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Retinitis PigmentosaSLAMNCT04359108

Environmental Localization Mapping and Guidance for Visual Prosthesis Users

A study testing Navigation system mode: Argus Vision, Navigation system mode: Depth Vision and Navigation system mode: Depth Vision with Haptic / Audio in people with Retinitis Pigmentosa and Visual Impairment, run by Johns Hopkins University at 2 sites in United States.

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

This study is driven by the hypothesis that independent navigation by blind users of visual prosthetic devices can be greatly aided by use of an autonomous navigational aid that provides information about the environment and guidance for navigation through multimodal sensory cues. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
What is being tested?
Navigation system mode: Argus Vision, Navigation system mode: Depth Vision and Navigation system mode: Depth Vision with Haptic / Audio
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
26 participants
Where
2 sitesUnited States
Study dates
16 Mar 2021to 30 Sep 2024
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

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

Who may be able to join

None listed.

Who cannot join

  • Subject is unwilling or unable to travel to testing facility for at least 3 days of testing within a one-week timeframe;
  • Subject does not speak English;
  • Subject has language or hearing impairment.

Trial locations and contacts

2 sites in 1 country.

United States2 sites
  • Johns Hopkins Medicine - Wilmer Eye Institute

    Baltimore, Maryland, 21205

  • Johns Hopkins Applied Physics Laboratory

    Laurel, Maryland, 20723

Other trials in United States

About this study

This study is driven by the hypothesis that independent navigation by blind users of visual prosthetic devices can be greatly aided by use of an autonomous navigational aid that provides information about the environment and guidance for navigation through multimodal sensory cues. For this study, the investigators developed a navigation system that uses on-board sensing to map the user's environment and compute navigable paths to desired destinations in real-time. Information regarding obstacles and directional guidance is communicated to the user via a combination of sensory modalities including limited vision (through the user's visual prosthesis), haptic, and audio cues. This study evaluates how effectively this navigational aid improves prosthetic vision users' ability to perform navigational tasks. The participants for this study include both retinal prosthesis users of the Argus II Retinal Prosthesis System (Argus II) and normally sighted individuals who use a virtual reality headset to simulate the limited vision of the Argus II system.

Read the detailed description

About 1.3 million Americans aged 40 and older are legally blind, a majority because of diseases with onset later in life, such as glaucoma and age-related macular degeneration. Second Sight Medical Products (SSMP) has developed the world's first FDA approved retinal implant, Argus II, intended to restore some functional vision for people suffering from retinitis pigmentosa (RP).

In this era of smart devices, generic navigation technology, such as GPS mapping apps for smartphones, can provide directions to help guide a blind user from point A to point B. However, these navigational aids do little to enable blind users to form an egocentric understanding of the surroundings, are not suited to navigation indoors, and do nothing to assist in avoiding obstacles to mobility. The Argus II, on the other hand, provides blind users with a limited visual representation of the users surroundings that improves users' ability to orient themselves and traverse obstacles, yet lacks features for high-level navigation and semantic interpretation of the surroundings. The proposed study aims to address these limitations of the Argus II through a synergy of state-of-the-art simultaneous localization and mapping (SLAM) and scene recognition technologies.

This study is driven by the hypothesis that independent navigation by blind users of visual prosthetic devices can be greatly aided by use of an autonomous navigational aid that provides information about the environment and guidance for navigation through multimodal sensory cues. The investigators developed a navigation system that uses on-board sensing and SLAM-based algorithms to continuously construct a map of the user's environment and locate the user within that map in real-time. On-board path planning algorithms compute optimal navigation routes to reach desired destinations based on the constructed map. The system then communicates obstacle locations and navigational cues to the user while navigating via a combination of sensory modalities. The participants for this study include blind Argus II users, who use their retinal implant for vision, and normally sighted individuals, who use a virtual reality headset to simulate the limited vision of a retinal prosthesis.

The sensory modalities used by the navigational aid to communicate information back to the user include:

  • Limited vision is provided via the user's visual prosthesis, with the Argus II retinal implant supporting an image size of 10 x 6 pixels spanning approximately 18 x 11 degrees field-of-view. Images sent to the visual implant are derived from video frames provided by forward-facing cameras integrated within headgear worn by the user. Three forms of vision feedback are evaluated in this study including: 1) the standard vision output of the Argus II (which uses texture-based processing including difference-of-Gaussian and contrast enhancement filters), 2) an enhanced depth-based vision mode that uses the depth sensing capabilities of the navigational aid to highlight above-ground obstacles, and 3) a high field of view depth-based vision mode that doubles the pixel size and field of view of the visual feedback in each dimension. The depth-vision modes display only above-ground obstacles with increasing brightness relative to decreasing distance from the user; the ground and obstacles beyond a threshold distance are not displayed in order to declutter the visual scene. The high field-of-view depth-vision mode is only utilized by normally sighted participants, as this mode exceeds the vision capabilities of the Argus II implant.
  • Haptic cues indicate the direction in which the user should advance in order to follow the path computed by the navigational aid to reach a target destination. The haptic cues are generated by vibrators situated at five positions located left-to-right along the users forehead, which are built into user-worn headgear. The five vibration points indicate for the user to turn in directions: "far left", "slight left", "straight ahead", "slight right", and "far right".
  • Audio cues provide an audible alert when the user approaches an obstacle within 1.5 feet and provide verbal updates on the remaining distance to reach the destination along the path computed by the navigational aid.

This study compares participants' performance in completing navigation tasks using five different modes and combinations of the foregoing sensory modalities as follows: 1) Argus vision, 2) depth vision, 3) depth vision with haptic and audio, 4) haptic and audio (without vision), and 5) high field-of-view depth vision.

The navigation tasks performed by the participants using these modalities include navigating through a dense obstacle field and navigating between rooms within an indoor facility that requires successful traversal of non-trivial paths.

In addition, a third experiment evaluates the effect of resolution and field-of-view of the retinal implant upon participants' ability to visually discern relative distances to different obstacles based on optical flow patterns induced by the participant's motion when approaching obstacles situated at different distances ahead of the user. For this experiment, the following four vision settings are evaluated: 1) low resolution / low field-of-view, 2) low resolution / high field-of-view, 3) high resolution / low field-of-view, and 4) high resolution / high field-of-view. The "low" settings correspond to the values of the Argus II system, whereas the "high" settings corresponding to a doubling of the "low" values along each dimension. For Argus user participants, only the low resolution / low field-of-view setting is evaluated since the Argus II retinal implant is incapable of supporting the higher vision settings.

Being tested
Navigation system mode: Argus Vision, Navigation system mode: Depth Vision, Navigation system mode: Depth Vision with Haptic / Audio, Navigation system mode: Haptic / Audio, Navigation system mode: High Field-of-View Depth Vision
Keywords
Retinal Prosthesis, Argus II
Medical subject headings
Retinitis Pigmentosa, Vision Disorders

What participants receive

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

  • Navigation system mode: Argus VisionDevice

    This intervention uses the navigational aid with the output sensory modalities configured as follows:

    • Vision: Argus mode
    • Haptics: none
    • Audio: none Since this mode only provides the standard Argus vision, it is equivalent to using the base Argus II system without the navigational aid.
  • Navigation system mode: Depth VisionDevice

    This intervention uses the navigational aid with the output sensory modalities configured as follows:

    • Vision: Depth mode (at Argus II resolution and field-of-view)
    • Haptics: none
    • Audio: none
  • Navigation system mode: Depth Vision with Haptic / AudioDevice

    This intervention uses the navigational aid with the output sensory modalities configured as follows:

    • Vision: Depth mode (at Argus II resolution and field-of-view)
    • Haptics: yes
    • Audio: yes
  • Navigation system mode: Haptic / AudioDevice

    This intervention uses the navigational aid with the output sensory modalities configured as follows:

    • Vision: none
    • Haptics: yes
    • Audio: yes Since this mode does not provide any visual feedback, it is equivalent to using navigational aid completely blind without a visual prosthesis.
  • Navigation system mode: High Field-of-View Depth VisionDevice

    This intervention uses the navigational aid with the output sensory modalities configured as follows:

    • Vision: High Field-of-View Depth mode (at twice the Argus II resolution and field-of-view along each dimension)
    • Haptics: none
    • Audio: none
  • Distance test vision mode: Low Resolution / Low Field-of-ViewDevice

    This intervention performs the relative distance to two obstacles test with the user's vision output configured as follows:

    • Resolution: Low
    • Field-of-View: Low
  • Distance test vision mode: Low Resolution / High Field-of-ViewDevice

    This intervention performs the relative distance to two obstacles test with the user's vision output configured as follows:

    • Resolution: Low
    • Field-of-View: High
  • Distance test vision mode: High Resolution / Low Field-of-ViewDevice

    This intervention performs the relative distance to two obstacles test with the user's vision output configured as follows:

    • Resolution: High
    • Field-of-View: Low
  • Distance test vision mode: High Resolution / High Field-of-ViewDevice

    This intervention performs the relative distance to two obstacles test with the user's vision output configured as follows:

    • Resolution: High
    • Field-of-View: High
Study groups in NCT04359108
Study groupRoleWhat they receive
Evaluation of normally sighted participants using a simulated visual prosthesisExperimentalAll normally sighted participants will be assigned to this arm of the study. This study group will perform all experiments using a virtual reality headset (Oculus Go) to simulate the limited vision of a retinal prosthesis system. This study group will include all interventions, including those that both match and exceed the visual performance of the Argus II system.
Receives: Device: Navigation system mode: Argus Vision; Device: Navigation system mode: Depth Vision; Device: Navigation system mode: Depth Vision with Haptic / Audio; Device: Navigation system mode: Haptic / Audio; Device: Navigation system mode: High Field-of-View Depth Vision; Device: Distance test vision mode: Low Resolution / Low Field-of-View; Device: Distance test vision mode: Low Resolution / High Field-of-View; Device: Distance test vision mode: High Resolution / Low Field-of-View; Device: Distance test vision mode: High Resolution / High Field-of-View
Evaluation of blind participants using the Argus II retinal prosthesisExperimentalAll blind participants who have been implanted with the Argus II Retinal Prosthesis System will be assigned to this arm of the study. This study group will be limited to performing a subset of the interventions including only those that do not exceed the visual performance of the Argus II system.
Receives: Device: Navigation system mode: Argus Vision; Device: Navigation system mode: Depth Vision; Device: Navigation system mode: Depth Vision with Haptic / Audio; Device: Navigation system mode: Haptic / Audio; Device: Distance test vision mode: Low Resolution / Low Field-of-View

What is being measured

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

  1. Duration of Time to Complete Navigational Tasks as Assessed by the Mean Duration of Travel in Seconds Normalized by the Nominal Path Distance in Meters

    Participants will be asked to complete the navigation tasks of crossing an obstacle field approximately 6 meters in length and navigating to a target destination located about 20 - 30 meters away. The normalized duration of time to complete each navigation task will be measured in seconds. To account for variability in the path distances of different trials, the measured time will be normalized by a reference (nominal) path distance in meters associated with the configuration of each trial. The mean normalized time across all trials will be computed for each intervention.

    Measured: Up to 7 minutes for each navigation task, on Day 1 or Day 2

  2. Distance Traversed to Complete Navigational Tasks as Assessed by the Mean Distance Traveled in Meters Normalized by the Nominal Path Distance in Meters

    Participants will be asked to complete the navigation tasks of crossing an obstacle field approximately 6 meters in length and navigating to a target destination located about 20 - 30 meters away. The normalized distance traversed to complete each navigation task will be measured. To account for variability in the path distances of different trials, the measured distance will be normalized by a reference (nominal) path distance in meters associated with the configuration of each trial. The mean normalized distance across all trials will be computed for each intervention.

    Measured: Up to 7 minutes for each navigation task, on Day 1 or Day 2

  3. Obstacle Avoidance While Completing Navigational Tasks as Assessed by the Mean Number of Contacts With Obstacles Normalized by the Nominal Path Distance in Meters

    Participants will be asked to complete the navigation tasks of crossing an obstacle field approximately 6 meters in length and navigating to a target destination located about 20 - 30 meters away. The number of contacts with obstacles encountered while completing each navigation task will be measured. To account for variability in the path distances of different trials, the number of contacts will be normalized by a reference (nominal) path distance in meters associated with the configuration of each trial. The mean normalized number of contacts with obstacles across all trials will be computed for each intervention.

    Measured: Up to 7 minutes for each navigation task, on Day 1 or Day 2

  4. Success in Completing Navigational Tasks as Assessed by the Mean Percentage of Trials Where Participants Successfully Reached the Intended Destination

    Participants will be asked to navigate to a target destination located about 20 - 30 meters away. We will measure success rate as the mean number of trials for which each participants successfully reached the intended destination divided by the total number of trials performed by that participant for each intervention.

    Measured: Up to 7 minutes for each navigation task, on Day 1 or Day 2

  5. Accuracy of Relative Distance Judgments as Assessed by the Percentage of Correct Responses

    Participants will be presented with two physical objects and asked to identify which of the objects is the nearer one after walking a controlled distance down a centerline oriented between the objects. We will measure accuracy as the percentage of correct responses (the total number of correct responses divided by the total number of trials times 100).

    Measured: Up to 60 seconds for each discrimination task, on Day 1 or Day 2

Timeline

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

  1. First posted24 Apr 2020
  2. Study start16 Mar 2021
  3. Primary completion30 Sep 2024
  4. Study completion30 Sep 2024

Resources

More details

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

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Basic science
Allocation
Non-randomised
Intervention model
Single group
Masking
None (open label)
Enrolment
26 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04359108
Sponsor's protocol ID
IRB00228932
Other IDs
1R01EY029741-01A1
Acronym
SLAM
Status last verified
Feb 2025
First submitted
21 Apr 2020
Last updated
10 Mar 2025
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No: Results from this study will be disseminated through conference presentations and peer-reviewed publications. However, IPD will not be shared outside the study team.

Publications

  • Christie B, Acosta NN, Sadeghi R, Kartha A, Ewulum C, Caspi A, Tenore FV, Dagnelie G, Klatzky RL, Billings SD. Autonomous multisensory enhancement of a visual neuroprosthesis for navigation: technical proof-of-concept with simulated prosthetic vision and single-subject case study of a visual prosthesis user. J Neural Eng. 2026 Feb 5;23(1). doi: 10.1088/1741-2552/ae3d67.

    PubMed 41587489

Questions about this trial

What is this clinical trial studying?

A study testing Navigation system mode: Argus Vision, Navigation system mode: Depth Vision and Navigation system mode: Depth Vision with Haptic / Audio in people with Retinitis Pigmentosa and Visual Impairment, run by Johns Hopkins University at 2 sites in United States.

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 0 inclusion and 3 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 Mar 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in United States. 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?

Yes. Results are posted in the registry (first posted 10 Mar 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Duration of Time to Complete Navigational Tasks as Assessed by the Mean Duration of Travel in Seconds Normalized by the Nominal Path Distance in Meters (time frame: Up to 7 minutes for each navigation task, on Day 1 or Day 2). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04359108, which also lists 1 linked publication.

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 Mar 2025.

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