Effects of different viewing modes in virtual reality games on visual function parameters and subjective symptoms: A cross-sectional study

To investigate the influence of an eye ointment on functional visual acuity (FVA) and ocular wavefront aberration. In 11 healthy volunteers (6 men and 5 women), visual function parameters, such as FVA, visual maintenance ratios (VMR), and minimal visual acuity (minVA), were assessed by the FVA measurement system before and 2, 5, 10, 20, 30, 40, 50, 60, 90, 120, 180, and 240 min after administration of ofloxacin eye ointment. Ocular aberration was also measured, and the root mean square (RMS) of second-, third-, fourth-, and total higher-order aberrations was determined. The time course of changes in each parameter was statistically analyzed by using repeated-measures analysis of variance and the Dunnett post hoc test, and relationships between visual function and ocular aberration parameters were also analyzed by the Pearson correlation test. FVA, VMR, and minVA showed significant deteriorations at 2-, 5-, 10-, and 20 min after administration of eye ointment compared with the baseline values (P<0.05). All components of ocular wavefront aberration such as second-, third-, fourth-, and total higher-order RMS significantly increased at 2- and 5 min after the administration of eye ointment compared with the baseline values (P<0.05). In addition, deteriorations of these visual function parameters were significantly correlated with reduced blink numbers (Pearson's correlation coefficient; r=- 0.76, P=0.017 for FVA, r=0.79, P=0.013 for VMR, and r=-0.62, P=0.040 for minVA), and VMR was significantly related with changes in second-order RMS (r=-0.60, P=0.049). Eye ointment significantly reduced visual function for at least 20 min. Especially, minVA was worse than 0.155 logMAR, which is legally required for driving, for 3 h after the administration. In addition, increases in lower-order aberration and low blink rates were associated with the degradation of visual function.

Impact of visual function on computer task accuracy and reaction time in a cohort of patients with age-related macular degeneration

How much music contributes to player experience (PX) in virtual reality (VR) games remains unclear in the games user research literature. A core factor of PX in VR games that has not been studied before (in relation to audio or otherwise) is time perception. Thus, we provide the first empirical exploration of how music affects time perception in a VR game. In a user study (N=64), we investigated the effects of music on PX and time perception (operationalized as retrospective time estimation). Participants retrospectively perceived time to pass significantly quicker in the VR game when music was present, but reported no difference in PX components, including immersion. This contributes to ongoing discourse on the surprising lack of music effects in VR games. Moreover, our results highlight the need to re-conceptualize our understanding of the relationship between time perception and immersion in games.

PurposeTo compare progressive changes in visual function parameters in patients with Fuchs entothelial dystrophy (FED) who underwent Descemet Membrane Endothelial Keratoplasty (DMEK). To compare visual results after DMEK with visual function parameters in healthy subjects without corneal pathology.MethodsThirty patients (30 eyes) with FED who underwent DMEK surgery were included in the study. All subjects underwent best corrected visual acuity (BCVA) evaluation using the ETDRS optotype in photopic and scotopic conditions, and contrast sensitivity (CS) assessment using the CSV 1000 and the Pelli Robson test in different lighting conditions, preoperatively, at 1 and 6 months after surgery. Thirty eyes of 30 healthy controls were evaluated using the same protocol and compared with the patients’ final postsurgery data.ResultsA significant improvement in all visual function parameters was observed in patients 1 month (p &lt; 0.05) and 6 months (p &lt; 0.05) after DMEK, compared with preoperative levels. No significant differences were observed between patients and healthy controls in the lowest spatial frequency of 3cpd (photopic, p = 0.891; mesopic, p = 0.064; mesopic with glare, p = 0.786). Healthy controls had significantly higher BCVA in photopic and scotopic conditions (p = 0.015, p = 0.03, respectively), better CS measured with the CSV 1000 test in the spatial frequencies of 6 cpd, 12 cpd and 18 cpd and with the Pelli Robson test (p = 0.002).ConclusionsDMEK improves visual function parameters in patients with FED in the first month after surgery. Patients who underwent DMEK present similar contrast sensitivity to healthy subjects in lower frequencies. However, the rest of the values assessed were significantly lower in DMEK patients compared to healthy controls 6 months after surgery.

Physical discomforts, such as sickness, experienced during virtual reality (VR) gaming were analyzed using electroencephalography (EEG). Correlations between the results of a survey on the physical discomforts felt during a head mounted 360° VR gaming and EEGs were analyzed. EEGs were measured using 19 electrodes before, during, and after VR gaming. The brain was categorized into eight regions and EEGs were analyzed for each region. After gaming, a questionnaire was completed, and correlations between the scores of nausea, ocular discomfort, and disorientation and EEGs were examined. Before and during VR, there were substantial changes in the absolute power and relative power bands depending on the region of interest. The analysis of correlations with the physical discomforts classified based on the questionnaire showed that the theta and beta waves from the occipital and temporal lobes exhibited significant correlations. The EEGs before and after VR gaming did not exhibit significant changes. In this study, a qualitative analysis on the physical discomforts occurring during VR was conducted based on EEG. We expect that EEG can be utilized in providing customized VR capable of minimizing physical discomforts by analyzing the EEG measured in real time and providing feedback to VR gaming.

The aims of this study were 1) To evaluate retinal nerve fiber layer (fRNFL) thickness and ganglion cell layer plus inner plexiform layer (GCIPL) thickness at the fovea in eyes affected with traumatic optic neuropathy (TON) compared with contralateral normal eyes, 2) to further evaluate these thicknesses within 3 weeks following trauma (defined as “early TON”), and 3) to investigate the relationship between these retinal layer thicknesses and visual function in TON eyes. Twenty-nine patients with unilateral TON were included. Horizontal and vertical spectral-domain optical coherence tomography (SD-OCT) scans of the fovea were taken in patients with unilateral TON. The main outcome measure was thickness of the entire retina, fRNFL, and GCIPL in eight areas. Thickness of each retinal layer was compared between affected and unaffected eyes. The correlation between the thickness of each retinal layer and visual function parameters, including best corrected visual acuity, color vision, P100 latency, and P100 amplitude in visual evoked potential (VEP), mean deviation (MD) and visual field index (VFI) in Humphrey visual field analysis in TON eyes was analyzed. Thicknesses of the entire retina, fRNFL, and GCIPL in SD-OCT were significantly thinner (3–36%) in all measurement areas of TON eyes compared to those in healthy eyes (all p<0.05). Whereas, only GCIPL in the outer nasal, superior, and inferior areas was significantly thinner (5–10%) in the early TON eyes than that in the control eyes (all p<0.01). A significant correlation was detected between retinal layer thicknesses and visual function parameters including color vision, P100 latency and P100 amplitude in VEP, MD, and VFI (particularly P100 latency, MD, and VFI) (r = -0.70 to 0.84). Among the retinal layers analyzed in this study, GCIPL (particularly in the superior and inferior areas) was most correlated with these five visual function parameters (r = -0.70 to 0.71). Therefore, evaluation of morphological change of each retinal layer using SD-OCT can help in understanding TON pathophysiology and indirectly assessing visual function. Moreover, evaluation of the morphological change of the GCIPL in TON eyes may be useful to assess visual function in patients with early TON.

The aim of this study is to evaluate the effectiveness of an eccentric viewing training program that combines biofeedback training using micro-perimetry with home exercises on multiple visual function parameters and to explore potential relationships between post-treatment visual function parameters. A retrospective observational review of 27 participants who underwent the training program was performed. Eligible participants were diagnosed with bilateral central scotomas secondary to age-related macular degeneration. All participants undertook up to 15 visual and acoustic biofeedback training sessions and were required to partake in traditional home exercises between sessions. The biofeedback training was conducted in the better eye using the Macular Integrity Assessment microperimeter (MAIA). Distance and near acuity, contrast sensitivity and fixation stability quantified by the P1 and P2 values and the 63% and 95% bivariate contour ellipse area (BCEA) before and after the rehabilitation program were recorded. Significant improvement was noted post-training for distance visual acuity (t(26) = 4938 p = .000), near visual acuity (Z = −4.461 p = .000), contrast sensitivity (Z = −3.647 p = .000) and fixation stability for all measures, including P1 (t(26) = −9.490 p = .000), P2 (t(26) = −7.338 p = 0.000), 63% BCEA (Z = 3.569 p = .000) and 95% BCEA (t(26) = 4.687 p = .000). Significant medium-to-large correlations were also found between most visual function variables. Visual and acoustic biofeedback in conjunction with home exercises has the potential to improve visual function parameters in patients with age-related macular degeneration and irreversible central vision loss.

Several studies compared the player experience of Virtual Reality (VR) games and non-VR games. However, there is a lack of research on the specific subject of VR and non-VR multiplayer games. Therefore, this work explores how implementing a multiplayer game in VR may influence the player experience compared to the non-VR alternative. We developed a short multiplayer puzzle game that can be played as a VR game or as a non-VR game. The player experience of the different game versions was evaluated by having players answer the Game Experience Questionnaire by IJsselsteijn et al. and the Simulator Sickness Questionnaire by Kennedy et al. after playing each version. The results showed that a majority of the aspects of player experience were rated significantly higher for the VR versions compared to the non-VR alternative. However, it was noted that two different VR versions fared differently compared to the non-VR alternative, and they scored vastly different when calculating a total simulator sickness score. We conclude that implementing similar multiplayer games in VR can improve the player experience, but care is required to achieve the best player experience in VR.

Video games are popular as entertainment tools. Yet, they can also be used as tools for other activities, including relaxation and meditation. Virtual reality (VR) games have enhanced player experiences thanks to immersive applications, such as VR cinema, virtual browsing, and virtual spaces that can be used as an extension of the physical area. Among those applications, VR shows promise for relaxing and therapeutic applications. However, most of these applications position users in a passive interaction with their environment. This project explores if relaxation and mindfulness in VR can be achieved through active player engagement, where users directly control their character and provide input. Two versions of a relaxing video game were made: (1) a PC version where the player flies and explores natural landscapes in-game on a classical PC gaming setup (i.e., a monitor display, keyboard, and gamepad); (2) a VR version, where the game is played via head-mounted display (HMD), specifically the Oculus Quest. I used a brain-computer interface (BCI), specifically the "Emotiv Insight" Electroencephalography (EEG) headband, to record participants' brainwave activities while playing the game. Based on the results of my study, I found a statistically significant difference on both theta and alpha brainwave frequencies (i.e., the brainwaves that express relaxation and engagement) between the PC and VR versions of the game. Furthermore, I collected qualitative impressions of both the PC and VR games, where participants reported their subjective levels of relaxation after each version. The results of the survey show that participants experienced enhanced relaxations states in VR compared to PC. This thesis contributes empirical evidence that VR games can be used to further enhance relaxation states in players and show promise for applications in mindfulness and meditation through active player engagement.--Author's abstract

Instead of traditional free movement, node-based movement can be used in virtual reality (VR) games. In node-based movement systems, players navigate by jumping to set locations. Node-based movement is similar to hypertext navigation. We show that the hypertext lostness measure can be used as a game analytic to evaluate navigational efficiency. In a randomized controlled trial with 25 adolescent participants, an immersive desktop game environment and a VR game environment were compared on the transmission of in-game educational content and navigational efficiency. Results show that the hypertext lostness measure is also valuable outside its original hypertext domain: in VR. VR did not improve players' retention of factual knowledge, but did significantly improve players' spatial knowledge and navigational efficiency. We conclude (a) the hypertext lostness measure is also valuable for node-based VR games and (b) VR games add to spatial learning, even when compared with already immersive desktop games.

Purpose The present study explored participants’ experiences with and perceptions of using fully immersive head-mounted virtual reality (VR) gaming as rehabilitation after stroke. Methods Four men and three women (median age 64 years) with chronic stroke and varying motor impairment (mild to severe) were interviewed after 10 weeks of VR training on the commercial HTC Vive system, focusing on the upper extremities. Inductive qualitative thematic analysis was performed. Results The analysis revealed three main themes: playing the game, benefits and effects, and personalizing the game. Playing the game encompasses both the feeling of being immersed in the game and descriptions of the gaming being motivating and fun. Benefits and effects describe the participants’ expectations of potential benefits, the importance of getting feed-back, and the impact in daily life. Personalizing the game includes finding the right game and level, and the participants’ need for support to achieve full use of the training. Conclusions Participants with chronic stroke described the fully immersive VR gaming intervention as a fun and motivating way to improve their functioning in everyday life. Qualitative studies are needed to explore how people with stroke perceive VR gaming when it is implemented in real clinical environments. Clinical implications VR gaming was perceived as a positive and motivating rehabilitation after stroke. Getting feedback and perceiving benefits are essential parts of VR rehabilitation. Commercial fully immersive VR-games might be an option for stroke rehabilitation when the game can be personalized and support is available.

Autonomous robots that are interfaced with virtual or augmented reality gaming are increasingly being developed to provide repetitive intensive practice to promote increased compliance and facilitate better outcomes in neurorehabilitation therapies. These therapist robots, equipped with a set of sensors and actuators for monitorizing the environment, allows health professionals to supervise the recovery of patients with serious disability. In this paper, a new system for supervising neuro-rehabilitation therapies using autonomous robots is presented. The therapy explained in this work is based on a set of virtual reality games developed by using robotics technologies, such as RGB-D camera and depth image processing. Three different virtual reality games have been developed in the application to gain better outcomes during the therapy, each one focuses on a typical exercise: ‘Touch the apple’, ‘Follow the path’ and ‘Imitate the dance’. Both, the virtual reality games and the main robotics technologies for their development, are explained in this paper.

Virtual reality (VR) games offer potential as a fun and immersive way to get enough physical activity to gain significant health benefits. Currently, there is no established way to describe the type and level of physical activity a person can expect to gain when playing a VR game. Nor is there a way of reporting to a person about the exercise they actually did. To address this, we have designed a visual overview that depicts the nature of exercise an individual actually did. To assess the visualisation, we selected four VR games with very different exercise profiles. We used them in a qualitative study with 7 people, so that we could demonstrate how our visualisation could represent the individual differences in the nature and level of physical activity for each game. Our contribution is the design of the first visualisation to represent the nature of exercise gained in VR games, as a personalised, compact summary of the exertion an individual had in a game.

Virtual reality (VR) games are currently becoming part of the public-space entertainment (e.g., VR amusement parks). Therefore, VR games should be attractive for players, as well as for bystanders. Current VR systems are still mostly focused on enhancing the experience of the head-mounted display (HMD) users; thus, bystanders without an HMD cannot enjoy the experience together with the HMD users. We propose the "ReverseCAVE": a proof-of-concept prototype for public VR visualization using CAVE-based projection with translucent screens for bystanders toward a shareable VR experience. The screens surround the HMD user and the VR environment is projected onto the screens. This enables the bystanders to see the HMD user and the VR environment simultaneously. We designed and implemented the ReverseCAVE, and evaluated it in terms of the degree of attention, attractiveness, enjoyment, and shareability, assuming that it is used in a public space. Thus, we can make the VR world more accessible and enhance the public VR experience of the bystanders via the ReverseCAVE.

The retrospective and subjective nature of clinical interviews is an important shortcoming of current psychiatric diagnosis. Consequently, there is a clear need for objective and standardized tools. Virtual reality (VR) can be used to achieve controlled symptom provocation, which allows direct assessment for the clinician. We developed a video VR game to provoke and assess obsessive-compulsive disorder (OCD) symptoms in a standardized and controlled environment. The first objective was to evaluate if the VR game is capable of provoking symptoms in OCD patients as opposed to healthy controls. The second objective was to evaluate the tolerability of the VR game in OCD patients. The VR game was created using a first-person perspective and confronted patients with 15 OCD-specific items, while simultaneously measuring OCD symptoms, including the number of compulsions, anxiety, tension, uncertainty, and urge to control. In this pilot study, eight patients and eight healthy controls performed the VR game. OCD patients performed significantly more compulsions (U = 5, p = 0.003) during the VR game. The anxiety, tension, uncertainty, and urge to control in response to the specific items were also higher for OCD patients, although significance was not yet reached because of the small sample. There were no substantial adverse effects. The results of this pilot study indicate that the VR game is capable of provoking a variety of OCD symptoms in OCD patients, as opposed to healthy controls, and is a potential valuable tool to objectify and standardize an OCD diagnosis.