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Lorenceau J, Ajasse S, Barbet R, Boucart M, Chavane F, Lamirel C, Legras R, Matonti F, Rateaux M, Rouland JF, Sahel JA, Trinquet L, Wexler M, Vignal-Clermont C. Method to Quickly Map Multifocal Pupillary Response Fields (mPRF) Using Frequency Tagging. Vision (Basel) 2024; 8:17. [PMID: 38651438 PMCID: PMC11036301 DOI: 10.3390/vision8020017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/27/2024] [Indexed: 04/25/2024] Open
Abstract
We present a method for mapping multifocal Pupillary Response Fields in a short amount of time using a visual stimulus covering 40° of the visual angle divided into nine contiguous sectors simultaneously modulated in luminance at specific, incommensurate, temporal frequencies. We test this multifocal Pupillary Frequency Tagging (mPFT) approach with young healthy participants (N = 36) and show that the spectral power of the sustained pupillary response elicited by 45 s of fixation of this multipartite stimulus reflects the relative contribution of each sector/frequency to the overall pupillary response. We further analyze the phase lag for each temporal frequency as well as several global features related to pupil state. Test/retest performed on a subset of participants indicates good repeatability. We also investigate the existence of structural (RNFL)/functional (mPFT) relationships. We then summarize the results of clinical studies conducted with mPFT on patients with neuropathies and retinopathies and show that the features derived from pupillary signal analyses, the distribution of spectral power in particular, are homologous to disease characteristics and allow for sorting patients from healthy participants with excellent sensitivity and specificity. This method thus appears as a convenient, objective, and fast tool for assessing the integrity of retino-pupillary circuits as well as idiosyncrasies and permits to objectively assess and follow-up retinopathies or neuropathies in a short amount of time.
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Affiliation(s)
- Jean Lorenceau
- Integrative Neuroscience and Cognition Center, UMR8002, Université Paris Cité, 75006 Paris, France; (R.B.); (M.W.)
| | | | - Raphael Barbet
- Integrative Neuroscience and Cognition Center, UMR8002, Université Paris Cité, 75006 Paris, France; (R.B.); (M.W.)
| | - Muriel Boucart
- CNRS, INSERM UMR-S 1172-Lille Neurosciences & Cognition, 59000 Lille, France;
| | - Frédéric Chavane
- Institut des Neurosciences de la Timone-CNRS UMR 7289, 13005 Marseille, France;
| | - Cédric Lamirel
- Hopital Fondation, Adolphe de Rothschild 29, rue Manin, 75019 Paris, France; (C.L.); (C.V.-C.)
| | - Richard Legras
- LuMIn, CNRS, ENS Paris-Saclay, Centrale Supelec, Université Paris-Saclay, 91192 Orsay, France;
| | - Frédéric Matonti
- Centre Monticelli Paradis d’Ophtalmologie, 13008 Marseille, France;
| | - Maxence Rateaux
- Centre BORELLI, Université Paris Cité, ENS Paris-Saclay, CNRS, INSERM, SSA, 75006 Paris, France;
| | - Jean-François Rouland
- Department of Ophthalmology, Hôpital Claude Huriez, CHRU de Lille, 59037 Lille, France;
| | - José-Alain Sahel
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA 15219, USA;
| | - Laure Trinquet
- Faculté des Sciences Médicales et Paramédicales, Aix-Marseille Université, 13385 Marseille, France;
| | - Mark Wexler
- Integrative Neuroscience and Cognition Center, UMR8002, Université Paris Cité, 75006 Paris, France; (R.B.); (M.W.)
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Zhong T, Zhou J, Yan T, Qiu J, Wang Y, Lu W. Pseudo-time Series Structural MRI Revealing Progressive Gray Matter Changes with Elevated Intraocular Pressure in Primary Open-Angle Glaucoma: A Preliminary Study. Acad Radiol 2024:S1076-6332(24)00155-7. [PMID: 38580519 DOI: 10.1016/j.acra.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/05/2024] [Accepted: 03/15/2024] [Indexed: 04/07/2024]
Abstract
RATIONALE AND OBJECTIVES Primary open-angle glaucoma (POAG) is accompanied with gray matter (GM) changes across the brain. However, causal relationships of the GM changes have not been fully understood. Our aim was to investigate the causality of GM progressive changes in POAG using Granger causality (GC) analysis and structural MRI. MATERIALS AND METHODS Structural MRI from 20 healthy controls and 30 POAG patients with elevated intraocular pressure (IOP) were collected. We performed voxel-wise GM volume comparisons between control and POAG groups, and between control and four POAG subgroups (categorized by IOP). Then, we sequenced the structural MRI data of all POAG patients and conducted both voxel-wise and region of interest (ROI)-wise GC analysis to investigate the causality of GM volume changes in POAG brain. RESULTS Compared to healthy controls, reduced GM volumes across the brain were found, GM volume enlargements in the thalamus, caudate nucleus and cuneus were also observed in POAG brain (false discovery rate (FDR) corrected at q< 0.05). As IOP elevated, the reductions of GM volume were more severe in the cerebellum and frontal lobe. GC analysis revealed that the bilateral cerebellum, visual cortices, and the frontal regions served independently as primary hubs of the directional causal network, and projected causal effects to the parietal and temporal regions of the brain (FDR corrected at q<0.05). CONCLUSION POAG exhibits progressive GM alterations across the brain, with oculomotor regions and visual cortices as independent primary hubs. The current results may deepen our understanding of neuropathology of POAG.
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Affiliation(s)
- Tianzheng Zhong
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Taian, China; Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Jian Zhou
- Department of Radiology, Taian City Central Hospital, Taian, China
| | - Tingqin Yan
- Department of Ophthalmology, Taian City Central Hospital, Taian, China
| | - Jianfeng Qiu
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Taian, China; Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Yi Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Weizhao Lu
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Taian, China.
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Davost T, Rouland JF, Blanckaert E, Warniez A, Boucart M. Spatial attention and central crowding in primary open angle glaucoma. Clin Exp Optom 2024; 107:219-226. [PMID: 36862980 DOI: 10.1080/08164622.2023.2182185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 03/04/2023] Open
Abstract
CLINICAL RELEVANCE Measuring the impact of spatial attention on signal detection in damaged parts of the visual field can be a useful tool for eye care practitioners. BACKGROUND Studies on letter perception have shown that glaucoma exacerbates difficulties to detect a target within flankers (crowding) in parafoveal vision. A target can be missed because it is not seen or because attention was not focused at that location. This prospective study evaluates the contribution of spatial pre-cueing on target detection. METHOD Fifteen patients and 15 age-matched controls were presented with letters displayed for 200 ms. Participants were asked to identify the orientation of the target letter T in two conditions: an isolated letter (uncrowded condition) and a letter with two flankers (crowded condition). The spacing between target and flankers was manipulated. The stimuli were randomly displayed at the fovea and at the parafovea at 5° left or right of fixation. A spatial cue preceded the stimuli in 50% of the trials. When present, the cue always signalled the correct location of the target. RESULTS Pre-cueing the spatial location of the target significantly improved performance for both foveal and parafoveal presentations in patients but not in controls who were at ceiling level. Unlike controls, patients exhibited an effect of crowding at the fovea with a higher accuracy for the isolated target than for the target flanked by two letters with no spacing between the elements. CONCLUSION Higher susceptibility to central crowding supports data showing abnormal foveal vision in glaucoma. Exogenous orienting of attention facilitates perception in parts of the visual field with reduced sensitivity.
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Affiliation(s)
- Theophile Davost
- Department of Ophthalmology, Lille University Hospital, Hôpital Huriez, Lille, France
| | - Jean François Rouland
- Department of Ophthalmology, Lille University Hospital, Hôpital Huriez, Lille, France
- Lille Neurosciences and Cognition, University of Lille, Lille, France
| | - Edouard Blanckaert
- Department of Ophthalmology, Lille University Hospital, Hôpital Huriez, Lille, France
| | - Aude Warniez
- Lille Neurosciences and Cognition, University of Lille, Lille, France
| | - Muriel Boucart
- Lille Neurosciences and Cognition, University of Lille, Lille, France
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Nieboer W, Ghiani A, de Vries R, Brenner E, Mann DL. Eye Tracking to Assess the Functional Consequences of Vision Impairment: A Systematic Review. Optom Vis Sci 2023; 100:861-875. [PMID: 38165789 DOI: 10.1097/opx.0000000000002088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024] Open
Abstract
BACKGROUND Eye tracking is a promising method for objectively assessing functional visual capabilities, but its suitability remains unclear when assessing the vision of people with vision impairment. In particular, accurate eye tracking typically relies on a stable and reliable image of the pupil and cornea, which may be compromised by abnormalities associated with vision impairment (e.g., nystagmus, aniridia). OBJECTIVES This study aimed to establish the degree to which video-based eye tracking can be used to assess visual function in the presence of vision impairment. DATA SOURCES A systematic review was conducted using PubMed, EMBASE, and Web of Science databases, encompassing literature from inception to July 2022. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS Studies included in the review used video-based eye tracking, included individuals with vision impairment, and used screen-based tasks unrelated to practiced skills such as reading or driving. STUDY APPRAISAL AND SYNTHESIS METHODS The included studies were assessed for quality using the Strengthening the Reporting of Observational Studies in Epidemiology assessment tool. Data extraction and synthesis were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS Our analysis revealed that five common tests of visual function were used: (i) fixation stability, (ii) smooth pursuit, (iii) saccades, (iv) free viewing, and (v) visual search. The studies reported considerable success when testing individuals with vision impairment, yielding usable data from 96.5% of participants. LIMITATIONS There was an overrepresentation of conditions affecting the optic nerve or macula and an underrepresentation of conditions affecting the anterior segment or peripheral retina. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS The results offer promise for the use of eye tracking to assess the visual function of a considerable proportion of those with vision impairment. Based on the findings, we outline a framework for how eye tracking can be used to test visual function in the presence of vision impairment.
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Affiliation(s)
| | - Andrea Ghiani
- Department of Human Movement Sciences, Amsterdam Movement Sciences and Institute of Brain and Behaviour Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Ralph de Vries
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Eli Brenner
- Department of Human Movement Sciences, Amsterdam Movement Sciences and Institute of Brain and Behaviour Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - David L Mann
- Department of Human Movement Sciences, Amsterdam Movement Sciences and Institute of Brain and Behaviour Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Yeon JS, Jung HN, Kim JY, Jung KI, Park HYL, Park CK, Kim HW, Kim MS, Kim YC. Deviated Saccadic Trajectory as a Biometric Signature of Glaucoma. Transl Vis Sci Technol 2023; 12:15. [PMID: 37440248 PMCID: PMC10353744 DOI: 10.1167/tvst.12.7.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 05/31/2023] [Indexed: 07/14/2023] Open
Abstract
Purpose To investigate whether the trajectories of saccadic eye movements (SEMs) significantly differ between glaucoma patients and controls. Methods SEMs were recorded by video-based infrared oculography in 53 patients with glaucoma and 41 age-matched controls. Participants were asked to bilaterally view 24°-horizontal, 14°-vertical, and 20°-diagonal eccentric Goldmann III-sized stimuli. SEMs were evaluated with respect to the saccadic reaction time (SRT), the mean velocity, amplitude, and two novel measures: departure angle (DA) and arrival angle (AA). These parameters were compared between the groups and the associations of SEM parameters with glaucoma parameters and integrated visual field defects were investigated. Results Glaucoma patients exhibited increased mean SRT, DA, and AA values compared with controls for 14°-vertical visual targets (P = 0.05, P < 0.01, and P < 0.01, respectively). The SRT, DA, and AA were significantly associated with the mean and pattern standard deviations of perimetry and with the mean RNFL thickness by OCT (all P < 0.001). Glaucoma was associated with the AA (P = 0.05) and both the SRT (P = 0.01) and DA (P = 0.04) were associated with integrated visual field defects. Conclusions The saccadic trajectories of glaucoma patients depart in an erroneous path and compensate the disparity by deviating the trajectory at arrival. Translational Relevance The initial deviation that we observed (despite continuous exposure to the stimulus) suggests the disoriented spatial perception of glaucoma patients which may be relevant to difficulties encountered daily.
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Affiliation(s)
- Ji Su Yeon
- Gangnam St. Mary's One Eye Clinic, Seoul, Republic of Korea
| | - Ha Na Jung
- Gangnam St. Mary's One Eye Clinic, Seoul, Republic of Korea
| | - Jae Young Kim
- Gangnam St. Mary's One Eye Clinic, Seoul, Republic of Korea
| | - Kyong In Jung
- College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hae-Young Lopilly Park
- College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chan Kee Park
- College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyo Won Kim
- Gangnam St. Mary's One Eye Clinic, Seoul, Republic of Korea
| | - Man Soo Kim
- Gangnam St. Mary's One Eye Clinic, Seoul, Republic of Korea
| | - Yong Chan Kim
- College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Ophthalmology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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McDonald MA, Stevenson CH, Kersten HM, Danesh-Meyer HV. Eye Movement Abnormalities in Glaucoma Patients: A Review. Eye Brain 2022; 14:83-114. [PMID: 36105571 PMCID: PMC9467299 DOI: 10.2147/eb.s361946] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 07/09/2022] [Indexed: 11/23/2022] Open
Abstract
Glaucoma is a common condition that relies on careful clinical assessment to diagnose and determine disease progression. There is growing evidence that glaucoma is associated not only with loss of retinal ganglion cells but also with degeneration of cortical and subcortical brain structures associated with vision and eye movements. The effect of glaucoma pathophysiology on eye movements is not well understood. In this review, we examine the evidence surrounding altered eye movements in glaucoma patients compared to healthy controls, with a focus on quantitative eye tracking studies measuring saccades, fixation, and optokinetic nystagmus in a range of visual tasks. The evidence suggests that glaucoma patients have alterations in several eye movement domains. Patients exhibit longer saccade latencies, which worsen with increasing glaucoma severity. Other saccadic abnormalities include lower saccade amplitude and velocity, and difficulty inhibiting reflexive saccades. Fixation is pathologically altered in glaucoma with reduced stability. Optokinetic nystagmus measures have also been shown to be abnormal. Complex visual tasks (eg reading, driving, and navigating obstacles), integrate these eye movements and result in behavioral adaptations. The review concludes with a summary of the evidence and recommendations for future research in this emerging field.
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Affiliation(s)
- Matthew A McDonald
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand
| | - Clark H Stevenson
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand
| | - Hannah M Kersten
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand.,Eye Institute, Auckland, New Zealand
| | - Helen V Danesh-Meyer
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand.,Eye Institute, Auckland, New Zealand
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7
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Mathieu R, Hereth E, Lenoble Q, Rouland JF, McKendrick AM, Boucart M. Spatial frequency bands used by patients with glaucoma to recognize facial expressions. VISUAL COGNITION 2022. [DOI: 10.1080/13506285.2022.2044948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Rémi Mathieu
- Inserm, CNRS, CHU Lille, UMR-S 1172 - Lille Neuroscience & Cognition, University of Lille, Lille, France
| | - Esther Hereth
- Institute of glaucoma, Saint Joseph Hospital, Paris, France
| | - Quentin Lenoble
- Inserm, CNRS, CHU Lille, UMR-S 1172 - Lille Neuroscience & Cognition, University of Lille, Lille, France
| | - Jean-François Rouland
- Inserm, CNRS, CHU Lille, UMR-S 1172 - Lille Neuroscience & Cognition, University of Lille, Lille, France
| | - Allison M. McKendrick
- Department of Optometry and Vision Sciences, University of Melbourne, Parkville, Australia
| | - Muriel Boucart
- Inserm, CNRS, CHU Lille, UMR-S 1172 - Lille Neuroscience & Cognition, University of Lille, Lille, France
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Soans RS, Renken RJ, John J, Bhongade A, Raj D, Saxena R, Tandon R, Gandhi TK, Cornelissen FW. Patients Prefer a Virtual Reality Approach Over a Similarly Performing Screen-Based Approach for Continuous Oculomotor-Based Screening of Glaucomatous and Neuro-Ophthalmological Visual Field Defects. Front Neurosci 2021; 15:745355. [PMID: 34690682 PMCID: PMC8526798 DOI: 10.3389/fnins.2021.745355] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/13/2021] [Indexed: 11/15/2022] Open
Abstract
Standard automated perimetry (SAP) is the gold standard for evaluating the presence of visual field defects (VFDs). Nevertheless, it has requirements such as prolonged attention, stable fixation, and a need for a motor response that limit application in various patient groups. Therefore, a novel approach using eye movements (EMs) - as a complementary technique to SAP - was developed and tested in clinical settings by our group. However, the original method uses a screen-based eye-tracker which still requires participants to keep their chin and head stable. Virtual reality (VR) has shown much promise in ophthalmic diagnostics - especially in terms of freedom of head movement and precise control over experimental settings, besides being portable. In this study, we set out to see if patients can be screened for VFDs based on their EM in a VR-based framework and if they are comparable to the screen-based eyetracker. Moreover, we wanted to know if this framework can provide an effective and enjoyable user experience (UX) compared to our previous approach and the conventional SAP. Therefore, we first modified our method and implemented it on a VR head-mounted device with built-in eye tracking. Subsequently, 15 controls naïve to SAP, 15 patients with a neuro-ophthalmological disorder, and 15 glaucoma patients performed three tasks in a counterbalanced manner: (1) a visual tracking task on the VR headset while their EM was recorded, (2) the preceding tracking task but on a conventional screen-based eye tracker, and (3) SAP. We then quantified the spatio-temporal properties (STP) of the EM of each group using a cross-correlogram analysis. Finally, we evaluated the human-computer interaction (HCI) aspects of the participants in the three methods using a user-experience questionnaire. We find that: (1) the VR framework can distinguish the participants according to their oculomotor characteristics; (2) the STP of the VR framework are similar to those from the screen-based eye tracker; and (3) participants from all the groups found the VR-screening test to be the most attractive. Thus, we conclude that the EM-based approach implemented in VR can be a user-friendly and portable companion to complement existing perimetric techniques in ophthalmic clinics.
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Affiliation(s)
- Rijul Saurabh Soans
- Department of Electrical Engineering, Indian Institute of Technology – Delhi, New Delhi, India
- Laboratory of Experimental Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Remco J. Renken
- Department of Biomedical Sciences of Cells and Systems, Cognitive Neuroscience Center, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - James John
- Department of Electrical Engineering, Indian Institute of Technology – Delhi, New Delhi, India
| | - Amit Bhongade
- Department of Electrical Engineering, Indian Institute of Technology – Delhi, New Delhi, India
| | - Dharam Raj
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Rohit Saxena
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Radhika Tandon
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Tapan Kumar Gandhi
- Department of Electrical Engineering, Indian Institute of Technology – Delhi, New Delhi, India
| | - Frans W. Cornelissen
- Laboratory of Experimental Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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Thepass G, Lemij HG, Vermeer KA, van der Steen J, Pel JJM. Slowed Saccadic Reaction Times in Seemingly Normal Parts of Glaucomatous Visual Fields. Front Med (Lausanne) 2021; 8:679297. [PMID: 34513866 PMCID: PMC8426641 DOI: 10.3389/fmed.2021.679297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 08/02/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: In eye movement perimetry, peripheral stimuli are confirmed by goal-directed eye movements toward the stimulus. The saccadic reaction time (SRT) is regarded as an index of visual field responsiveness, whereas in standard automated perimetry (SAP), the visual field sensitivity is tested. We investigated the relation between visual field sensitivity and responsiveness in corresponding locations of the visual field in healthy controls and in patients with mild, moderate and advanced glaucoma. Materials and Methods: Thirty-four healthy control subjects and 42 glaucoma patients underwent a 54-point protocol in eye movement perimetry (EMP) and a 24-2 SITA standard protocol in a Humphrey Field Analyzer. The visual field points were stratified by total deviation sensitivity loss in SAP into 6 strata. A generalized linear mixed model was applied to determine the influence of the various factors. Results: The generalized linear mixed model showed that the mean SRT increased with increasing glaucoma severity, from 479 ms in the control eyes to 678 ms in the eyes of patients with advanced glaucoma (p < 0.001). Mean SRTs significantly increased with increasing SAP sensitivity loss. Even at the locations where no sensitivity loss was detected by SAP (total deviation values greater or equal than 0 dB), we found lengthened SRTs in mild, moderate and advanced glaucoma compared to healthy controls (p < 0.05) and in moderate and advanced glaucoma compared to mild glaucoma (p < 0.05). At locations with total deviation values between 0 and −3 dB, −3 and −6 dB and −6 and −12 dB, we found similar differences. Conclusions: The lengthened SRT in areas with normal retinal sensitivities in glaucomatous eyes, i.e., planning and execution of saccades to specific locations, precede altered sensory perception as assessed with SAP. Better understanding of altered sensory processing in glaucoma might allow earlier diagnosis of emerging glaucoma.
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Affiliation(s)
- Gijs Thepass
- Vestibular and Ocular Motor Research Group, Department of Neuroscience, Erasmus MC, Rotterdam, Netherlands.,Rotterdam Ophthalmic Institute, Rotterdam, Netherlands
| | - Hans G Lemij
- Glaucoma Service, Rotterdam Eye Hospital, Rotterdam, Netherlands
| | | | - Johannes van der Steen
- Vestibular and Ocular Motor Research Group, Department of Neuroscience, Erasmus MC, Rotterdam, Netherlands.,Royal Dutch Visio, Huizen, Netherlands
| | - Johan J M Pel
- Vestibular and Ocular Motor Research Group, Department of Neuroscience, Erasmus MC, Rotterdam, Netherlands
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Comparison of Saccadic Eye Movements Among the High-tension Glaucoma, Primary Angle-closure Glaucoma, and Normal-tension Glaucoma. J Glaucoma 2021; 30:e76-e82. [PMID: 33394842 DOI: 10.1097/ijg.0000000000001757] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 11/28/2020] [Indexed: 11/25/2022]
Abstract
PRCIS Saccadic eye movements were compared between high-tension glaucoma (HTG), normal-tension glaucoma (NTG), and primary angle-closure glaucoma (PACG). Saccades were differently affected between the subtypes of primary glaucoma. AIM The aim of the study was to compare saccadic eye movements in eyes with HTG, PACG, and NTG. METHODS Saccadic eye movements were recorded using the eye tracker Eyelink-1000 in 52 participants: 15 HTG, 14 PACG, 8 NTG, and 15 normal controls. All participants underwent a complete ophthalmic and visual field examination. Prosaccades were measured using the gap paradigm. Prosaccades were measured at 3 target eccentricities (5-, 7-, and 10-degree eccentricity). All prosaccade targets were projected outside the area of visual field defect. Saccade latency, average and peak velocity, and amplitude difference of the saccades were compared between glaucoma subtypes. RESULTS The mean±SD age was lesser in controls compared with glaucoma (P=0.02). The mean age in all the glaucoma subtypes was comparable (P=0.92). The average mean deviation in PACG (-16.66±6.69 dB) was worse (P=0.01) than in HTG (-11.56±6.08 dB) and NTG (-9.55±3.96 dB). The latencies were delayed, average and peak velocities were reduced, and saccades were hypometric in glaucoma compared with controls (P<0.01). Between subtypes, the differences in latency (P<0.01), peak velocity (P=0.02), and amplitude (P=0.02) were significant. Saccadic eye movements were significantly different in NTG compared with other glaucoma subtypes (post hoc analysis; latency (HTG vs. NTG; P<0.01, HTG vs. PACG; P=0.01), peak velocity (HTG vs. NTG; P=0.02) and amplitude difference (HTG vs. NTG; P=0.02). CONCLUSIONS Saccadic eye movement parameters were differently affected among the glaucoma subtypes. Saccadic parameters were more affected in NTG.
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11
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Soans RS, Grillini A, Saxena R, Renken RJ, Gandhi TK, Cornelissen FW. Eye-Movement-Based Assessment of the Perceptual Consequences of Glaucomatous and Neuro-Ophthalmological Visual Field Defects. Transl Vis Sci Technol 2021; 10:1. [PMID: 34003886 PMCID: PMC7873497 DOI: 10.1167/tvst.10.2.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Assessing the presence of visual field defects (VFD) through procedures such as perimetry is an essential aspect of the management and diagnosis of ocular disorders. However, even the latest perimetric methods have shortcomings-a high cognitive demand and requiring prolonged stable fixation and feedback through a button response. Consequently, an approach using eye movements (EM)-as a natural response-has been proposed as an alternate way to evaluate the presence of VFD. This approach has given good results for computer-simulated VFD. However, its use in patients is not well documented yet. Here we use this new approach to quantify the spatiotemporal properties (STP) of EM of various patients suffering from glaucoma and neuro-ophthalmological VFD and controls. Methods In total, 15 glaucoma patients, 37 patients with a neuro-ophthalmological disorder, and 21 controls performed a visual tracking task while their EM were being recorded. Subsequently, the STP of EM were quantified using a cross-correlogram analysis. Decision trees were used to identify the relevant STP and classify the populations. Results We achieved a classification accuracy of 94.5% (TPR/sensitivity = 96%, TNR/specificity = 90%) between patients and controls. Individually, the algorithm achieved an accuracy of 86.3% (TPR for neuro-ophthalmology [97%], glaucoma [60%], and controls [86%]). The STP of EM were highly similar across two different control cohorts. Conclusions In an ocular tracking task, patients with VFD due to different underlying pathology make EM with distinctive STP. These properties are interpretable based on different clinical characteristics of patients and can be used for patient classification. Translational Relevance Our EM-based screening tool may complement existing perimetric techniques in clinical practice.
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Affiliation(s)
- Rijul Saurabh Soans
- Department of Electrical Engineering, Indian Institute of Technology - Delhi, New Delhi, India.,Laboratory of Experimental Ophthalmology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Alessandro Grillini
- Laboratory of Experimental Ophthalmology, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Rohit Saxena
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Remco J Renken
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, The Netherlands
| | - Tapan Kumar Gandhi
- Department of Electrical Engineering, Indian Institute of Technology - Delhi, New Delhi, India
| | - Frans W Cornelissen
- Laboratory of Experimental Ophthalmology, University Medical Center Groningen, University of Groningen, The Netherlands
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12
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Garric C, Rouland JF, Lenoble Q. Glaucoma and Computer Use: Do Contrast and Color Enhancements Improve Visual Comfort in Patients? Ophthalmol Glaucoma 2021; 4:531-540. [PMID: 33556588 DOI: 10.1016/j.ogla.2021.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 01/28/2021] [Accepted: 01/28/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To estimate the impact of glaucoma on computer use and to assess specific adaptations of the graphical interface to this form of visual impairment. DESIGN Prospective, experimental cohort study. PARTICIPANTS Forty-nine participants were recruited: 16 patients with primary open-angle glaucoma (mean ± SD, 62.7 ± 5.6 years of age), 17 age-matched participants (mean ± SD, 59.1 ± 8.3 years of age), and 16 young control participants (mean ± SD, 23.3 ± 2.1 years of age). METHODS An ophthalmologic examination before the study evaluated the level of visual loss (mean deviation), visual acuity (logarithm of the minimum angle of resolution units), and contrast sensitivity (CS) of the primary open-angle glaucoma patients. Each participant underwent the following measurements: an information technology (IT) experience questionnaire, a preference task monitored by eye tracking, and a feedback session. The experimental task was based on ecological computer scenes with 3 enhancement levels (low, medium, and high), determined by gradual modulation of contrast, luminance, and color. Participants were asked to select the most readable and comfortable stimulus among 4 images displayed on the screen: the original computer scene and 3 enhanced versions. MAIN OUTCOME MEASURES Clinical, oculomotor, and subjective data were computed together in a multivariate model by using a principal component analysis (PCA). RESULTS The PCA revealed 3 principal components accounting for 72% of the total variance of the data and showed a greater need for enhanced computer scenes in glaucoma patients, an equal preference for low and medium enhancement within the 3 groups, and significantly longer oculomotor behavior in the patient groups. Subjective reports of difficulty using IT because of vision were correlated with visual impairment and high enhancement preference. Contrast sensitivity was critical to explaining the main variations of the data. A reduced CS had a significant effect on the preference for enhanced computer scenes (r = -0.43; P < 0.002) and a less effective exploration velocity (r = 0.43; P < 0.002). CONCLUSIONS Glaucoma alters the global exploration of computer scenes. High enhancement of the graphical interface could improve visual comfort during computer use. Subjective patients' reports underline the importance of including IT questions in visual-related quality-of-life questionnaires.
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Affiliation(s)
- Clémentine Garric
- Inserm, CHU Lille, U1172-LilNCog (JPARC)-Lille Neurosciences and Cognition, Université de Lille, Lille, France; CNRS, CHU Lille, UMR 9193, SCALab, Sciences Cognitives et Sciences Affectives, Université de Lille, Lille, France
| | - Jean-François Rouland
- Inserm, CHU Lille, U1172-LilNCog (JPARC)-Lille Neurosciences and Cognition, Université de Lille, Lille, France; CNRS, CHU Lille, UMR 9193, SCALab, Sciences Cognitives et Sciences Affectives, Université de Lille, Lille, France; Department of Ophthalmology, Claude Huriez Hospital, Université de Lille, Lille, France
| | - Quentin Lenoble
- Inserm, CHU Lille, U1172-LilNCog (JPARC)-Lille Neurosciences and Cognition, Université de Lille, Lille, France; CNRS, CHU Lille, UMR 9193, SCALab, Sciences Cognitives et Sciences Affectives, Université de Lille, Lille, France.
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13
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Mazumdar D, Meethal NSK, George R, Pel JJM. Saccadic reaction time in mirror image sectors across horizontal meridian in eye movement perimetry. Sci Rep 2021; 11:2630. [PMID: 33514780 PMCID: PMC7846759 DOI: 10.1038/s41598-021-81762-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 12/28/2020] [Indexed: 01/10/2023] Open
Abstract
In eye movement perimetry (EMP), the saccadic reaction time (SRT) to ‘seen’ visual stimuli are delayed in glaucoma. Evaluating SRT behaviour in hemi-field sectors could refine its clinical implication. The development phase included 60 controls retrospectively and for the test cohort in evaluation phase, another 30 healthy subjects and 30 glaucoma patients were recruited prospectively. The SRTs were used to calculate the normative limits within 5 predefined hemi-field sectors. Scores were assigned to probabilities for SRT at the level of 5%, 2.5% 1% and 0.5%. Per sector pair, a probability score limit (PSL) was calculated at each of the four levels and were compared with the scores obtained from the test cohort. The classification accuracy ‘normal versus abnormal’ was assessed for PSL in EMP and compared with glaucoma hemi-field test in standard automated perimetry. We found no statistically significant differences in SRTs between the mirror sectors in healthy subjects. The PSL at 2.5% had moderate classification accuracy with a specificity of 77% and sensitivity 70%. This could be suggestive of an SRT delay in the overall visual field in glaucoma.
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Affiliation(s)
- Deepmala Mazumdar
- Vestibular and Ocular Motor Research Group, Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands.,Medical and Vision Research Foundation, Chennai, India
| | - Najiya S Kadavath Meethal
- Vestibular and Ocular Motor Research Group, Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands.,Medical and Vision Research Foundation, Chennai, India
| | - Ronnie George
- Medical and Vision Research Foundation, Chennai, India
| | - Johan J M Pel
- Vestibular and Ocular Motor Research Group, Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands. .,Department of Neuroscience, Room EE 1453, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
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14
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A Saccadic Choice Task for Target Face Detection at Large Visual Eccentricities in Patients with Glaucoma. Optom Vis Sci 2020; 97:871-878. [PMID: 33055511 DOI: 10.1097/opx.0000000000001586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE Little is known about the perception of glaucomatous patients at large visual eccentricities. We show that the patients' performance drops beyond 40° eccentricity even for large images of scenes, suggesting that clinical tests should assess the patients' vision at larger eccentricities than 24 or 30°. PURPOSE Daily activities such as visual search, spatial navigation, and hazard detection require rapid scene recognition on a wide field of view. We examined whether participants with visual field loss at standard automated perimetry 30-2 were able to detect target faces at large visual eccentricities. METHODS Twelve patients with glaucoma and 14 control subjects were asked to detect a face in a two-alternative saccadic forced choice task. Pairs of scenes, one containing a face, were randomly displayed at 10, 20, 40, 60, or 80° eccentricity on a panoramic screen covering 180° horizontally. Participants were asked to detect and to saccade toward the scene containing a face. RESULTS Saccade latencies were significantly slower in patients (264 milliseconds; confidence interval [CI], 222 to 306 milliseconds) than in control subjects (207 milliseconds; CI, 190 to 226 milliseconds), and accuracy was significantly lower in patients (70% CI, 65 to 85%) than in control subjects (75.7% CI, 71.5 to 79.5%). Although still significantly above chance at 60°, the patients' performance dropped beyond 40° eccentricity. The control subjects' performance was still above chance at 80° eccentricity. CONCLUSIONS In patients with various degrees of peripheral visual field defect, performance dropped beyond 40° eccentricity for large images at a high contrast. This result could reflect reduced spread of exploration in glaucoma.
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15
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Gestefeld B, Grillini A, Marsman JBC, Cornelissen FW. Using natural viewing behavior to screen for and reconstruct visual field defects. J Vis 2020; 20:11. [PMID: 32940625 PMCID: PMC7500151 DOI: 10.1167/jov.20.9.11] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
There is a need for simple and effective ways to screen for visual field defects (VFD). Watching a movie is a simple task most humans are familiar with. Therefore we assessed whether it is possible to detect and reconstruct visual field defects based on free viewing eye movements, recorded while watching movie clips. Participants watched 90 movie clips of one minute, with and without simulated visual field defects (sVFD), while their eye movements were tracked. We simulated homonymous hemianopia (HH) (left and right sided) and glaucoma (small nasal arc, large nasal arc, and tunnel vision). We generated fixation density maps of the visual field and trained a linear support vector machine to predict the viewing conditions of each trial of each participant based on these maps. To reconstruct the visual field defect, we computed “viewing priority” maps and maps of differences in fixation density of the visual field of each participant. We were able to classify the simulated visual field condition with more than 85% accuracy. In simulated HH, the viewing priority distribution over the visual field indicated the location of the sVFD in the simulated HH condition. In simulated glaucoma the difference in fixation density to the control condition indicated the location of the sVFD. It is feasible to use natural viewing behavior to screen for and reconstruct (simulated) visual field defects. Movie clip viewing in combination with eye tracking may thus provide an alternative to or supplement standard automated perimetry, in particular in patients who cannot perform the latter technique.
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Affiliation(s)
- Birte Gestefeld
- Laboratory for Experimental Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Alessandro Grillini
- Laboratory for Experimental Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Jan-Bernard C Marsman
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Frans W Cornelissen
- Laboratory for Experimental Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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16
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Tatham AJ, Murray IC, McTrusty AD, Cameron LA, Perperidis A, Brash HM, Fleck BW, Minns RA. Speed and accuracy of saccades in patients with glaucoma evaluated using an eye tracking perimeter. BMC Ophthalmol 2020; 20:259. [PMID: 32605609 PMCID: PMC7325566 DOI: 10.1186/s12886-020-01528-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 06/18/2020] [Indexed: 11/30/2022] Open
Abstract
Background To examine the speed and accuracy of saccadic eye movements during a novel eye tracking threshold visual field assessment and determine whether eye movement parameters may improve ability to detect glaucoma. Methods A prospective study including both eyes of 31 patients with glaucoma and 23 controls. Standard automated perimetry (SAP) and eye tracking perimetry (saccadic vector optokinetic perimetry, SVOP) was performed. SVOP provided data on threshold sensitivity, saccade latency, and two measures of accuracy of saccades (direction bias and amplitude bias). The relationship between eye movement parameters and severity of glaucoma was examined and Receiver Operating Characteristic curves were used to assess ability to detect glaucoma. Results Patients with glaucoma had significantly slower saccades (602.9 ± 50.0 ms versus 578.3 ± 44.6 ms for controls, P = 0.009) and reduced saccade accuracy (direction bias = 7.4 ± 1.8 versus 6.5 ± 1.5 degrees, P = 0.006). There was a significant slowing of saccades and saccades became less accurate with worsening SAP sensitivity. Slower saccades were associated with increased odds of glaucoma; however, the AUC for saccade latency was only 0.635 compared to 0.914 for SVOP sensitivity. Conclusion Patients with glaucoma had significant differences in eye movements compared to healthy subjects, with a relationship between slower and less accurate eye movements and worse glaucoma severity. However, in a multivariable model, eye movement parameters were not of additional benefit in differentiating eyes with glaucoma from healthy controls.
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Affiliation(s)
- Andrew J Tatham
- University of Edinburgh, Edinburgh, UK. .,Princess Alexandra Eye Pavilion, 45 Chalmers Street, Edinburgh, EH3 9HA, UK.
| | | | - Alice D McTrusty
- University of Edinburgh, Edinburgh, UK.,Glasgow Caledonian University, Glasgow, UK
| | - Lorraine A Cameron
- University of Edinburgh, Edinburgh, UK.,Glasgow Caledonian University, Glasgow, UK
| | | | | | - Brian W Fleck
- University of Edinburgh, Edinburgh, UK.,Princess Alexandra Eye Pavilion, 45 Chalmers Street, Edinburgh, EH3 9HA, UK.,Royal Hospital for Sick Children, Edinburgh, UK
| | - Robert A Minns
- University of Edinburgh, Edinburgh, UK.,Royal Hospital for Sick Children, Edinburgh, UK
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17
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Evaluation of eye movements and visual performance in patients with cataract. Sci Rep 2020; 10:9875. [PMID: 32555224 PMCID: PMC7303140 DOI: 10.1038/s41598-020-66817-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 05/25/2020] [Indexed: 11/11/2022] Open
Abstract
Eye movement is an essential component of visual perception. Eye movement disorders have been observed in many eye disease, and are thought to affect various visual performance in daily life. However, eye movement behaviors of the elderly with cataract are poorly understood, and the impact of cataract surgery on eye movements has not been investigated. In this study, we observed the eye movement behaviors in thirty patients with bilateral age-related cataract while performing three performance-based tasks (visual search, face recognition and reading). Eye movements were automatically recorded by an eye tracker during task performance. We found an overall improved visual performance postoperatively, presented as elevated percentage of correctly identified objects and faces, reduced search time and increased reading speed. Eye movement parameters were found significantly altered after cataract surgery. Fixation count, total fixation duration and total visit duration were markedly increased in the visual search task and face recognition task. The proportion of regressive saccades was obviously decreased in the reading task. These eye movement parameters were found to be correlated with the measures of visual performance. Our findings suggested a potential association between the eye movement disturbance and impaired visual performance, and provided a new insight on the potential usefulness of eye movement as an objective and valid tool to understand visual impairments caused by cataract, as well as evaluate practical outcomes of cataract surgery.
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18
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Jones PR, Somoskeöy T, Chow-Wing-Bom H, Crabb DP. Seeing other perspectives: evaluating the use of virtual and augmented reality to simulate visual impairments (OpenVisSim). NPJ Digit Med 2020; 3:32. [PMID: 32195367 PMCID: PMC7064490 DOI: 10.1038/s41746-020-0242-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 02/11/2020] [Indexed: 12/26/2022] Open
Abstract
Simulations of visual impairment are used to educate and inform the public. However, evidence regarding their accuracy remains lacking. Here we evaluated the effectiveness of modern digital technologies to simulate the everyday difficulties caused by glaucoma. 23 normally sighted adults performed two everyday tasks that glaucoma patients often report difficulties with: a visual search task in which participants attempted to locate a mobile phone in virtual domestic environments (virtual reality (VR)), and a visual mobility task in which participants navigated a physical, room-scale environment, while impairments were overlaid using augmented reality (AR). On some trials, a gaze-contingent simulated scotoma-generated using perimetric data from a real patient with advanced glaucoma-was presented in either the superior or inferior hemifield. The main outcome measure was task completion time. Eye and head movements were also tracked and used to assess individual differences in looking behaviors. The results showed that the simulated impairments substantially impaired performance in both the VR (visual search) and AR (visual mobility) tasks (both P < 0.001). Furthermore, and in line with previous patient data: impairments were greatest when the simulated Visual Field Loss (VFL) was inferior versus superior (P < 0.001), participants made more eye and head movements in the inferior VFL condition (P < 0.001), and participants rated the inferior VFL condition as more difficult (P < 0.001). Notably, the difference in performance between the inferior and superior conditions was almost as great as the difference between a superior VFL and no impairment at all (VR: 71%; AR: 70%). We conclude that modern digital simulators are able to replicate and objectively quantify some of the key everyday difficulties associated with visual impairments. Advantages, limitations, and possible applications of current technologies are discussed. Instructions are also given for how to freely obtain the software described (OpenVisSim).
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Affiliation(s)
- Pete R. Jones
- Division of Optometry and Visual Science, School of Health Science, Northampton Square, City, University of London, London, EC1V 0HB UK
- Institute of Ophthalmology, University College London (UCL), 11-43 Bath Street, London, EC1V 9EL UK
- NIHR Moorfields Biomedical Research Centre, London, EC1V 2PD UK
| | - Tamás Somoskeöy
- Division of Optometry and Visual Science, School of Health Science, Northampton Square, City, University of London, London, EC1V 0HB UK
| | - Hugo Chow-Wing-Bom
- Institute of Ophthalmology, University College London (UCL), 11-43 Bath Street, London, EC1V 9EL UK
- NIHR Moorfields Biomedical Research Centre, London, EC1V 2PD UK
| | - David P. Crabb
- Division of Optometry and Visual Science, School of Health Science, Northampton Square, City, University of London, London, EC1V 0HB UK
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19
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Visual Field Plots: A Comparison Study Between Standard Automated Perimetry and Eye Movement Perimetry. J Glaucoma 2020; 29:351-361. [PMID: 32108671 DOI: 10.1097/ijg.0000000000001477] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
PRéCIS:: This eye movement perimetry (EMP) study describes the development of saccadic reaction time (SRT)-based visual field plots, which could effectively display the presence, location, and extent of glaucomatous defects and support clinical decision-making. PURPOSE EMP is capable of discriminating normal from glaucomatous visual field defects on the basis of average delays in SRTs. To classify the presence and extent of age-corrected visual field defects, it is required to create SRT-based probability maps. AIM The aim of this study was to create visual field probability plots based on SRTs and to evaluate their clinical applicability by 2 glaucoma specialists. MATERIALS AND METHODS The development phase included 95 controls segregated into 5 age-bins to estimate normative limits of SRT. Next, for the testing phase, a set of 28 healthy subjects and 24 glaucoma patients were recruited who underwent standard automated perimetry (SAP) and EMP visual field testing. Fifty-two SAP and EMP plots were presented to 2 glaucoma specialists to classify them as normal or abnormal and to identify the defect location and pattern as 1 or more of 7 predefined categories. RESULTS The glaucoma specialists showed a sensitivity of 100% and a specificity of 93% and 96% for identifying normal versus abnormal visual field. For specialists 1 and 2, 85% and 92%, respectively, of EMP reports were assigned to the same category as SAP. The reports that did not agree with SAP were graded to a higher defect pattern. The intermethod agreement for specialists 1 and 2 was κ 0.92 and 0.96, respectively. CONCLUSION SRT-based visual field probability plots provided a comprehensive summary of an individual's visual field status and showed comparable clinical applicability to that of SAP plots.
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Abstract
SIGNIFICANCE Glaucoma has been shown to impair hazard detection ability and increase crash risk compared to controls. Differences in visual search behavior of the driving scene may explain these differences; however, there has been limited investigation of this issue with inconsistent findings. PURPOSE Through eye movement tracking of older drivers with glaucoma, we explored their visual search behavior in comparison with controls while performing the DriveSafe, a slide recognition test purported to predict fitness to drive. METHODS Thirty-one drivers with glaucoma (mean age, 71.7 ± 6.3 years; average better-eye mean defect,-3 dB; average worse-eye mean defect,-12 dB) and 25 age-matched controls underwent measurements of their visual acuity, contrast sensitivity, visual fields, and useful field of view (visual processing speeds). Participants' eye movements were recorded while they completed the DriveSafe test, which consists of brief presentations of static, real-world driving scenes containing various road users (pedestrians, bicycles, vehicles). Participants reported the types, positions, and direction of travel of road users in each image; the score was the total number of correctly reported items (maximum, 128). RESULTS Drivers with glaucoma had significantly worse DriveSafe scores (P = .03), fixated on road users for shorter durations (P < .001), and exhibited smaller saccades (P = .02) compared with controls. For all participants, longer fixation times on road users (P < .001) was the eye movement measure most strongly associated with better DriveSafe scores; this relationship was not significantly different between groups. Useful field-of-view divided attention was the strongest visual predictor of DriveSafe scores. CONCLUSIONS Eye movement changes in the glaucoma group may reflect increased difficulty in identifying relevant objects in the visual scene, which may be related to their lower DriveSafe scores. Given the DriveSafe's potential utility in assessing drivers with visual impairment before on-road testing, further investigations on how DriveSafe performance and eye movement patterns compare to those during on-road driving are warranted.
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21
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Reading Ability in Primary Open-angle Glaucoma: Evaluation with Radner Reading Charts. Optom Vis Sci 2019; 96:55-61. [PMID: 30570594 DOI: 10.1097/opx.0000000000001319] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE This study determined the impact of visual disabilities caused by glaucoma on the patient's everyday life and emphasized the importance of developing strategies to improve reading ability in primary open-angle glaucoma (POAG) patients. PURPOSE The purposes of this study were to investigate the reading performances of patients affected by POAG using the Italian version of the Radner Reading Charts and to test the presence of correlation between visual field (VF) damage and reading parameters. METHODS In this cross-sectional observational study, all patients underwent a complete ophthalmic evaluation including VF testing and evaluation of reading performance using the Radner Reading Charts. The parameters for testing reading performance were reading acuity in logRAD, reading speed in words per minute, maximum reading speed, critical print size, and reading mistakes. Primary open-angle glaucoma and healthy groups were compared using the Mann-Whitney U test. The correlation between VF and reading parameters in glaucomatous eyes was assessed using Spearman correlation analysis. Based on VF mean deviation, each POAG patient had differences in reading performance between his/her best and worst eyes when compared using the paired Wilcoxon test. Statistical significance was set at P ≤ .05. RESULTS Eighty POAG patients and 60 healthy controls were enrolled. Glaucomatous subjects read slowly (166.63 ± 29.40 vs. 193.84 ± 26.20 words per minute, P < .0001) and made more mistakes than did healthy subjects. The critical print size for POAG patients was larger than the one for controls (0.52 ± 0.18 vs. 0.62 ± 0.16, P < .0001). Reading parameters showed a moderate correlation with VF mean deviation. The reading parameters were significantly impaired in the worst eye, and this result confirms the impact of VF loss on reading ability. CONCLUSIONS This study demonstrated that glaucomatous patients read slowly and with more errors. Reading performances showed a good correlation with VF defect.
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22
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Tarita-Nistor L, Samet S, Trope GE, González EG. Dominance wave propagation during binocular rivalry in mild glaucoma. Vision Res 2019; 165:64-71. [PMID: 31678616 DOI: 10.1016/j.visres.2019.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 10/02/2019] [Accepted: 10/09/2019] [Indexed: 12/23/2022]
Abstract
Glaucoma is both a progressive optic neuropathy and a neurodegenerative disease affecting structures in the primary visual pathway. Other vision-associated areas may also be affected, including the corpus callosum which is involved in inter-hemispheric transfer. This study evaluated dominance wave propagation during binocular rivalry to probe the efficacy of the inter-hemispheric transfer in 20 patients with mild open angle glaucoma and 25 age-matched controls. The two groups were matched for functional measures such as stereo-acuity, binocular visual acuity, and visual field mean deviation. Monocular functional and structural measures were equivalent for the left and right eye of each participant. Using Wilson et al.'s travelling wave paradigm [Nature, 412 (2001) 907-910], intra- and inter-hemispheric failure rates of traveling wave transmission and the travelling wave propagation times were recorded for the two groups. For the control group, the wave propagation failure rate was significantly greater for the inter- than for the intra-hemispheric condition, but for the glaucoma group, the failure rates were equally high for the two conditions. The wave propagation time was significantly longer for the inter- than for the intra-hemispheric condition for the control group, while the opposite was true for the glaucoma group. These results reveal changes in the wave dynamics of rivalry dominance in patients with mild glaucoma who otherwise have normal performance on standard functional measures.
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Affiliation(s)
| | - Saba Samet
- Krembil Research Institute, Toronto, Canada; Faculty of Medicine, University of Toronto, Canada
| | - Graham E Trope
- Krembil Research Institute, Toronto, Canada; Ophthalmology and Vision Science, University of Toronto, Canada
| | - Esther G González
- Krembil Research Institute, Toronto, Canada; Ophthalmology and Vision Science, University of Toronto, Canada
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23
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Mazumdar D, Meethal NSK, Panday M, Asokan R, Thepass G, George RJ, van der Steen J, Pel JJM. Effect of Age, Sex, Stimulus Intensity, and Eccentricity on Saccadic Reaction Time in Eye Movement Perimetry. Transl Vis Sci Technol 2019; 8:13. [PMID: 31388465 PMCID: PMC6670042 DOI: 10.1167/tvst.8.4.13] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 05/13/2019] [Indexed: 11/24/2022] Open
Abstract
Purpose In eye movement perimetry (EMP), the extent of the visual field is tested by assessing the saccades using an eye tracker. The aim of the present study was to determine the effects of age and sex of the subjects, the eccentricity and intensity of the peripheral stimuli on saccadic reaction time (SRT), and the interaction between these parameters in healthy participants. Methods Healthy participants aged between 20 to 70 years underwent a complete ophthalmic examination and an EMP test. SRT was determined from detected peripheral stimuli of four intensity levels. A multilevel mixed-model analysis was used to verify the influence of subject and stimulus characteristics on SRT within the tested visual field. Results Ninety-five subjects (mean age 43.0 [15.0] years) were included. Age, stimulus intensity, and eccentricity had a statistically significant effect on SRT, not sex. SRTs were significantly faster with increasing stimulus intensity and decreasing eccentricity (P < 0.001). At the lowest stimulus intensity of 192 cd/m2, a significant interaction was found between age and eccentricity. Conclusions The current study demonstrated significant SRT dependence across the visual field measured up to 27°, irrespective of sex. The presented SRT values may serve as a first normative guide for EMP. Translational Relevance This report of SRT interaction can aid in refining its use as a measure of visual field responsiveness.
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Affiliation(s)
- Deepmala Mazumdar
- Vestibular and Ocular Motor Research Group, Department of Neuroscience, Erasmus MC, the Netherlands.,Medical and Vision Research Foundation, Chennai, India
| | - Najiya S Kadavath Meethal
- Vestibular and Ocular Motor Research Group, Department of Neuroscience, Erasmus MC, the Netherlands.,Medical and Vision Research Foundation, Chennai, India
| | - Manish Panday
- Medical and Vision Research Foundation, Chennai, India
| | - Rashima Asokan
- Medical and Vision Research Foundation, Chennai, India.,Elite School of Optometry, Chennai, India
| | - Gijs Thepass
- Vestibular and Ocular Motor Research Group, Department of Neuroscience, Erasmus MC, the Netherlands
| | | | - Johannes van der Steen
- Vestibular and Ocular Motor Research Group, Department of Neuroscience, Erasmus MC, the Netherlands.,Royal Dutch Visio, Huizen, the Netherlands
| | - Johan J M Pel
- Medical and Vision Research Foundation, Chennai, India
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Lajoie K, Miller AB, Strath RA, Neima DR, Marigold DS. Glaucoma-Related Differences in Gaze Behavior When Negotiating Obstacles. Transl Vis Sci Technol 2018; 7:10. [PMID: 30050727 PMCID: PMC6058912 DOI: 10.1167/tvst.7.4.10] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 06/04/2018] [Indexed: 11/24/2022] Open
Abstract
Purpose Safe navigation requires avoiding objects. Visual field loss may affect how one visually samples the environment, and may thus contribute to bumping into objects and falls. We tested the hypothesis that gaze strategies and the number of collisions differ between people with glaucoma and normally sighted controls when navigating around obstacles, particularly under multitasking situations. Methods Twenty persons with moderate-severe glaucoma and 20 normally sighted controls walked around a series of irregularly spaced vertical obstacles under the following three conditions: walking with obstacles only, walking and counting backward to simulate a conversation, and walking while performing a concurrent visual search task to simulate locating a landmark. We quantified gaze patterns and the number of obstacle contacts. Results Compared with controls, people with glaucoma directed gaze closer to their current position (P < 0.05). They also directed a larger proportion of fixations (in terms of number and duration) to obstacles (P < 0.05). Despite this finding, considerably more people with glaucoma contacted an obstacle (P < 0.05). Multitasking led to changes in gaze behavior in both groups, and this was accompanied by a large increase in obstacle contacts among those with glaucoma (P < 0.05). Conclusions Glaucoma alters gaze patterns when negotiating a series of obstacles and increases the likelihood of collisions. Multitasking in this situation exacerbates these changes. Translational Relevance Understanding glaucoma-related changes in gaze behavior during walking in cluttered environments may provide critical insight for orientation and mobility specialists and guide the design of gaze training interventions to improve mobility.
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Affiliation(s)
- Kim Lajoie
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Andreas B Miller
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Robert A Strath
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada
| | - David R Neima
- Ophthalmology Private Practice, New Westminster, British Columbia, Canada
| | - Daniel S Marigold
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, British Columbia, Canada
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25
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Coordination of Gaze Behavior and Foot Placement During Walking in Persons With Glaucoma. J Glaucoma 2018; 27:55-63. [DOI: 10.1097/ijg.0000000000000819] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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26
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McTrusty AD, Cameron LA, Perperidis A, Brash HM, Tatham AJ, Agarwal PK, Murray IC, Fleck BW, Minns RA. Comparison of Threshold Saccadic Vector Optokinetic Perimetry (SVOP) and Standard Automated Perimetry (SAP) in Glaucoma. Part II: Patterns of Visual Field Loss and Acceptability. Transl Vis Sci Technol 2017; 6:4. [PMID: 28900577 PMCID: PMC5588911 DOI: 10.1167/tvst.6.5.4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 07/13/2017] [Indexed: 11/30/2022] Open
Abstract
Purpose We compared patterns of visual field loss detected by standard automated perimetry (SAP) to saccadic vector optokinetic perimetry (SVOP) and examined patient perceptions of each test. Methods A cross-sectional study was done of 58 healthy subjects and 103 with glaucoma who were tested using SAP and two versions of SVOP (v1 and v2). Visual fields from both devices were categorized by masked graders as: 0, normal; 1, paracentral defect; 2, nasal step; 3, arcuate defect; 4, altitudinal; 5, biarcuate; and 6, end-stage field loss. SVOP and SAP classifications were cross-tabulated. Subjects completed a questionnaire on their opinions of each test. Results We analyzed 142 (v1) and 111 (v2) SVOP and SAP test pairs. SVOP v2 had a sensitivity of 97.7% and specificity of 77.9% for identifying normal versus abnormal visual fields. SAP and SVOP v2 classifications showed complete agreement in 54% of glaucoma patients, with a further 23% disagreeing by one category. On repeat testing, 86% of SVOP v2 classifications agreed with the previous test, compared to 91% of SAP classifications; 71% of subjects preferred SVOP compared to 20% who preferred SAP. Conclusions Eye-tracking perimetry can be used to obtain threshold visual field sensitivity values in patients with glaucoma and produce maps of visual field defects, with patterns exhibiting close agreement to SAP. Patients preferred eye-tracking perimetry compared to SAP. Translational relevance This first report of threshold eye tracking perimetry shows good agreement with conventional automated perimetry and provides a benchmark for future iterations.
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Affiliation(s)
- Alice D McTrusty
- University of Edinburgh, Edinburgh, Scotland, United Kingdom.,Glasgow Caledonian University, Glasgow, Scotland, United Kingdom
| | - Lorraine A Cameron
- University of Edinburgh, Edinburgh, Scotland, United Kingdom.,Glasgow Caledonian University, Glasgow, Scotland, United Kingdom
| | - Antonios Perperidis
- University of Edinburgh, Edinburgh, Scotland, United Kingdom.,Heriot Watt University, Edinburgh, Scotland, United Kingdom
| | - Harry M Brash
- University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - Andrew J Tatham
- University of Edinburgh, Edinburgh, Scotland, United Kingdom.,Princess Alexandra Eye Pavilion, Edinburgh, Scotland, United Kingdom
| | - Pankaj K Agarwal
- Princess Alexandra Eye Pavilion, Edinburgh, Scotland, United Kingdom
| | - Ian C Murray
- University of Edinburgh, Edinburgh, Scotland, United Kingdom
| | - Brian W Fleck
- University of Edinburgh, Edinburgh, Scotland, United Kingdom.,Princess Alexandra Eye Pavilion, Edinburgh, Scotland, United Kingdom.,Royal Hospital for Sick Children, Edinburgh, Scotland, United Kingdom
| | - Robert A Minns
- University of Edinburgh, Edinburgh, Scotland, United Kingdom.,Royal Hospital for Sick Children, Edinburgh, Scotland, United Kingdom
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27
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Sun MJ, Rubin GS, Akpek EK, Ramulu PY. Impact of Glaucoma and Dry Eye on Text-Based Searching. Transl Vis Sci Technol 2017; 6:24. [PMID: 28670502 PMCID: PMC5491118 DOI: 10.1167/tvst.6.3.24] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 01/09/2017] [Indexed: 11/24/2022] Open
Abstract
PURPOSE We determine if visual field loss from glaucoma and/or measures of dry eye severity are associated with difficulty searching, as judged by slower search times on a text-based search task. METHODS Glaucoma patients with bilateral visual field (VF) loss, patients with clinically significant dry eye, and normally-sighted controls were enrolled from the Wilmer Eye Institute clinics. Subjects searched three Yellow Pages excerpts for a specific phone number, and search time was recorded. RESULTS A total of 50 glaucoma subjects, 40 dry eye subjects, and 45 controls completed study procedures. On average, glaucoma patients exhibited 57% longer search times compared to controls (95% confidence interval [CI], 26%-96%, P < 0.001), and longer search times were noted among subjects with greater VF loss (P < 0.001), worse contrast sensitivity (P < 0.001), and worse visual acuity (P = 0.026). Dry eye subjects demonstrated similar search times compared to controls, though worse Ocular Surface Disease Index (OSDI) vision-related subscores were associated with longer search times (P < 0.01). Search times showed no association with OSDI symptom subscores (P = 0.20) or objective measures of dry eye (P > 0.08 for Schirmer's testing without anesthesia, corneal fluorescein staining, and tear film breakup time). CONCLUSIONS Text-based visual search is slower for glaucoma patients with greater levels of VF loss and dry eye patients with greater self-reported visual difficulty, and these difficulties may contribute to decreased quality of life in these groups. TRANSLATIONAL RELEVANCE Visual search is impaired in glaucoma and dry eye groups compared to controls, highlighting the need for compensatory strategies and tools to assist individuals in overcoming their deficiencies.
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Affiliation(s)
| | | | - Esen K. Akpek
- Dry Eye and Ocular Surface Clinic, The Wilmer Eye Institute, The Johns Hopkins University, Baltimore, MD, USA
| | - Pradeep Y. Ramulu
- Glaucoma Center of Excellence, The Wilmer Eye Institute, The Johns Hopkins University, Baltimore, MD, USA
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Effect of glaucoma on eye movement patterns and laboratory-based hazard detection ability. PLoS One 2017; 12:e0178876. [PMID: 28570621 PMCID: PMC5453592 DOI: 10.1371/journal.pone.0178876] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 05/20/2017] [Indexed: 11/24/2022] Open
Abstract
Purpose The mechanisms underlying the elevated crash rates of older drivers with glaucoma are poorly understood. A key driving skill is timely detection of hazards; however, the hazard detection ability of drivers with glaucoma has been largely unexplored. This study assessed the eye movement patterns and visual predictors of performance on a laboratory-based hazard detection task in older drivers with glaucoma. Methods Participants included 30 older drivers with glaucoma (71±7 years; average better-eye mean deviation (MD) = −3.1±3.2 dB; average worse-eye MD = −11.9±6.2 dB) and 25 age-matched controls (72±7 years). Visual acuity, contrast sensitivity, visual fields, useful field of view (UFoV; processing speeds), and motion sensitivity were assessed. Participants completed a computerised Hazard Perception Test (HPT) while their eye movements were recorded using a desk-mounted Tobii TX300 eye-tracking system. The HPT comprises a series of real-world traffic videos recorded from the driver’s perspective; participants responded to road hazards appearing in the videos, and hazard response times were determined. Results Participants with glaucoma exhibited an average of 0.42 seconds delay in hazard response time (p = 0.001), smaller saccades (p = 0.010), and delayed first fixation on hazards (p<0.001) compared to controls. Importantly, larger saccades were associated with faster hazard responses in the glaucoma group (p = 0.004), but not in the control group (p = 0.19). Across both groups, significant visual predictors of hazard response times included motion sensitivity, UFoV, and worse-eye MD (p<0.05). Conclusions Older drivers with glaucoma had delayed hazard response times compared to controls, with associated changes in eye movement patterns. The association between larger saccades and faster hazard response time in the glaucoma group may represent a compensatory behaviour to facilitate improved performance.
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29
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Yucel YH, Gupta N. A framework to explore the visual brain in glaucoma with lessons from models and man. Exp Eye Res 2015; 141:171-8. [DOI: 10.1016/j.exer.2015.07.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 06/29/2015] [Accepted: 07/09/2015] [Indexed: 01/13/2023]
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30
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Dekeyster E, Aerts J, Valiente-Soriano FJ, De Groef L, Vreysen S, Salinas-Navarro M, Vidal-Sanz M, Arckens L, Moons L. Ocular hypertension results in retinotopic alterations in the visual cortex of adult mice. Curr Eye Res 2015; 40:1269-83. [PMID: 25615273 DOI: 10.3109/02713683.2014.990983] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE Glaucoma is a group of optic neuropathies characterized by the loss of retinal ganglion cells (RGCs). Since ocular hypertension (OHT) is a main risk factor, current therapies are predominantly based on lowering eye pressure. However, a subset of treated patients continues to lose vision. More research into pathological mechanisms underlying glaucoma is therefore warranted in order to develop novel therapeutic strategies. In this study we investigated the impact of OHT from eye to brain in mice. METHODS Monocular hypertension (mOHT) was induced in CD-1 mice by laser photocoagulation (LP) of the perilimbal and episcleral veins. The impact on the retina and its main direct target area, the superficial superior colliculus (sSC), was examined via immunostainings for Brn3a, VGluT2 and GFAP. Alterations in neuronal activity in V1 and extrastriate areas V2L and V2M were assessed using in situ hybridization for the activity reporter gene zif268. RESULTS Transient mOHT resulted in diffuse and sectorial RGC degeneration. In the sSC contralateral to the OHT eye, a decrease in VGluT2 immunopositive synaptic connections was detected one week post LP, which appeared to be retinotopically linked to the sectorial RGC degeneration patterns. In parallel, hypoactivity was discerned in contralateral retinotopic projection zones in V1 and V2. Despite complete cortical reactivation 4 weeks post LP, in the sSC no evidence for recovery of RGC synapse density was found and also the concomitant inflammation was not completely resolved. Nevertheless, sSC neurons appeared healthy upon histological inspection and subsequent analysis of cell density revealed no differences between the ipsi- and contralateral sSC. CONCLUSION In addition to RGC death, OHT induces loss of synaptic connections and neuronal activity in the visual pathway and is accompanied by an extensive immune response. Our findings stress the importance of looking beyond the eye and including the whole visual system in glaucoma research.
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Affiliation(s)
- Eline Dekeyster
- a Neural Circuit Development and Regeneration Research Group, Department of Biology, KU Leuven , Leuven , Belgium
| | - Jeroen Aerts
- b Laboratory of Neuroplasticity and Neuroproteomics, Department of Biology , KU Leuven , Leuven , Belgium and
| | | | - Lies De Groef
- a Neural Circuit Development and Regeneration Research Group, Department of Biology, KU Leuven , Leuven , Belgium
| | - Samme Vreysen
- b Laboratory of Neuroplasticity and Neuroproteomics, Department of Biology , KU Leuven , Leuven , Belgium and
| | - Manuel Salinas-Navarro
- a Neural Circuit Development and Regeneration Research Group, Department of Biology, KU Leuven , Leuven , Belgium
| | - Manuel Vidal-Sanz
- c Department of Ophthalmology , University of Murcia and IMIB-Arrixaca , Murcia , Spain
| | - Lutgarde Arckens
- b Laboratory of Neuroplasticity and Neuroproteomics, Department of Biology , KU Leuven , Leuven , Belgium and
| | - Lieve Moons
- a Neural Circuit Development and Regeneration Research Group, Department of Biology, KU Leuven , Leuven , Belgium
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Mazumdar D, Pel JJM, Panday M, Asokan R, Vijaya L, Shantha B, George R, Van Der Steen J. Comparison of saccadic reaction time between normal and glaucoma using an eye movement perimeter. Indian J Ophthalmol 2014; 62:55-9. [PMID: 24492502 PMCID: PMC3955071 DOI: 10.4103/0301-4738.126182] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIM To compare the saccadic reaction time (SRT) in both the central and peripheral visual field in normal and glaucomatous eyes using eye movement perimetery (EMP). MATERIALS AND METHODS Fifty-four normal and 25 glaucoma subjects underwent EMP and visual field testing on the Humphrey Field Analyser (HFA) 24-2 program. The EMP is based on infrared tracking of the corneal reflex. Fifty-four test locations corresponding to the locations on the 24-2 HFA program were tested. SRTs at different eccentricities and for different severities of glaucoma were compared between normal and glaucoma subjects. RESULTS Mean SRT was calculated for both normal and glaucoma subjects. Mann-Whitney U test showed statistically significant (P < 0.001) differences in SRT's between normal and glaucoma subjects in all zones. CONCLUSION SRT was prolonged in eyes with glaucoma across different eccentricities.
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Affiliation(s)
| | | | | | | | | | | | - Ronnie George
- Sri Jadhavbhai Nathmal Singhvi Department of Glaucoma, Medical and Vision Research Foundation, Chennai, Tamil Nadu, India
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32
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Burton R, Smith ND, Crabb DP. Eye movements and reading in glaucoma: observations on patients with advanced visual field loss. Graefes Arch Clin Exp Ophthalmol 2014; 252:1621-30. [PMID: 25074043 DOI: 10.1007/s00417-014-2752-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 06/02/2014] [Accepted: 07/14/2014] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To investigate the relationship between reading speed and eye movements in patients with advanced glaucomatous visual field (VF) defects and age-similar visually healthy people. METHODS Eighteen patients with advanced bilateral VF defects (mean age: 71, standard deviation [SD]: 7 years) and 39 controls (mean age: 67, SD: 8 years) had reading speed measured using short passages of text on a computer set-up incorporating eye tracking. Scanpaths were plotted and analysed from these experiments to derive measures of 'perceptual span' (total number of letters read per number of saccades) and 'text saturation' (the distance between the first and last fixation on lines of text). Another eye movement measure, termed 'saccadic frequency' (total number of saccades made to read a single word), was derived from a separate lexical decision task, where words were presented in isolation. RESULTS Significant linear association was demonstrated between perceptual span and reading speed in patients (R (2) = 0.42) and controls (R (2) = 0.56). Linear association between saccadic frequency during the LDT and reading speed was also found in patients (R (2) = 0.42), but not in controls (R (2) = 0.02). Patients also exhibited greater average text saturation than controls (P = 0.004). CONCLUSION Some, but not all, patients with advanced VF defects read slower than controls using short text passages. Differences in eye movement behaviour may partly account for this variability in patients. These patients were shown to saturate lines of text more during reading, which may explain previously-reported difficulties with sustained reading.
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Affiliation(s)
- Robyn Burton
- Department of Optometry and Visual Science, City University London, Northampton Square, London, EC1V 0HB, UK
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33
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Abstract
PURPOSE Large moving scenes can induce a sensation of self-motion in stationary observers. This illusion is called "vection." Glaucoma progressively affects the functioning of peripheral vision, which plays an important role in inducing vection. It is still not known whether vection can be induced in these patients and, if it can, whether the interaction between visual and vestibular inputs is solved appropriately. The aim of this study was to investigate vection responses in patients with mild to moderate open-angle glaucoma. METHODS Fifteen patients with mild to moderate glaucoma and 15 age-matched controls were exposed to a random-dot pattern at a short viewing distance and in a dark room. The pattern was projected on a large screen and rotated clockwise with an angular speed of 45 degrees per second to induce a sensation of self-rotation. Vection latency, vection duration, and objective and subjective measures of tilt were obtained in three viewing conditions (binocular, and monocular with each eye). Each condition lasted 2 minutes. RESULTS Patients with glaucoma had longer vection latencies (p = 0.005) than, but the same vection duration as, age-matched controls. Viewing condition did not affect vection responses for either group. The control group estimated the tilt angle as being significantly larger than the actual maximum tilt angle measured with the tilt sensor (p = 0.038). There was no relationship between vection measures and visual field sensitivity for the glaucoma group. CONCLUSIONS These findings suggest that, despite an altered visual input that delays vection, the neural responses involved in canceling the illusion of self-motion remain intact in patients with mild peripheral visual field loss.
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