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Maniarasu P, Shasane PH, Pai VH, Kuzhuppilly NIR, Ve RS, Ballae Ganeshrao S. Does the sampling frequency of an eye tracker affect the detection of glaucomatous visual field loss? Ophthalmic Physiol Opt 2024; 44:378-387. [PMID: 38149468 DOI: 10.1111/opo.13267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 12/28/2023]
Abstract
PURPOSE Evidence suggests that eye movements have potential as a tool for detecting glaucomatous visual field defects. This study evaluated the influence of sampling frequency on eye movement parameters in detecting glaucomatous visual field defects during a free-viewing task. METHODS We investigated eye movements in two sets of experiments: (a) young adults with and without simulated visual field defects and (b) glaucoma patients and age-matched controls. In Experiment 1, we recruited 30 healthy volunteers. Among these, 10 performed the task with a gaze-contingent superior arcuate (SARC) scotoma, 10 performed the task with a gaze-contingent biarcuate (BARC) scotoma and 10 performed the task without a simulated scotoma (NoSim). The experimental task involved participants freely exploring 100 images, each for 4 s. Eye movements were recorded using the LiveTrack Lightning eye-tracker (500 Hz). In Experiment 2, we recruited 20 glaucoma patients and 16 age-matched controls. All participants underwent similar experimental tasks as in Experiment 1, except only 37 images were shown for exploration. To analyse the effect of sampling frequency, data were downsampled to 250, 120 and 60 Hz. Eye movement parameters, such as the number of fixations, fixation duration, saccadic amplitude and bivariate contour ellipse area (BCEA), were computed across various sampling frequencies. RESULTS Two-way ANOVA revealed no significant effects of sampling frequency on fixation duration (simulation, p = 0.37; glaucoma patients, p = 0.95) and BCEA (simulation, p = 0.84; glaucoma patients: p = 0.91). BCEA showed good distinguishability in differentiating groups across different sampling frequencies, whereas fixation duration failed to distinguish between glaucoma patients and controls. Number of fixations and saccade amplitude showed variations with sampling frequency in both simulations and glaucoma patients. CONCLUSION In both simulations and glaucoma patients, BCEA consistently differentiated them from controls across various sampling frequencies.
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Affiliation(s)
- Priyanka Maniarasu
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Prathamesh Harshad Shasane
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Vijaya H Pai
- Department of Ophthalmology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Neetha I R Kuzhuppilly
- Department of Ophthalmology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Ramesh S Ve
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Shonraj Ballae Ganeshrao
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
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2
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Lenoble Q, Lossouarn A, Rouland JF, Boucart M. Reduced peripheral vision in glaucoma and boundary extension. Clin Exp Optom 2024; 107:234-241. [PMID: 35946410 DOI: 10.1080/08164622.2022.2107892] [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: 04/11/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 10/15/2022] Open
Abstract
CLINICAL RELEVANCE Peripheral vision is known to be critical for spatial navigation. However, visual cognition, which impacts peripheral vision, has not been studied extensively in glaucoma. BACKGROUND Spatial memory was assessed with a known to induce a robust memory distortion called "boundary extension" in which participants erroneously remember seeing more of a scene than was present in the sensory input. METHODS Fifteen patients with glaucoma and 15 age-matched normally sighted controls participated in the experiment. Participants were shown 10 photographs of natural scenes randomly displayed for 0.5 s or 10 s. Following each scene, the participant was asked to draw it from memory. RESULTS On average, boundary extension was larger, by 12%, for patients than for controls, but the difference was significant for 4 photographs. Patients tended to add more space between the object and the edges than there was between the objects and the border of the photograph. A control experiment in which participants were asked to draw isolated objects without scene context resulted in a significant reduction of the memory distortion in both groups, but patients still drew the objects smaller than controls. CONCLUSION The reduced field of view in glaucoma has an impact on spatial memory for scenes and on perception of size.
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Affiliation(s)
- Quentin Lenoble
- Lille Neuroscience & Cognition, Université Lille, Lille, France
| | - Adrien Lossouarn
- Service d'ophtalmologie, Centre Hospitalier Universitaire de Lille, Lille, France
| | | | - Muriel Boucart
- Lille Neuroscience & Cognition, Université Lille, Lille, France
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3
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Blanckaert E, Rouland JF, Davost T, Warniez A, Boucart M. Higher susceptibility to central crowding in glaucoma. Clin Exp Optom 2024; 107:227-233. [PMID: 36183782 DOI: 10.1080/08164622.2022.2124848] [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: 07/02/2022] [Revised: 08/09/2022] [Accepted: 09/06/2022] [Indexed: 10/07/2022] Open
Abstract
CLINICAL RELEVANCE Crowding limits many daily life activities, such as reading and the visual search for objects in cluttered environments. Excessive sensitivity to crowding, especially in central vision, may amplify the difficulties of patients with ocular pathologies. It is thus important to investigate what limits visual activities and how to improve it. BACKGROUND Numerous studies have reported reduced contrast sensitivity in central vision in patients with glaucoma. However, deficits have also been observed for letter recognition at high contrast, suggesting that contrast alone cannot completely account for impaired central perception. METHOD Seventeen patients and fifteen age-matched controls were randomly presented with letters in central or parafoveal vision at 5° eccentricity for 200 ms. They were asked to decide whether the central T was upright or inverted. The T was either presented in isolation (uncrowded) or flanked by two Hs (crowded) at various spacings. Contrast was manipulated: 60% and 5%. RESULTS Compared to controls, patients exhibited a significant effect of crowding in central vision, with higher accuracy for the isolated T than for HTH only at low contrast. In parafoveal vision, an effect of crowding was also observed only in patients. The spacing to escape crowding varied as a function of contrast. Larger spacing was required at low contrast than at high contrast. Susceptibility to crowding was related to central visual field defect for central presentations and to contrast sensitivity for parafoveal presentations, only at low contrast. Controls were at ceiling level both for central and parafoveal presentations. CONCLUSION Crowding limits visual perception, impeding reading and object recognition in cluttered environments. Visual field defects and lower contrast sensitivity in glaucoma can increase susceptibility to central and parafoveal crowding, the deleterious effect of which can be improved by manipulating contrast and spacing between elements.
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Affiliation(s)
- Edouard Blanckaert
- 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
| | - Theophile Davost
- 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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4
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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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5
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Reddingius P, Asfaw DS, Mönter VM, Smith ND, Jones PR, Crabb DP. Data on eye movements of glaucoma patients with asymmetrical visual field loss during free viewing. Data Brief 2023; 48:109184. [PMID: 37234734 PMCID: PMC10206150 DOI: 10.1016/j.dib.2023.109184] [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: 03/30/2023] [Accepted: 04/24/2023] [Indexed: 05/28/2023] Open
Abstract
This paper describes data from Asfaw at al. [1], which examined the eye movements of glaucoma patients (n=15) with pronounced asymmetrical vision loss (visual field loss worse in one eye). This allows for within-subject comparisons between the better and worse eye, thereby controlling for the effects of individual differences between patients. All patients had a clinical diagnosis of open angle glaucoma (OAG). Participants were asked to look at images of nature monocularly (free viewing; fellow eye patched) while gaze was recorded at 1000 Hz using a remote eye tracker (EyeLink 1000). Raw and processed eye tracking data are provided. In addition, clinical (visual acuity, contrast sensitivity and visual field) and demographic information (age, sex) are provided.
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6
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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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Srinivasan R, Turpin A, McKendrick AM. Developing a Screening Tool for Areas of Abnormal Central Vision Using Visual Stimuli With Natural Scene Statistics. Transl Vis Sci Technol 2022; 11:34. [PMID: 35195703 PMCID: PMC8883145 DOI: 10.1167/tvst.11.2.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose Previous studies show that some visual field (VF) defects are detectable from visual search behavior; for example, when watching video. Here, we developed and tested a VF testing approach that measures the number of fixations to find targets on a background with spatial frequency content similar to natural scenes. Methods Twenty-one older controls and 20 people with glaucoma participated. Participants searched for a Gabor (6 c/°) that appeared in one of 25 possible locations within a 15° (visual angle) 1/f noise background (RMS contrast: 0.20). Procedure performance was assessed by calculating sensitivity and specificity for different combinations of control performance limits (p = 95%, 98%, 99%), number of target locations with fixations outside control performance limits (k = 0 to 25) and number of repeated target presentations (n = 1 to 20). Results Controls made a median of two to three fixations (twenty-fifth to seventy-fifth percentile: two to four) to locate the target depending on location. A VF was flagged “abnormal” when the number of fixations was greater than the p = 99% for k = 3 or more locations with n = 2 repeated presentations, giving 85% sensitivity and 95.2% specificity. The median test time for controls was 85.71 (twenty-fifth to seventy-fifth percentile: 66.49–113.53) seconds. Conclusion Our prototype test demonstrated effective and efficient screening of abnormal areas in central vision. Translational Relevance Visual search behavior can be used to detect central vision loss and may produce results that relate well to performance in natural visual environments.
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Affiliation(s)
- Rekha Srinivasan
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Andrew Turpin
- School of Computing and Information Systems, The University of Melbourne, Parkville, Victoria, Australia
| | - Allison M McKendrick
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
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8
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Krishnan S, Amudha J, Tejwani S. Intelligent-based decision support system for diagnosing glaucoma in primary eyecare centers using eye tracker. JOURNAL OF INTELLIGENT & FUZZY SYSTEMS 2021. [DOI: 10.3233/jifs-189846] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
It is quite alarming that the increase of glaucoma is due to the lack of awareness of the disease and the cost for glaucoma screening. The primary eye care centers need to include a comprehensive glaucoma screening and include machine learning models to elaborate it as decision support system. The proposed system considers the state of art of eye gaze features to understand cognitive processing, direction and restriction of visual field. There is no significant difference in global and local ratio and skewness value of fixation duration and saccade amplitude, which suggest that there is no difference in cognitive processing. The significance value of saccadic extent along vertical axis, Horizontal Vertical ratio (HV ratio), convex hull area and saccadic direction show that there is restriction in vertical visual field. The statistical measures (p < 0.05) and Spearman correlation coefficient with class label validate the results. The proposed system compared the performance of seven classifiers: Naïve Bayes classifier, linear and kernel Support Vector classifiers, decision tree classifier, Adaboost, random forest and eXtreme Gradient Boosting (XGBoost) classifier. The discrimination of eye gaze features of glaucoma and normal is efficiently done by XGBoost with accuracy 1.0. The decision support system is cost-effective and portable.
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Affiliation(s)
- Sajitha Krishnan
- Department of Computer Science and Engineering, Amrita School of Engineering, Bengaluru, Amrita Vishwa Vidyapeetham, India
| | - J. Amudha
- Department of Computer Science and Engineering, Amrita School of Engineering, Bengaluru, Amrita Vishwa Vidyapeetham, India
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9
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Carvalho J, Renken RJ, Cornelissen FW. Predictive masking of an artificial scotoma is associated with a system-wide reconfiguration of neural populations in the human visual cortex. Neuroimage 2021; 245:118690. [PMID: 34758382 DOI: 10.1016/j.neuroimage.2021.118690] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 10/19/2021] [Accepted: 10/28/2021] [Indexed: 11/29/2022] Open
Abstract
The visual brain has the remarkable capacity to complete our percept of the world even when the information extracted from the visual scene is incomplete. This ability to predict missing information based on information from spatially adjacent regions is an intriguing attribute of healthy vision. Yet, it gains particular significance when it masks the perceptual consequences of a retinal lesion, leaving patients unaware of their partial loss of vision and ultimately delaying diagnosis and treatment. At present, our understanding of the neural basis of this masking process is limited which hinders both quantitative modeling as well as translational application. To overcome this, we asked the participants to view visual stimuli with and without superimposed artificial scotoma (AS). We used fMRI to record the associated cortical activity and applied model-based analyzes to track changes in cortical population receptive fields and connectivity in response to the introduction of the AS. We found that throughout the visual field and cortical hierarchy, pRFs shifted their preferred position towards the AS border. Moreover, extrastriate areas biased their sampling of V1 towards sections outside the AS projection zone, thereby effectively masking the AS with signals from spared portions of the visual field. We speculate that the signals that drive these system-wide population modifications originate in extrastriate visual areas and, through feedback, also reconfigure the neural populations in the earlier visual areas.
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Affiliation(s)
- Joana Carvalho
- Laboratory of Experimental Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Laboratory of Preclinical MRI, Champalimaud Centre for the Unknown, Avenida de Brasília, Lisbon, Portugal 1400-038.
| | - Remco J Renken
- Cognitive Neuroscience Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Frans W Cornelissen
- Laboratory of Experimental Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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10
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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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Thibaut M, Tran T, Szaffarczyk S, Boucart M. Impact of age‐related macular degeneration on object searches in realistic panoramic scenes. Clin Exp Optom 2021; 101:372-379. [DOI: 10.1111/cxo.12644] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 10/10/2017] [Accepted: 10/24/2017] [Indexed: 01/11/2023] Open
Affiliation(s)
| | - Thi‐ha‐chau Tran
- SCALab, University of Lille, CNRS, Lille, France,
- Department of Ophthalmology, Lille Group Hospitals, Lille Catholic University, Lille, France,
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12
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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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13
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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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14
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Asfaw DS, Jones PR, Edwards LA, Smith ND, Crabb DP. Using eye movements to detect visual field loss: a pragmatic assessment using simulated scotoma. Sci Rep 2020; 10:9782. [PMID: 32555198 PMCID: PMC7299979 DOI: 10.1038/s41598-020-66196-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 05/15/2020] [Indexed: 12/02/2022] Open
Abstract
Glaucoma is a leading cause of irreversible sight-loss and has been shown to affect natural eye-movements. These changes may provide a cheap and easy-to-obtain biomarker for improving disease detection. Here, we investigated whether these changes are large enough to be clinically useful. We used a gaze-contingent simulated visual field (VF) loss paradigm, in which participants experienced a variable magnitude of simulated VF loss based on longitudinal data from a real glaucoma patient (thereby controlling for other variables, such as age and general health). Fifty-five young participants with healthy vision were asked to view two short videos and three pictures, either with: (1) no VF loss, (2) moderate VF loss, or (3) advanced VF loss. Eye-movements were recorded using a remote eye tracker. Key eye-movement parameters were computed, including saccade amplitude, the spread of saccade endpoints (bivariate contour ellipse area), location of saccade landing positions, and similarity of fixations locations among participants (quantified using kernel density estimation). The simulated VF loss caused some statistically significant effects in the eye movement parameters. Yet, these effects were not capable of consistently identifying simulated VF loss, despite it being of a magnitude likely easily detectable by standard automated perimetry.
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Affiliation(s)
- Daniel S Asfaw
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, EC1V 0HB, UK
| | - Pete R Jones
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, EC1V 0HB, UK
| | - Laura A Edwards
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, EC1V 0HB, UK
| | - Nicholas D Smith
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, EC1V 0HB, UK
| | - David P Crabb
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, EC1V 0HB, UK.
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15
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David EJ, Lebranchu P, Perreira Da Silva M, Le Callet P. Predicting artificial visual field losses: A gaze-based inference study. J Vis 2020; 19:22. [PMID: 31868896 DOI: 10.1167/19.14.22] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Visual field defects are a world-wide concern, and the proportion of the population experiencing vision loss is ever increasing. Macular degeneration and glaucoma are among the four leading causes of permanent vision loss. Identifying and characterizing visual field losses from gaze alone could prove crucial in the future for screening tests, rehabilitation therapies, and monitoring. In this experiment, 54 participants took part in a free-viewing task of visual scenes while experiencing artificial scotomas (central and peripheral) of varying radii in a gaze-contingent paradigm. We studied the importance of a set of gaze features as predictors to best differentiate between artificial scotoma conditions. Linear mixed models were utilized to measure differences between scotoma conditions. Correlation and factorial analyses revealed redundancies in our data. Finally, hidden Markov models and recurrent neural networks were implemented as classifiers in order to measure the predictive usefulness of gaze features. The results show separate saccade direction biases depending on scotoma type. We demonstrate that the saccade relative angle, amplitude, and peak velocity of saccades are the best features on the basis of which to distinguish between artificial scotomas in a free-viewing task. Finally, we discuss the usefulness of our protocol and analyses as a gaze-feature identifier tool that discriminates between artificial scotomas of different types and sizes.
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Affiliation(s)
| | - Pierre Lebranchu
- University of Nantes and Nantes University Hospital, Nantes, France
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16
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Gopalakrishnan S, Jacob CES, Kumar M, Karunakaran V, Raman R. Comparison of Visual Parameters Between Normal Individuals and People with Low Vision in a Virtual Environment. CYBERPSYCHOLOGY BEHAVIOR AND SOCIAL NETWORKING 2020; 23:171-178. [DOI: 10.1089/cyber.2019.0235] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Sarika Gopalakrishnan
- Shanmugha Arts, Science, Technology & Research Academy (SASTRA) University, Thanjavur, India
- Low Vision Care Clinic, Medical Research Foundation, Sankara Nethralaya, Chennai, India
| | | | - Meenakshi Kumar
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, India
| | | | - Rajiv Raman
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, India
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17
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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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18
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Asfaw DS, Jones PR, Mönter VM, Smith ND, Crabb DP. Does Glaucoma Alter Eye Movements When Viewing Images of Natural Scenes? A Between-Eye Study. Invest Ophthalmol Vis Sci 2019; 59:3189-3198. [PMID: 29971443 DOI: 10.1167/iovs.18-23779] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate whether glaucoma produces measurable changes in eye movements. Methods Fifteen glaucoma patients with asymmetric vision loss (difference in mean deviation [MD] > 6 dB between eyes) were asked to monocularly view 120 images of natural scenes, presented sequentially on a computer monitor. Each image was viewed twice-once each with the better and worse eye. Patients' eye movements were recorded with an Eyelink 1000 eye-tracker. Eye-movement parameters were computed and compared within participants (better eye versus worse eye). These parameters included a novel measure: saccadic reversal rate (SRR), as well as more traditional metrics such as saccade amplitude, fixation counts, fixation duration, and spread of fixation locations (bivariate contour ellipse area [BCEA]). In addition, the associations of these parameters with clinical measures of vision were investigated. Results In the worse eye, saccade amplitude\(\def\upalpha{\unicode[Times]{x3B1}}\)\(\def\upbeta{\unicode[Times]{x3B2}}\)\(\def\upgamma{\unicode[Times]{x3B3}}\)\(\def\updelta{\unicode[Times]{x3B4}}\)\(\def\upvarepsilon{\unicode[Times]{x3B5}}\)\(\def\upzeta{\unicode[Times]{x3B6}}\)\(\def\upeta{\unicode[Times]{x3B7}}\)\(\def\uptheta{\unicode[Times]{x3B8}}\)\(\def\upiota{\unicode[Times]{x3B9}}\)\(\def\upkappa{\unicode[Times]{x3BA}}\)\(\def\uplambda{\unicode[Times]{x3BB}}\)\(\def\upmu{\unicode[Times]{x3BC}}\)\(\def\upnu{\unicode[Times]{x3BD}}\)\(\def\upxi{\unicode[Times]{x3BE}}\)\(\def\upomicron{\unicode[Times]{x3BF}}\)\(\def\uppi{\unicode[Times]{x3C0}}\)\(\def\uprho{\unicode[Times]{x3C1}}\)\(\def\upsigma{\unicode[Times]{x3C3}}\)\(\def\uptau{\unicode[Times]{x3C4}}\)\(\def\upupsilon{\unicode[Times]{x3C5}}\)\(\def\upphi{\unicode[Times]{x3C6}}\)\(\def\upchi{\unicode[Times]{x3C7}}\)\(\def\uppsy{\unicode[Times]{x3C8}}\)\(\def\upomega{\unicode[Times]{x3C9}}\)\(\def\bialpha{\boldsymbol{\alpha}}\)\(\def\bibeta{\boldsymbol{\beta}}\)\(\def\bigamma{\boldsymbol{\gamma}}\)\(\def\bidelta{\boldsymbol{\delta}}\)\(\def\bivarepsilon{\boldsymbol{\varepsilon}}\)\(\def\bizeta{\boldsymbol{\zeta}}\)\(\def\bieta{\boldsymbol{\eta}}\)\(\def\bitheta{\boldsymbol{\theta}}\)\(\def\biiota{\boldsymbol{\iota}}\)\(\def\bikappa{\boldsymbol{\kappa}}\)\(\def\bilambda{\boldsymbol{\lambda}}\)\(\def\bimu{\boldsymbol{\mu}}\)\(\def\binu{\boldsymbol{\nu}}\)\(\def\bixi{\boldsymbol{\xi}}\)\(\def\biomicron{\boldsymbol{\micron}}\)\(\def\bipi{\boldsymbol{\pi}}\)\(\def\birho{\boldsymbol{\rho}}\)\(\def\bisigma{\boldsymbol{\sigma}}\)\(\def\bitau{\boldsymbol{\tau}}\)\(\def\biupsilon{\boldsymbol{\upsilon}}\)\(\def\biphi{\boldsymbol{\phi}}\)\(\def\bichi{\boldsymbol{\chi}}\)\(\def\bipsy{\boldsymbol{\psy}}\)\(\def\biomega{\boldsymbol{\omega}}\)\(\def\bupalpha{\unicode[Times]{x1D6C2}}\)\(\def\bupbeta{\unicode[Times]{x1D6C3}}\)\(\def\bupgamma{\unicode[Times]{x1D6C4}}\)\(\def\bupdelta{\unicode[Times]{x1D6C5}}\)\(\def\bupepsilon{\unicode[Times]{x1D6C6}}\)\(\def\bupvarepsilon{\unicode[Times]{x1D6DC}}\)\(\def\bupzeta{\unicode[Times]{x1D6C7}}\)\(\def\bupeta{\unicode[Times]{x1D6C8}}\)\(\def\buptheta{\unicode[Times]{x1D6C9}}\)\(\def\bupiota{\unicode[Times]{x1D6CA}}\)\(\def\bupkappa{\unicode[Times]{x1D6CB}}\)\(\def\buplambda{\unicode[Times]{x1D6CC}}\)\(\def\bupmu{\unicode[Times]{x1D6CD}}\)\(\def\bupnu{\unicode[Times]{x1D6CE}}\)\(\def\bupxi{\unicode[Times]{x1D6CF}}\)\(\def\bupomicron{\unicode[Times]{x1D6D0}}\)\(\def\buppi{\unicode[Times]{x1D6D1}}\)\(\def\buprho{\unicode[Times]{x1D6D2}}\)\(\def\bupsigma{\unicode[Times]{x1D6D4}}\)\(\def\buptau{\unicode[Times]{x1D6D5}}\)\(\def\bupupsilon{\unicode[Times]{x1D6D6}}\)\(\def\bupphi{\unicode[Times]{x1D6D7}}\)\(\def\bupchi{\unicode[Times]{x1D6D8}}\)\(\def\buppsy{\unicode[Times]{x1D6D9}}\)\(\def\bupomega{\unicode[Times]{x1D6DA}}\)\(\def\bupvartheta{\unicode[Times]{x1D6DD}}\)\(\def\bGamma{\bf{\Gamma}}\)\(\def\bDelta{\bf{\Delta}}\)\(\def\bTheta{\bf{\Theta}}\)\(\def\bLambda{\bf{\Lambda}}\)\(\def\bXi{\bf{\Xi}}\)\(\def\bPi{\bf{\Pi}}\)\(\def\bSigma{\bf{\Sigma}}\)\(\def\bUpsilon{\bf{\Upsilon}}\)\(\def\bPhi{\bf{\Phi}}\)\(\def\bPsi{\bf{\Psi}}\)\(\def\bOmega{\bf{\Omega}}\)\(\def\iGamma{\unicode[Times]{x1D6E4}}\)\(\def\iDelta{\unicode[Times]{x1D6E5}}\)\(\def\iTheta{\unicode[Times]{x1D6E9}}\)\(\def\iLambda{\unicode[Times]{x1D6EC}}\)\(\def\iXi{\unicode[Times]{x1D6EF}}\)\(\def\iPi{\unicode[Times]{x1D6F1}}\)\(\def\iSigma{\unicode[Times]{x1D6F4}}\)\(\def\iUpsilon{\unicode[Times]{x1D6F6}}\)\(\def\iPhi{\unicode[Times]{x1D6F7}}\)\(\def\iPsi{\unicode[Times]{x1D6F9}}\)\(\def\iOmega{\unicode[Times]{x1D6FA}}\)\(\def\biGamma{\unicode[Times]{x1D71E}}\)\(\def\biDelta{\unicode[Times]{x1D71F}}\)\(\def\biTheta{\unicode[Times]{x1D723}}\)\(\def\biLambda{\unicode[Times]{x1D726}}\)\(\def\biXi{\unicode[Times]{x1D729}}\)\(\def\biPi{\unicode[Times]{x1D72B}}\)\(\def\biSigma{\unicode[Times]{x1D72E}}\)\(\def\biUpsilon{\unicode[Times]{x1D730}}\)\(\def\biPhi{\unicode[Times]{x1D731}}\)\(\def\biPsi{\unicode[Times]{x1D733}}\)\(\def\biOmega{\unicode[Times]{x1D734}}\)\((P = 0.012; - 13\% \)) and BCEA \((P = 0.005; - 16\% )\) were smaller, while SRR was greater (\(P = 0.018; + 16\% \)). There was a significant correlation between the intereye difference in BCEA, and differences in MD values (\({\rm{Spearman^{\prime} s}}\ r = 0.65;P = 0.01\)), while differences in SRR were associated with differences in visual acuity (\({\rm{Spearman^{\prime} s}}\ r = 0.64;P = 0.01\)). Furthermore, between-eye differences in BCEA were a significant predictor of between-eye differences in MD: for every 1-dB difference in MD, BCEA reduced by 6.2% (95% confidence interval, 1.6%-10.3%). Conclusions Eye movements are altered by visual field loss, and these changes are related to changes in clinical measures. Eye movements recorded while passively viewing images could potentially be used as biomarkers for visual field damage.
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Affiliation(s)
- Daniel S Asfaw
- Division of Optometry and Visual Science, School of Health Science, City, University of London, London, United Kingdom
| | - Pete R Jones
- Division of Optometry and Visual Science, School of Health Science, City, University of London, London, United Kingdom
| | - Vera M Mönter
- Division of Optometry and Visual Science, School of Health Science, City, University of London, London, United Kingdom
| | - Nicholas D Smith
- Division of Optometry and Visual Science, School of Health Science, City, University of London, London, United Kingdom
| | - David P Crabb
- Division of Optometry and Visual Science, School of Health Science, City, University of London, London, United Kingdom
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19
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Senger C, da Silva MJL, De Moraes CG, Messias A, Paula JS. Spatial correlation between localized decreases in exploratory visual search performance and areas of glaucomatous visual field loss. Graefes Arch Clin Exp Ophthalmol 2018; 257:153-160. [PMID: 30368564 DOI: 10.1007/s00417-018-4164-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 08/29/2018] [Accepted: 10/15/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Visual search is a critical skill for several daily tasks and may be compromised in patients with impaired vision. The objective of this study was to study the relationships between exploratory visual search performance (EVSP) visual field (VF) sensitivity in patients with glaucoma. METHODS Primary open-angle glaucoma patients (POAG; n = 29) and healthy (Control; n = 28) individuals with best corrected visual acuity better than 0.2 logMAR underwent a comprehensive ophthalmological examination, including Humphrey VF tests (24-2 SITA-Standard), and a monocular exploratory visual search digit-based task performed using a software that quantifies the time spent to find a targert on a random array of digits distributed on nine sequential screens. The screens were divided into five areas to topographically match with five VF sectors. RESULTS As expected, POAG eyes had worse VF mean deviation (MD) sensitivity and EVSP than Controls (MD - 8.02 ± 7.88 dB vs - 1.43 ± 1.50 dB, p < 0.0001; and total EVSP time 106.42 ± 59.64 s vs 52.75 ± 19.07 s, p < 0.0001). MD sensitivity of both groups significantly correlated with total EVSP time (POAG r = - 0.45, p = 0.01; and Control r = 0.37, p = 0.049). A significant relationship was observed between EVSP (individual time) and both visual acuity (p = 0.006) and glaucoma diagnosis (p = 0.005). The mean sensitivity of the peripheral VF areas of the POAG group showed significant correlation with the individual search time in the corresponding spatial areas, except in the peripheral superior temporal area (r = - 0.35, p = 0.06). CONCLUSION These data indicate that POAG patients' EVSP is impaired in topographically-correspondent VF areas with sensitivity loss. Visual search may be considered as a measure of impairment of daily activities in glaucoma patients, if further similar tests using binocular conditions corroborate our findings.
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Affiliation(s)
- Cassia Senger
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School- University of São Paulo, Av. Bandeirantes, 3900 - 12°. Andar. Ribeirão Preto, São Paulo, Brazil
| | - Marcelo Jordão Lopes da Silva
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School- University of São Paulo, Av. Bandeirantes, 3900 - 12°. Andar. Ribeirão Preto, São Paulo, Brazil
| | - Carlos Gustavo De Moraes
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, NY, USA
| | - André Messias
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School- University of São Paulo, Av. Bandeirantes, 3900 - 12°. Andar. Ribeirão Preto, São Paulo, Brazil
| | - Jayter Silva Paula
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School- University of São Paulo, Av. Bandeirantes, 3900 - 12°. Andar. Ribeirão Preto, São Paulo, Brazil.
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20
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Asfaw DS, Jones PR, Smith ND, Crabb DP. Data on eye movements in people with glaucoma and peers with normal vision. Data Brief 2018; 19:1266-1273. [PMID: 29922707 PMCID: PMC6005790 DOI: 10.1016/j.dib.2018.05.076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 05/15/2018] [Indexed: 11/28/2022] Open
Abstract
Eye movements of glaucoma patients have been shown to differ from age-similar control groups when performing everyday tasks, such as reading (Burton et al., 2012; Smith et al., 2014) [1], [2], visual search (Smith et al., 2012) [3], face recognition (Glen et al., 2013) [4], driving, and viewing static images (Smith et al., 2012) [5]. Described here is the dataset from a recent publication in which we compared the eye-movements of 44 glaucoma patients and 32 age-similar controls, while they watched a series of short video clips taken from television programs (Crabb et al., 2018) [6]. Gaze was recorded at 1000 Hz using a remote eye-tracker. We also provide demographic information and results from a clinical examination of vision for each participant.
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Affiliation(s)
- Daniel S Asfaw
- Division of Optometry and Visual Science, School of Health Science, City, University of London, London, EC1V 0HB, UK
| | - Pete R Jones
- Division of Optometry and Visual Science, School of Health Science, City, University of London, London, EC1V 0HB, UK
| | - Nicholas D Smith
- Division of Optometry and Visual Science, School of Health Science, City, University of London, London, EC1V 0HB, UK
| | - David P Crabb
- Division of Optometry and Visual Science, School of Health Science, City, University of London, London, EC1V 0HB, UK
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21
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Phu J, Kalloniatis M, Khuu SK. Reducing Spatial Uncertainty Through Attentional Cueing Improves Contrast Sensitivity in Regions of the Visual Field With Glaucomatous Defects. Transl Vis Sci Technol 2018; 7:8. [PMID: 29600116 PMCID: PMC5868861 DOI: 10.1167/tvst.7.2.8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 01/21/2018] [Indexed: 11/24/2022] Open
Abstract
Purpose Current clinical perimetric test paradigms present stimuli randomly to various locations across the visual field (VF), inherently introducing spatial uncertainty, which reduces contrast sensitivity. In the present study, we determined the extent to which spatial uncertainty affects contrast sensitivity in glaucoma patients by minimizing spatial uncertainty through attentional cueing. Methods Six patients with open-angle glaucoma and six healthy subjects underwent laboratory-based psychophysical testing to measure contrast sensitivity at preselected locations at two eccentricities (9.5° and 17.5°) with two stimulus sizes (Goldmann sizes III and V) under different cueing conditions: 1, 2, 4, or 8 points verbally cued. Method of Constant Stimuli and a single-interval forced-choice procedure were used to generate frequency of seeing (FOS) curves at locations with and without VF defects. Results At locations with VF defects, cueing minimizes spatial uncertainty and improves sensitivity under all conditions. The effect of cueing was maximal when one point was cued, and rapidly diminished when more points were cued (no change to baseline with 8 points cued). The slope of the FOS curve steepened with reduced spatial uncertainty. Locations with normal sensitivity in glaucomatous eyes had similar performance to that of healthy subjects. There was a systematic increase in uncertainty with the depth of VF loss. Conclusions Sensitivity measurements across the VF are negatively affected by spatial uncertainty, which increases with greater VF loss. Minimizing uncertainty can improve sensitivity at locations of deficit. Translational Relevance Current perimetric techniques introduce spatial uncertainty and may therefore underestimate sensitivity in regions of VF loss.
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Affiliation(s)
- Jack Phu
- Centre for Eye Health, University of New South Wales, Kensington, NSW, Australia.,School of Optometry and Vision Science, University of New South Wales, Kensington, NSW, Australia
| | - Michael Kalloniatis
- Centre for Eye Health, University of New South Wales, Kensington, NSW, Australia.,School of Optometry and Vision Science, University of New South Wales, Kensington, NSW, Australia
| | - Sieu K Khuu
- School of Optometry and Vision Science, University of New South Wales, Kensington, NSW, Australia
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22
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Authié CN, Berthoz A, Sahel JA, Safran AB. Adaptive Gaze Strategies for Locomotion with Constricted Visual Field. Front Hum Neurosci 2017; 11:387. [PMID: 28798674 PMCID: PMC5529417 DOI: 10.3389/fnhum.2017.00387] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 07/12/2017] [Indexed: 11/13/2022] Open
Abstract
In retinitis pigmentosa (RP), loss of peripheral visual field accounts for most difficulties encountered in visuo-motor coordination during locomotion. The purpose of this study was to accurately assess the impact of peripheral visual field loss on gaze strategies during locomotion, and identify compensatory mechanisms. Nine RP subjects presenting a central visual field limited to 10-25° in diameter, and nine healthy subjects were asked to walk in one of three directions-straight ahead to a visual target, leftward and rightward through a door frame, with or without obstacle on the way. Whole body kinematics were recorded by motion capture, and gaze direction in space was reconstructed using an eye-tracker. Changes in gaze strategies were identified in RP subjects, including extensive exploration prior to walking, frequent fixations of the ground (even knowing no obstacle was present), of door edges, essentially of the proximal one, of obstacle edge/corner, and alternating door edges fixations when approaching the door. This was associated with more frequent, sometimes larger rapid-eye-movements, larger movements, and forward tilting of the head. Despite the visual handicap, the trajectory geometry was identical between groups, with a small decrease in walking speed in RPs. These findings identify the adaptive changes in sensory-motor coordination, in order to ensure visual awareness of the surrounding, detect changes in spatial configuration, collect information for self-motion, update the postural reference frame, and update egocentric distances to environmental objects. They are of crucial importance for the design of optimized rehabilitation procedures.
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Affiliation(s)
- Colas N Authié
- UPMC Université Paris 06, UMR S968, Institut de la Vision, Sorbonne UniversitésParis, France.,Institut National de la Santé et de la Recherche Médicale, U968, Institut de la VisionParis, France.,Centre National de la Recherche Scientifique, UMR 7210, Institut de la VisionParis, France.,Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Institut National de la Santé et de la Recherche Médicale-DHOS CIC 1423Paris, France
| | - Alain Berthoz
- Equipe Pr Alain Berthoz Professeur Emérite au Collège de FranceParis, France
| | - José-Alain Sahel
- UPMC Université Paris 06, UMR S968, Institut de la Vision, Sorbonne UniversitésParis, France.,Institut National de la Santé et de la Recherche Médicale, U968, Institut de la VisionParis, France.,Centre National de la Recherche Scientifique, UMR 7210, Institut de la VisionParis, France.,Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Institut National de la Santé et de la Recherche Médicale-DHOS CIC 1423Paris, France.,Institute of Ophthalmology, University College LondonLondon, United Kingdom.,Fondation Ophtalmologique Adolphe de RothschildParis, France.,Department of Ophthalmology, School of Medicine, University of PittsburghPittsburgh, PA, United States
| | - Avinoam B Safran
- UPMC Université Paris 06, UMR S968, Institut de la Vision, Sorbonne UniversitésParis, France.,Institut National de la Santé et de la Recherche Médicale, U968, Institut de la VisionParis, France.,Centre National de la Recherche Scientifique, UMR 7210, Institut de la VisionParis, France.,Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Institut National de la Santé et de la Recherche Médicale-DHOS CIC 1423Paris, France.,Département des Neurosciences, Université de GenèveGeneva, Switzerland
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23
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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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24
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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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Jones L, Bryan SR, Crabb DP. Gradually Then Suddenly? Decline in Vision-Related Quality of Life as Glaucoma Worsens. J Ophthalmol 2017; 2017:1621640. [PMID: 28469940 PMCID: PMC5392404 DOI: 10.1155/2017/1621640] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 03/05/2017] [Indexed: 11/18/2022] Open
Abstract
Purpose. To evaluate the relationship between self-reported vision-related quality of life (VRQL) and visual field (VF) loss in people from glaucoma clinics. Methods. A postal survey using the National Eye Institute Visual Function Questionnaire (NEI VFQ-25) was administered to people with a range of VF loss identified from a UK hospital-based glaucoma service database. Trends were assessed in a composite score from NEI VFQ-25 against better-eye mean deviation (BEMD) using linear regression and a spline-fitting method that can highlight where a monotonic relationship may have different stages. Results. A total of 636 patients (median [interquartile range] BEMD -2.1 [-5.2, -0.4] dB, median age 70 [60, 77] years) were analysed. Analysis of trends in the data revealed an average patient loses approximately 2 units (out of 100) on NEI VFQ-25 for every loss of 1 dB (BEMD) as VF defects first become bilateral, up to BEMD -5 dB. NEI VFQ-25 deterioration then appears to slow before a more rapid phase of change (4-5 units per 1 dB loss) after BEMD worsens beyond -15 dB. Conclusions. Relationship between decline in VRQL and VF worsening in glaucoma is unlikely to be linear; it more likely has different phases, and these should be further explored in longitudinal studies.
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Affiliation(s)
- Lee Jones
- Division of Optometry and Visual Science, School of Health Sciences, City, University of London, London, UK
| | - Susan R. Bryan
- Division of Optometry and Visual Science, School of Health Sciences, City, University of London, London, UK
| | - David P. Crabb
- Division of Optometry and Visual Science, School of Health Sciences, City, University of London, London, UK
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Abstract
Recent years have witnessed a remarkable growth in the way mathematics, informatics, and computer science can process data. In disciplines such as machine learning,
pattern recognition, computer vision, computational neurology, molecular biology,
information retrieval, etc., many new methods have been developed to cope with the
ever increasing amount and complexity of the data. These new methods offer interesting possibilities for processing, classifying and interpreting eye-tracking data. The
present paper exemplifies the application of topological arguments to improve the
evaluation of eye-tracking data. The task of classifying raw eye-tracking data into
saccades and fixations, with a single, simple as well as intuitive argument, described
as coherence of spacetime, is discussed, and the hierarchical ordering of the fixations
into dwells is shown. The method, namely identification by topological characteristics
(ITop), is parameter-free and needs no pre-processing and post-processing of the raw
data. The general and robust topological argument is easy to expand into complex
settings of higher visual tasks, making it possible to identify visual strategies.
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Affiliation(s)
- Oliver Hein
- Neurological University Clinic Hamburg UKE, Germany
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Eye-Tracking as a Tool to Evaluate Functional Ability in Everyday Tasks in Glaucoma. J Ophthalmol 2017; 2017:6425913. [PMID: 28293433 PMCID: PMC5331274 DOI: 10.1155/2017/6425913] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 11/26/2016] [Accepted: 12/21/2016] [Indexed: 11/23/2022] Open
Abstract
To date, few studies have investigated the eye movement patterns of individuals with glaucoma while they undertake everyday tasks in real-world settings. While some of these studies have reported possible compensatory gaze patterns in those with glaucoma who demonstrated good task performance despite their visual field loss, little is known about the complex interaction between field loss and visual scanning strategies and the impact on task performance and, consequently, on quality of life. We review existing approaches that have quantified the effect of glaucomatous visual field defects on the ability to undertake everyday activities through the use of eye movement analysis. Furthermore, we discuss current developments in eye-tracking technology and the potential for combining eye-tracking with virtual reality and advanced analytical approaches. Recent technological developments suggest that systems based on eye-tracking have the potential to assist individuals with glaucomatous loss to maintain or even improve their performance on everyday tasks and hence enhance their long-term quality of life. We discuss novel approaches for studying the visual search behavior of individuals with glaucoma that have the potential to assist individuals with glaucoma, through the use of personalized programs that take into consideration the individual characteristics of their remaining visual field and visual search behavior.
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Impact of Peripheral Field Loss on the Execution of Natural Actions: A Study With Glaucomatous Patients and Normally Sighted People. J Glaucoma 2016; 25:e889-e896. [DOI: 10.1097/ijg.0000000000000402] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Glen FC, Crabb DP. Living with glaucoma: a qualitative study of functional implications and patients' coping behaviours. BMC Ophthalmol 2015; 15:128. [PMID: 26445483 PMCID: PMC4596492 DOI: 10.1186/s12886-015-0119-7] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 09/28/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sight loss from glaucoma can have a significant impact on functioning and performing everyday activities, but this varies between patients. The purpose of this study was to explore whether patients with glaucoma use different coping strategies in response to their vision loss. METHODS Audio-recorded semi-structured interviews were conducted with 16 patients (median age: 71 [interquartile range [IQR]: 68 to 77 years]; 50 % female) about their experiences of living with glaucoma. Patients had their glaucoma diagnosis for at least 5 years (range: 6 to 29 years) and had a range of disease severities (median best eye Mean Deviation was -9.1 dB [IQR: -12.9 to -4.1 dB]). A framework approach to analysis was taken whereby data was indexed using manual and computer-assisted methods, with codes applied to depict areas of functioning perceived to be impacted by glaucoma and coping behaviours used in response to these difficulties. RESULTS In order to maintain independence, some patients increased confidence by making practical changes such as adjusting lighting, using handrails and magnifying glasses, or actively changed aspects of their behaviour such as moving their head and eyes towards known areas of vision loss. Support from friends and family was often used, although some people worried about becoming a burden. Others imposed self-restrictions or gave up activities, thus compromising well-being and independence. Certain coping strategies were linked to time since diagnosis and location of vision loss. The type and quality of information received during clinical appointments, and the potential benefits of communication with other patients, emerged as other important themes. CONCLUSIONS Results from this qualitative study suggest that the adoption of certain coping behaviours and techniques may help some glaucomatous patients to adapt to their condition. An awareness of coping and adaptive strategies, in addition to the usual clinical tests, may provide a better insight into the impact of disease and help inform future educational and management strategies for glaucoma.
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Affiliation(s)
- Fiona C Glen
- Division of Optometry and Visual Science, School of Health Sciences, City University London, Northampton Square, London, EC1V 0HB, UK.
| | - David P Crabb
- Division of Optometry and Visual Science, School of Health Sciences, City University London, Northampton Square, London, EC1V 0HB, UK.
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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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Nguyen AM, van Landingham SW, Massof RW, Rubin GS, Ramulu PY. Reading ability and reading engagement in older adults with glaucoma. Invest Ophthalmol Vis Sci 2014; 55:5284-90. [PMID: 25052992 DOI: 10.1167/iovs.14-14138] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE We evaluated the impact of glaucoma-related vision loss on reading ability and reading engagement in 10 reading activities. METHODS A total of 63 glaucoma patients and 59 glaucoma suspect controls self-rated their level of reading difficulty for 10 reading items, and responses were analyzed using Rasch analysis to determine reading ability. Reading engagement was assessed by asking subjects to report the number of days per week they engaged in each reading activity. Reading restriction was determined as a decrement in engagement. RESULTS Glaucoma subjects more often described greater reading difficulty than controls for all tasks except puzzles (P < 0.05). The most difficult reading tasks involved puzzles, books, and finances, while the least difficult reading tasks involved notes, bills, and mail. In multivariable weighted least squares regression models of Rasch-estimated person measures of reading ability, less reading ability was found for glaucoma patients compared to controls (β = -1.60 logits, P < 0.001). Among glaucoma patients, less reading ability was associated with more severe visual field (VF) loss (β = -0.68 logits per 5-dB decrement in better-eye VF mean deviation [MD], P < 0.001) and contrast sensitivity (β = -0.76 logits per 0.1-unit lower log CS, P < 0.001). Each 5-dB decrement in the better-eye VF MD was associated with book reading on 18% fewer days (P = 0.003) and newspaper reading on 10% fewer days (P = 0.008). No statistically significant reading restriction was observed for other reading activities (P > 0.05). CONCLUSIONS Glaucoma patients have less reading ability and engage less in a variety of different reading activities, particularly those requiring sustained reading. Future work should evaluate the mechanisms underlying reading disability in glaucoma to determine how patients can maintain reading ability and engagement.
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Affiliation(s)
- Angeline M Nguyen
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
| | | | - Robert W Massof
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
| | - Gary S Rubin
- National Institute for Health Research Biomedical Research Centre (NIHR BRC) for Ophthalmology, University College London (UCL) Institute of Ophthalmology and Moorfields Eye Hospital, London, United Kingdom Visual Neuroscience, UCL Institute of Ophthalmology, London, United Kingdom
| | - Pradeep Y Ramulu
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
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Using eye tracking to assess reading performance in patients with glaucoma: a within-person study. J Ophthalmol 2014; 2014:120528. [PMID: 24883203 PMCID: PMC4026991 DOI: 10.1155/2014/120528] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 03/12/2014] [Indexed: 11/18/2022] Open
Abstract
Reading is often cited as a demanding task for patients with glaucomatous visual field (VF) loss, yet reading speed varies widely between patients and does not appear to be predicted by standard visual function measures. This within-person study aimed to investigate reading duration and eye movements when reading short passages of text in a patient's worse eye (most VF damage) when compared to their better eye (least VF damage). Reading duration and saccade rate were significantly different on average in the worse eye when compared to the better eye (P < 0.001) in 14 patients with glaucoma that had median (interquartile range) between-eye difference in mean deviation (MD; a standard clinical measure for VF loss) of 9.8 (8.3 to 14.8) dB; differences were not related to the size of the difference in MD between eyes. Patients with a more pronounced effect of longer reading duration on their worse eye made a larger proportion of "regressions" (backward saccades) and "unknown" EMs (not adhering to expected reading patterns) when reading with the worse eye when compared to the better eye. A between-eye study in patients with asymmetric disease, coupled with eye tracking, provides a useful experimental design for exploring reading performance in glaucoma.
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Glen FC, Smith ND, Crabb DP. Saccadic eye movements and face recognition performance in patients with central glaucomatous visual field defects. Vision Res 2013; 82:42-51. [DOI: 10.1016/j.visres.2013.02.010] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Revised: 02/07/2013] [Accepted: 02/09/2013] [Indexed: 11/30/2022]
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