driving ability is increasing in the next years since more and more aged employees will participate at the motorized traffic at night.

The German Fahrerlaubnisverordnung (FEV i.e. driving license regulation) specifies pass/fail criteria with regard to mesopic vision and glare sensitivity. The luminance level during nighttime driving is usually between 0.01 and 1 cd/m^2, and therefore can be attributed to the level of mesopic vision. However, over the last years, the attempt was made to introduce photopic contrast sensitivity test to diagnose nighttime driving ability (i.e. testing of contrast vision under daytime conditions without time consuming adaptation procedures). Current research aims at investigating the relationship between contrast tests under various luminance conditions (Wilhelm et al, 2013). It is questionable, whether photopic tests are at all reliable predictors with regard to nighttime driving (Gramberg-Danielsen et al., 1984, Hertenstein et al., Graefe´s Archive of Ophthalmology, 2016).

Read the detailed description

Subjects and Methods Adult patients with a distant binocular visual acuity of ≥ 0.8 (≥ 16/20; habitual correction) and healthy control subjects will be included in this explorative study after informed consent.

The study will be subdivided in the following (three) parts:

Part 1: Validation of the Aalen driving simulator set-up (ten patients with incipient to moderate cataract, i.e. opacities of the human lens of varying localization and of various degree of expression in at least one eye and ten age- and gender-correlated ophthalmologically healthy control subjects will be enrolled) Part 1.1.: Comprehensive ophthalmological/optical examination (Aalen University of Applied Sciences) including a detailed ophthalmological and medical history.

Part 1.2.: Baseline driving simulator test under mesopic conditions with/without glare under simulated static/simulated driving conditions (Aalen University of Applied Sciences) Part 1.3.: Baseline on road test under mesopic conditions with/without glare, under on road static/on road driving conditions (Aalen University of Applied Sciences) (If possible, the sequence of Part 1.2. and Part 1.3. will be randomly assigned.)

Part 2: Advanced driving simulator test (twenty patients with incipient to moderate cataract, i.e. opacities of the human lens of varying localization and of various degree of expression in at least one eye and twenty age- and gender-correlated ophthalmologically healthy control subjects will be enrolled. Subjects being enrolled in Part 1, will be asked to participate also at Part 2 and Part 3.) Part 2.1.: Comprehensive ophthalmological/optical examination of all (newly) enrolled patients and subjects who have not already been examined in Part. 1.1. (Aalen University of Applied Sciences).

Part 2.2.: Advanced driving simulator test under photopic and under mesopic simulated driving with and without glare (Würzburg Institute for Traffic Sciences = WIVW) in order to investigate the influence of glare on the driving behavior

Part 3: Representative driving simulator test (The [altogether fourty] subjects, enrolled in Part 2, will be enrolled in this part of the study.) Driving simulator test under photopic and mesopic conditions in oder to investigate glare on representative driving situations. Driving performance will be evaluated highly-standardized and partially automated on different parameters of operational and tactical driving behavior (S.A.F.E., Würzburg Institute for Traffic Sciences = WIVW).

Pass/fail rates are specified as described in the related manuals of the instruments. With regard to visual acuity measurements and assessment of mesopic contrast vision without/with glare, results are rated according to DIN 58220 - Part 3/ISO 10938: If less than three out of five subsequent presentations of an eight-position LANDOLT C (with two oblique and three horizontal/vertical gap locations in random sequence) are correctly identified, the session is rated as failed. Overlooking/missing reactions to obstacles (pedestrian [display dummy with dark clothing]/wild boar at the right roadside) are rated as failed.

For mesopic contrast vision testing, single LANDOLT optotpyes (visual acuity level 0.1 = 2/20) with the contrast levels (1:2, 1:5 and 1:23, respectively, according to AULHORN/HARMS) are presented via the Optovist Instrument (Vistec, Inc., Manching/Germany) or via the head up display (HUD) of the simulator vehicle/on road vehicle.

Photopic and mesopic contrast vision tests (without glare) are repeated once in order to assess the test retest variability of the related test procedure.

  1. LANDOLT C chart for presentation of high contrast optotypes according to DIN 58220 - Part 3/ISO 10938 (Visus GmbH, Stuttgart/Germany)
  2. Assessment of low contrast visual acuity using FrACT (Freiburg Visual Acuity Test, internet version 3.8.1)
  3. Assessment of photopic contrast sensitivity, using the MARS Letter Contrast Sensitivity Test (The Mars Perceptrix Corporation, NY 10514-2523,USA)
  4. Assessment of mesopic contrast sensitivity, using the OPTOVIST (VISTEC, Manching/FRG)
  5. Judgment of intraocular straylight, using the C-Quant (Straylight meter, OCULUS, Dutenhofen/FRG)
  6. Classification of human crystalline lens opacities, using the BQ 900 slitlamp (HAAG-STREIT, Köniz/CH), digital photography with dilated pupils, applying the LOCS III score
  7. Densitometry of the crystalline lens, using the Pentacam HR (OCULUS Inc., Dutenhofen/FRG)
  8. Digital Fundus Photography with dilated pupils (WX3D fundus camera, KOWA Optimed Deutschland GmbH, Düsseldorf/FRG)
  9. Aalen driving simulator: Two high performance VELVET planetarium projectors (Fa. ZEISS, Jena/FRG), AUDI A4 (AUDI Inc., Ingolstadt/FRG) with digital display and re-equipped (BFFT, Gaimersheim/FRG) with externally controllable head up display (HUD) for presentation of LANDOLT Cs with varying contrast levels, SILAB virtual reality environment (WIVW, Veitshöchheim/FRG), two mobile glare sources (LED arrays)
  10. Aalen on road parcours: AUDI A4 (AUDI Inc., Ingolstadt/FRG) with digital display, with externally controllable head up display (HUD, VW AG, Wolfsburg/FRG)) for presentation of LANDOLT Cs with varying contrast levels and equipped with dual brake (VEIGEL GmbH + Co KG, Künzelsau/FRG)
Being tested
Slit lamp (LOCS III Score)
Keywords
Traffic Ophthalmology, Glare, Cataract, Nighttime driving, contrast sensitivity, mesopic vision
Medical subject headings
Cataract, Vision Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Slit lamp (LOCS III Score)Diagnostic test

    Also called Oculus Pentacam (Scheimpflug procedure, densitometry)

    Diagnostic procedure only

Study groups in NCT03169855
Study groupRoleWhat they receive
Refractive media opacities: presentRefractive media opacities: present
Refractive media opacities: absentRefractive media opacities: absent
Receives: Diagnostic Test: Slit lamp (LOCS III Score)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Pass/fail rate (i.e. ratio of "no. of subjects passed" by "total no. of participants") with respect to a vision-related driving ability test

    Pass/fail rates will be assessed for vision related driving ability tests:

    (i) clinical photopic/mesopic contrast vision tests, (ii) glare tests, (iii) of driving simulator tests under mesopic conditions with and without glare, and (iv) on-road tests under mesopic conditions with and without glare

    Measured: From date of "first subject in" to date of "last subject out", i.e. over an 18 months period

Secondary outcomes (4)
  1. Rank of tested subjects with respect to a vision-related driving ability test

    Rank/i.e. sequence of tested subjects with respect to the results of a vision-related driving ability test [see clauses (i) to (iv), Outcome 1]

    Measured: From date of "first subject in" to date of "last subject out", i.e. over an 18 months period

  2. Test-retest reliability, expressed as "limits of agreement" (LOA) of a clinical contrast vision test

    Test-retest reliability of a clinical photopic/mesopic contrast vision test [see clauses (i) and (ii), Outcome 1]

    Measured: From date of "first subject in" to date of "last subject out", i.e. over an 18 months period

  3. Response time (in milliseconds) regarding to the gap recognition of a standardized optotype

    Response time regarding gap recognition of a standardized optotype (8 position LANDOLT C) with three contrast levels, presented via the head up display

    Measured: From date of "first subject in" to date of "last subject out", i.e. over an 18 months period

  4. Intensity of driving simulator sickness, assessed by a questionnaire

    Intensity of driving simulator sickness, assessed by a questionnaire

    Measured: From date of "first subject in" to date of "last subject out", i.e. over an 18 months period

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted30 May 2017
  2. Study start2 May 2017
  3. Primary completion31 Dec 2018
  4. Study completion31 Dec 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Other
Time perspective
Prospective
Enrolment
54 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03169855
Sponsor's protocol ID
F-2015-044#A1
Acronym
ContrastVal
Status last verified
Jan 2019
First submitted
19 May 2017
Last updated
10 Jan 2019
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

An observational study of Cataract and Traffic Accident, run by Aalen University at 1 site in Germany.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 21 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 10 Jan 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Germany. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pass/fail rate (i.e. ratio of "no. of subjects passed" by "total no. of participants") with respect to a vision-related driving ability test (time frame: From date of "first subject in" to date of "last subject out", i.e. over an 18 months period). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Jan 2019.

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