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Skelton AE, Franklin A, Bosten JM. Colour vision is aligned with natural scene statistics at 4 months of age. Dev Sci 2023; 26:e13402. [PMID: 37138516 DOI: 10.1111/desc.13402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 03/23/2023] [Accepted: 03/28/2023] [Indexed: 05/05/2023]
Abstract
Visual perception in adult humans is thought to be tuned to represent the statistical regularities of natural scenes. For example, in adults, visual sensitivity to different hues shows an asymmetry which coincides with the statistical regularities of colour in the natural world. Infants are sensitive to statistical regularities in social and linguistic stimuli, but whether or not infants' visual systems are tuned to natural scene statistics is currently unclear. We measured colour discrimination in infants to investigate whether or not the visual system can represent chromatic scene statistics in very early life. Our results reveal the earliest association between vision and natural scene statistics that has yet been found: even as young as 4 months of age, colour vision is aligned with the distributions of colours in natural scenes. RESEARCH HIGHLIGHTS: We find infants' colour sensitivity is aligned with the distribution of colours in the natural world, as it is in adults. At just 4 months, infants' visual systems are tailored to extract and represent the statistical regularities of the natural world. This points to a drive for the human brain to represent statistical regularities even at a young age.
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Affiliation(s)
- Alice E Skelton
- The Sussex Colour Group & Sussex Baby Lab, University of Sussex, Brighton, UK
| | - Anna Franklin
- The Sussex Colour Group & Sussex Baby Lab, University of Sussex, Brighton, UK
| | - Jenny M Bosten
- The Sussex Vision Lab, University of Sussex, Brighton, UK
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Lima DDS, Ventura DF. A review of experimental task design in psychophysical eye tracking research. Front Hum Neurosci 2023; 17:1112769. [PMID: 37662635 PMCID: PMC10469886 DOI: 10.3389/fnhum.2023.1112769] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 07/28/2023] [Indexed: 09/05/2023] Open
Abstract
While eye tracking is a technique commonly used in the experimental study of higher-level perceptual processes such as visual search, working memory, reading, and scene exploration, its use for the quantification of basic visual functions (visual acuity, contrast sensitivity, color vision, motion detection) is less explored. The use of eye movement features as dependent variables in a psychophysical investigation can serve multiple roles. They can be central in studies with neurological patients or infants that cannot comply with verbal instructions, understand task demands, and/or emit manual responses. The technique may also serve a complementary role, determining the conditions under which a manual or verbal response is given, such as stimulus position in the visual field, or it can afford the analysis of new dependent variables, such as the time interval between oculomotor and manual responses. Our objective is to review the literature that applied the eye tracking technique to psychophysical problems. The two questions our review raises are: can eye movements (reflex or voluntary) be an objective index of stimulus detection in psychophysical tasks? If so, under what conditions, and how does it compare with traditional paradigms requiring manual responses? Our (non-systematic) methodological review selected studies that used video-oculography as the technique of choice and had a basic visual function as their primary object of investigation. Studies satisfying those criteria were then categorized into four broad classes reflecting their main research interest: (1) stimulus detection and threshold estimation, (2) the effects of stimulus properties on fixational eye movements, (3) the effects of eye movements on perception, and (4) visual field assessment. The reviewed studies support the idea that eye tracking is a valuable technique for the study of basic perceptual processes. We discuss methodological characteristics within each of the proposed classification area, with the objective of informing future task design.
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Affiliation(s)
- Diego da Silva Lima
- Laboratory of Clinical Visual Psychophysics and Electrophysiology, University of São Paulo, São Paulo, Brazil
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Holmqvist K, Örbom SL, Hooge ITC, Niehorster DC, Alexander RG, Andersson R, Benjamins JS, Blignaut P, Brouwer AM, Chuang LL, Dalrymple KA, Drieghe D, Dunn MJ, Ettinger U, Fiedler S, Foulsham T, van der Geest JN, Hansen DW, Hutton SB, Kasneci E, Kingstone A, Knox PC, Kok EM, Lee H, Lee JY, Leppänen JM, Macknik S, Majaranta P, Martinez-Conde S, Nuthmann A, Nyström M, Orquin JL, Otero-Millan J, Park SY, Popelka S, Proudlock F, Renkewitz F, Roorda A, Schulte-Mecklenbeck M, Sharif B, Shic F, Shovman M, Thomas MG, Venrooij W, Zemblys R, Hessels RS. Eye tracking: empirical foundations for a minimal reporting guideline. Behav Res Methods 2023; 55:364-416. [PMID: 35384605 PMCID: PMC9535040 DOI: 10.3758/s13428-021-01762-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2021] [Indexed: 11/08/2022]
Abstract
In this paper, we present a review of how the various aspects of any study using an eye tracker (such as the instrument, methodology, environment, participant, etc.) affect the quality of the recorded eye-tracking data and the obtained eye-movement and gaze measures. We take this review to represent the empirical foundation for reporting guidelines of any study involving an eye tracker. We compare this empirical foundation to five existing reporting guidelines and to a database of 207 published eye-tracking studies. We find that reporting guidelines vary substantially and do not match with actual reporting practices. We end by deriving a minimal, flexible reporting guideline based on empirical research (Section "An empirically based minimal reporting guideline").
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Affiliation(s)
- Kenneth Holmqvist
- Department of Psychology, Nicolaus Copernicus University, Torun, Poland.
- Department of Computer Science and Informatics, University of the Free State, Bloemfontein, South Africa.
- Department of Psychology, Regensburg University, Regensburg, Germany.
| | - Saga Lee Örbom
- Department of Psychology, Regensburg University, Regensburg, Germany
| | - Ignace T C Hooge
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - Diederick C Niehorster
- Lund University Humanities Lab and Department of Psychology, Lund University, Lund, Sweden
| | - Robert G Alexander
- Department of Ophthalmology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | | | - Jeroen S Benjamins
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
- Social, Health and Organizational Psychology, Utrecht University, Utrecht, The Netherlands
| | - Pieter Blignaut
- Department of Computer Science and Informatics, University of the Free State, Bloemfontein, South Africa
| | | | - Lewis L Chuang
- Department of Ergonomics, Leibniz Institute for Working Environments and Human Factors, Dortmund, Germany
- Institute of Informatics, LMU Munich, Munich, Germany
| | | | - Denis Drieghe
- School of Psychology, University of Southampton, Southampton, UK
| | - Matt J Dunn
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK
| | | | - Susann Fiedler
- Vienna University of Economics and Business, Vienna, Austria
| | - Tom Foulsham
- Department of Psychology, University of Essex, Essex, UK
| | | | - Dan Witzner Hansen
- Machine Learning Group, Department of Computer Science, IT University of Copenhagen, Copenhagen, Denmark
| | | | - Enkelejda Kasneci
- Human-Computer Interaction, University of Tübingen, Tübingen, Germany
| | | | - Paul C Knox
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Ellen M Kok
- Department of Education and Pedagogy, Division Education, Faculty of Social and Behavioral Sciences, Utrecht University, Utrecht, The Netherlands
- Department of Online Learning and Instruction, Faculty of Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - Helena Lee
- University of Southampton, Southampton, UK
| | - Joy Yeonjoo Lee
- School of Health Professions Education, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Jukka M Leppänen
- Department of Psychology and Speed-Language Pathology, University of Turku, Turku, Finland
| | - Stephen Macknik
- Department of Ophthalmology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Päivi Majaranta
- TAUCHI Research Center, Computing Sciences, Faculty of Information Technology and Communication Sciences, Tampere University, Tampere, Finland
| | - Susana Martinez-Conde
- Department of Ophthalmology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Antje Nuthmann
- Institute of Psychology, University of Kiel, Kiel, Germany
| | - Marcus Nyström
- Lund University Humanities Lab, Lund University, Lund, Sweden
| | - Jacob L Orquin
- Department of Management, Aarhus University, Aarhus, Denmark
- Center for Research in Marketing and Consumer Psychology, Reykjavik University, Reykjavik, Iceland
| | - Jorge Otero-Millan
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, CA, USA
| | - Soon Young Park
- Comparative Cognition, Messerli Research Institute, University of Veterinary Medicine Vienna, Medical University of Vienna, Vienna, Austria
| | - Stanislav Popelka
- Department of Geoinformatics, Palacký University Olomouc, Olomouc, Czech Republic
| | - Frank Proudlock
- The University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Frank Renkewitz
- Department of Psychology, University of Erfurt, Erfurt, Germany
| | - Austin Roorda
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, CA, USA
| | | | - Bonita Sharif
- School of Computing, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Frederick Shic
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA
- Department of General Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - Mark Shovman
- Eyeviation Systems, Herzliya, Israel
- Department of Industrial Design, Bezalel Academy of Arts and Design, Jerusalem, Israel
| | - Mervyn G Thomas
- The University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Ward Venrooij
- Electrical Engineering, Mathematics and Computer Science (EEMCS), University of Twente, Enschede, The Netherlands
| | | | - Roy S Hessels
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
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Hepler LE, Martin SJ, Fuglseth K, Cuddihee L, Giannulis P, Arnold RW. Acuity Comparison Methods via Timed Test-Retest Precision of Matching-Card e-ETDRS Compared to PDI Check in Treated Amblyopes and Superb Normals. CLINICAL OPTOMETRY 2023; 15:81-95. [PMID: 37159586 PMCID: PMC10163880 DOI: 10.2147/opto.s409358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 04/26/2023] [Indexed: 05/11/2023]
Abstract
Purpose Existing and emerging visual acuity methods like dynamic and dichoptic presentation, preferential looking and eye tracking promise to afford better and earlier assessment in children with and without amblyopia so we propose methods needed to easily evaluate and compare their metrics. Subjects and Methods Patients older than 8 years with treated amblyopia and superb vision (logMAR -0.1 to -0.3) normals performed timed, patched eETDRS with Sloan matching card at 3.00 m and PDI Check dichoptic near rivalry dynamic test to demonstrate test re-Test and compared disparate acuity with intraclass correlation (ICC) and Bland Altman 95% limits of agreement (LOA) to generate a simple method of qualifying acuity test matching. Results 26 amblyopic patients and 11 superb-vision normals performed eETDRS retest, PDI Check retest and combined ICC of 0.98, 0.60 and 0.27, respectively, and Bland Altman LOA of 0.24, 2.06 and 2.28 logMAR. The time to test one eye with eETDRS had median (interquartile range; IQR) duration of 280 (205 to 346) seconds, while the PDI Check autostereoscopic dichoptic for both eyes only took 39 (30 to 47) seconds. Optimum ICC and LOA for visual acuity comparison should be >0.95 and <0.3 logMAR, whereas "good" ICC and should be 0.75-0.89 ICC and 1.0-1.49 logMAR LOA. Conclusion Superb vision subjects (logMAR < -0.1) and treated amblyopic patients confirmed optimum comparable eETDRS, and fair test re-Test PDI Check but suppression on near dichoptic testing confirmed disparity compared to optimized eETDRS distance acuity.
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Affiliation(s)
- Lucas E Hepler
- College of Osteopathic Medicine, Pacific Northwest University, Yakima, WA, USA
| | - Samuel J Martin
- School of Medicine, Loma Linda University, Loma Linda, CA, USA
| | - Kennedy Fuglseth
- College of Osteopathic Medicine, Pacific Northwest University, Yakima, WA, USA
| | - Laney Cuddihee
- Alaska Blind Child Discovery, Alaska Children’s EYE & Strabismus, Anchorage, AK, USA
| | - Peter Giannulis
- Alaska Blind Child Discovery, Alaska Children’s EYE & Strabismus, Anchorage, AK, USA
| | - Robert W Arnold
- Alaska Blind Child Discovery, Alaska Children’s EYE & Strabismus, Anchorage, AK, USA
- Correspondence: Robert W Arnold, Alaska Blind Child Discovery, Alaska Children’s EYE & Strabismus, 3500 Latouche #280, Anchorage, AK, 99508, USA, Tel +1907561-1917, Fax +1907563-5373, Email
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Sumalini R, Satgunam P. Grating acuity tests for infants, young children and individuals with disabilities: A review of recent advances. Semin Ophthalmol 2023; 38:76-84. [PMID: 36073743 DOI: 10.1080/08820538.2022.2116987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Accurate measurement of visual acuity is important in managing any ocular condition. Measuring visual acuity has always remained a challenge in infants, young children and individuals with disabilities who are unable to respond verbally. A variety of pediatric acuity tests that include both grating and recognition acuities have been described in the literature, some of which are outdated. This review paper aims to summarize the currently available and recently developed grating acuity tests that can be used for infants, young children and individuals with disabilities. METHODS A review of literature was carried out to identify tests that were currently available and recently developed. Additionally, search was also done on popular search engines and websites of companies. Tests identified were screened for availability and investigated for validity through published research in peer-reviewed journals. RESULTS A total of eight grating acuity tests were identified, out of which six of them were paper-based tests. The remaining two tests were app-based tests with established data for the typically developing pediatric cohort. The repeatability indices were available only for four grating acuity tests. CONCLUSIONS This review paper summarizes the basic features of the grating acuity tests and importantly, the parameters that determine the clinical utility of the tests such as the testability, acuity range, specific cohort studied, testing time and reliability indices. The paper also discusses the recent technological advancements in the field of acuity testing for the pediatric cohort and its comparisons with the conventional methods when available.
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Affiliation(s)
- Rebecca Sumalini
- Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India.,Institute for Vision Rehabilitation, L V Prasad Eye Institute, Hyderabad, India.,School of Health Sciences, Division of Optometry and Visual Sciences, City, University of London, London, UK
| | - PremNandhini Satgunam
- Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India
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Pérez Roche MT, Yam JC, Liu H, Gutierrez D, Pham C, Balasanyan V, García G, Cedillo Ley M, de Fernando S, Ortín M, Pueyo V. Visual Acuity and Contrast Sensitivity in Preterm and Full-Term Children Using a Novel Digital Test. CHILDREN (BASEL, SWITZERLAND) 2022; 10:children10010087. [PMID: 36670638 PMCID: PMC9856886 DOI: 10.3390/children10010087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/08/2022] [Accepted: 12/21/2022] [Indexed: 01/03/2023]
Abstract
Visual assessment in preverbal children mostly relies on the preferential looking paradigm. It requires an experienced observer to interpret the child's responses to a stimulus. DIVE (Device for an Integral Visual Examination) is a digital tool with an integrated eye tracker (ET) that lifts this requirement and automatizes this process. The aim of our study was to assess the development of two visual functions, visual acuity (VA) and contrast sensitivity (CS), with DIVE, in a large sample of children from 6 months to 14 years (y) of age, and to compare the results of preterm and full-term children. Participants were recruited in clinical settings from five countries. There were 2208 children tested, 609 of them were born preterm. Both VA and CS improved throughout childhood, with the maximum increase during the first 5 years of age. Gestational age, refractive error and age had an impact on VA results, while CS values were only influenced by age. With this study we report normative reference outcomes for VA and CS throughout childhood and validate the DIVE tests as a useful tool to measure basic visual functions in children.
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Affiliation(s)
- María Teresa Pérez Roche
- Ofthalmology Department, Miguel Servet University Hospital, 50009 Zaragoza, Spain
- Aragon Institute of Heatlh Research (IIS Aragón), 50009 Zaragoza, Spain
| | | | - Hu Liu
- The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Diego Gutierrez
- I3A Institute for Research in Engineering, Universidad de Zaragoza, 50009 Zaragoza, Spain
| | - Chau Pham
- National Institute of Ophthalmology, Hanoi 100000, Vietnam
| | | | - Gerardo García
- Strabismus and Pediatric Ophthalmology Department, Hospital de la Ceguera, APEC, Ciudad de Mexico 04030, Mexico
| | - Mauricio Cedillo Ley
- Strabismus and Pediatric Ophthalmology Department, Hospital de la Ceguera, APEC, Ciudad de Mexico 04030, Mexico
| | - Sandra de Fernando
- Ophthalmology Department, Cruces University Hospital, 48903 Barakaldo, Spain
| | | | - Victoria Pueyo
- Ofthalmology Department, Miguel Servet University Hospital, 50009 Zaragoza, Spain
- Aragon Institute of Heatlh Research (IIS Aragón), 50009 Zaragoza, Spain
- Correspondence:
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Wen J, Yang B, Li X, Cui J, Wang L. Automated assessment of grating acuity in infants and toddlers using an eye-tracking system. J Vis 2022; 22:8. [DOI: 10.1167/jov.22.12.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Jing Wen
- Department of Pediatric Ophthalmology, Peking University First Hospital, Peking University Children Vison Institute, Peking University, Beijing, China
| | - Bikun Yang
- Key Laboratory of Machine Perception, Peking University, Beijing, China
| | - Xiaoqing Li
- Department of Pediatric Ophthalmology, Peking University First Hospital, Peking University Children Vison Institute, Peking University, Beijing, China
| | - Jinshi Cui
- Key Laboratory of Machine Perception, Peking University, Beijing, China
| | - Li Wang
- School of Psychological and Cognitive Sciences, Peking University, Beijing, China
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Schlegelmilch K, Wertz AE. Visual segmentation of complex naturalistic structures in an infant eye-tracking search task. PLoS One 2022; 17:e0266158. [PMID: 35363809 PMCID: PMC8975119 DOI: 10.1371/journal.pone.0266158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/15/2022] [Indexed: 11/24/2022] Open
Abstract
An infant’s everyday visual environment is composed of a complex array of entities, some of which are well integrated into their surroundings. Although infants are already sensitive to some categories in their first year of life, it is not clear which visual information supports their detection of meaningful elements within naturalistic scenes. Here we investigated the impact of image characteristics on 8-month-olds’ search performance using a gaze contingent eye-tracking search task. Infants had to detect a target patch on a background image. The stimuli consisted of images taken from three categories: vegetation, non-living natural elements (e.g., stones), and manmade artifacts, for which we also assessed target background differences in lower- and higher-level visual properties. Our results showed that larger target-background differences in the statistical properties scaling invariance and entropy, and also stimulus backgrounds including low pictorial depth, predicted better detection performance. Furthermore, category membership only affected search performance if supported by luminance contrast. Data from an adult comparison group also indicated that infants’ search performance relied more on lower-order visual properties than adults. Taken together, these results suggest that infants use a combination of property- and category-related information to parse complex visual stimuli.
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Affiliation(s)
- Karola Schlegelmilch
- Max Planck Research Group Naturalistic Social Cognition, Max Planck Institute for Human Development, Berlin, Germany
- * E-mail:
| | - Annie E. Wertz
- Max Planck Research Group Naturalistic Social Cognition, Max Planck Institute for Human Development, Berlin, Germany
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Leppänen JM, Butcher JW, Godbout C, Stephenson K, Hendrixson DT, Griswold S, Rogers BL, Webb P, Koroma AS, Manary MJ. Assessing infant cognition in field settings using eye-tracking: a pilot cohort trial in Sierra Leone. BMJ Open 2022; 12:e049783. [PMID: 35177442 PMCID: PMC8860005 DOI: 10.1136/bmjopen-2021-049783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES To investigate the feasibility of eye-tracking-based testing of the speed of visual orienting in malnourished young children at rural clinics in Sierra Leone. DESIGN Prospective dual cohort study nested in a cluster-randomised trial. SETTING 8 sites participating in a cluster-randomised trial of supplementary feeding for moderate acute malnutrition (MAM). PARTICIPANTS For the MAM cohort, all infants aged 7-11 months at the eight sites were enrolled, 138 altogether. For controls, a convenience sample of all non-malnourished infants aged 7-11 months at the same sites were eligible, 60 altogether. A sample of 30 adults at the sites also underwent eye-tracking tests as a further control. INTERVENTIONS Infants with MAM were provided with supplementary feeding. OUTCOME MEASURES The primary outcomes were feasibility and reliability of eye-tracking-based testing of saccadic reaction time (SRT). Feasibility was assessed by the percent of successful tests in the infants. Reliability was measured with intraclass correlation coefficients (ICCs). Secondary outcomes were mean SRT based on nutritional state as well as and changes in mean SRT after supplementary feeding of MAM children. RESULTS Infants exhibited consistent orienting to targets on a computer screen (>95% of valid trials). Mean SRTs had moderate stability within visits (ICCs 0.60-0.69) and across the 4-week test-retest interval (0.53) in infants; the adult control group had greater SRT stability (within visit ICC=0.92). MAM infants had a trend toward higher adjusted SRT at baseline (difference=12.4 ms, 95% CI -2 to 26.9, p=0.09) and improvement in SRT 4 weeks thereafter (difference=-14 ms, 95% CI -26.2 to -1.7, p=0.025) compared with age-matched controls. CONCLUSIONS The results demonstrate the feasibility of eye-tracking-based testing in a resource-poor field setting and suggest eye-tracking measures have utility in the detection of group level effects of supplementary feeding.
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Affiliation(s)
- Jukka M Leppänen
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | | | - Claire Godbout
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri, USA
| | - Kevin Stephenson
- Department of Internal Medicine, Washington University in St Louis School of Medicine, St Louis, Missouri, USA
| | - D Taylor Hendrixson
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri, USA
| | - Stacy Griswold
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Beatrice Lorge Rogers
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Patrick Webb
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, USA
| | - Aminata S Koroma
- Food and Nutrition, Sierra Leone Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Mark J Manary
- Department of Pediatrics, Washington University in St Louis School of Medicine, St Louis, Missouri, USA
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10
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Age norms for grating acuity and contrast sensitivity in children using eye tracking technology. Int Ophthalmol 2021; 42:747-756. [PMID: 34622374 DOI: 10.1007/s10792-021-02040-4] [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: 02/25/2021] [Accepted: 09/22/2021] [Indexed: 10/20/2022]
Abstract
KEY MESSAGES Visual acuity is the most used method to assess visual function in children. Contrast sensitivity complements the information provided for visual acuity, but it is not commonly used in clinical practice. Digital devices are increasingly used as a method to evaluate visual function, due to multiple advantages. Testing with these devices can improve the evaluation of visual development in children from a few months of age. Visual acuity and contrast sensitivity tests, using eye tracking technology, are able to measure visual function in children across a wide range of ages, objectively, quickly and without need of an experienced examiner. PURPOSE To report age-normative values for grating visual acuity and contrast sensitivity in healthy children using a digital device with eye tracking technology and to validate the grating acuity test. METHODS In the first project of the study, we examined healthy children aged between 6 months and 7 years with normal ophthalmological assessment. Grating visual acuity (VA) and contrast sensitivity (CS) were assessed using a preferential gaze paradigm with a DIVE (Device for an Integral Visual Examination) assisted with eye tracking technology to provide age norms. For the validation project, we compared LEA grating test (LGT) with DIVE VA in a group of children aged between 6 months and 4 years with normal and abnormal visual development. RESULTS Fifty-seven children (2.86 ± 1.55 years) were examined with DIVE VA test and 44 successfully completed DIVE CS test (3.06 ± 1.41 years). Both, VA and CS values increased with age, mainly along the first two years of life. Sixty-nine patients (1.34 ± 0.61 years) were included in the DIVE VA test validation. The mean difference between LGT and DIVE VA was - 1.05 ± 4.54 cpd with 95% limits of agreement (LoA) of - 9.95-7.84 cpd. Agreement between the two tests was higher in children younger than 1 year with a mean difference of - 0.19 ± 4.02 cpd. CONCLUSIONS DIVE is an automatic, objective and reliable tool to assess several visual function parameters in children, and it has good agreement with classical VA tests, especially for the first stage of life.
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11
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Perperidis A, McTrusty AD, Cameron LA, Murray IC, Brash HM, Fleck BW, Minns RA, Tatham AJ. The Assessment of Visual Fields in Infants Using Saccadic Vector Optokinetic Perimetry (SVOP): A Feasibility Study. Transl Vis Sci Technol 2021; 10:14. [PMID: 34003948 PMCID: PMC7961122 DOI: 10.1167/tvst.10.3.14] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 12/30/2020] [Indexed: 11/30/2022] Open
Abstract
Purpose To examine the feasibility of saccadic vector optokinetic perimetry (SVOP), an automated eye tracking perimeter, as a tool for visual field (VF) assessment in infants. Methods Thirteen healthy infants aged between 3.5 and 12.0 months were tested binocularly using an adapted SVOP protocol. SVOP uses eye tracking technology to measure gaze responses to stimuli presented on a computer screen. Modifications of SVOP for testing infants included adjusting the fixation target to display a short animation, increasing the stimulus size to equivalent to Goldmann V, and introducing a tiered test pattern strategy. Binocular, single-quadrant confrontation VF testing and Keeler preferential looking cards visual acuity testing was also performed. Results Using multiple test attempts when required, all but the youngest infant (12 of 13 [92.3%]) successfully completed a 4-point screening test. Seven infants (53.8%) successfully completed the 12-point test, four (30.8%) successfully completed the 20-point test, and three (23.1%) successfully completed the 40-point test. The effect of multiple test attempts and the complexity of the test pattern (number of test points) on performance was investigated, including test completion rate, percentage of correctly seen stimuli, and average time per tested stimulus. Conclusions The modified SVOP test strategy allowed successful assessment of binocular VFs in healthy infants. Future data collection from larger cohorts of infants is needed to derive normative limits of detection and assess accuracy in detecting and monitoring infant VF abnormalities. Translational Relevance Eye tracking perimetry may provide a useful method of automated VF assessment in infants.
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Affiliation(s)
- Antonios Perperidis
- Department of Child Life and Health, University of Edinburgh, Edinburgh, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Alice D. McTrusty
- Department of Child Life and Health, University of Edinburgh, Edinburgh, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Lorraine A. Cameron
- Department of Child Life and Health, University of Edinburgh, Edinburgh, UK
- Department of Vision Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Ian C. Murray
- Department of Child Life and Health, University of Edinburgh, Edinburgh, UK
| | - Harry M. Brash
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Brian W. Fleck
- Department of Child Life and Health, University of Edinburgh, Edinburgh, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Princess Alexandra Eye Pavilion, Edinburgh, UK
| | - Robert A. Minns
- Department of Child Life and Health, University of Edinburgh, Edinburgh, UK
- Royal Hospital for Sick Children, Edinburgh, UK
| | - Andrew J. Tatham
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Princess Alexandra Eye Pavilion, Edinburgh, UK
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12
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Mooney SWJ, Alam NM, Hill NJ, Prusky GT. Gradiate: A radial sweep approach to measuring detailed contrast sensitivity functions from eye movements. J Vis 2020; 20:17. [PMID: 33369613 PMCID: PMC7774112 DOI: 10.1167/jov.20.13.17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 11/07/2020] [Indexed: 11/24/2022] Open
Abstract
The contrast sensitivity function (CSF) is an informative measure of visual health, but the practical difficulty of measuring it has impeded detailed analyses of its relationship to different visual disorders. Furthermore, most existing tasks cannot be used in populations with cognitive impairment. We analyzed detailed CSFs measured with a nonverbal procedure called "Gradiate," which efficiently infers visibility from eye movements and manipulates stimulus appearance in real time. Sixty observers of varying age (38 with refractive error) were presented with moving stimuli. Stimulus spatial frequency and contrast advanced along 15 radial sweeps through CSF space in response to stimulus-congruent eye movements. A point on the CSF was recorded when tracking ceased. Gradiate CSFs were reliable and in high agreement with independent low-contrast acuity thresholds. Overall CSF variation was largely captured by two orthogonal factors ("radius" and "slope") or two orthogonal shape factors when size was normalized ("aspect ratio" and "curvature"). CSF radius was highly predictive of LogMAR acuity, as were aspect ratio and curvature together, but only radius was predictive of observer age. Our findings suggest that Gradiate holds promise for assessing spatial vision in both verbal and nonverbal populations and indicate that variation between detailed CSFs can reveal useful information about visual health.
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Affiliation(s)
- Scott W J Mooney
- Burke Neurological Institute, White Plains, NY, USA
- Blythedale Children's Hospital, Valhalla, NY, USA
| | - Nazia M Alam
- Burke Neurological Institute, White Plains, NY, USA
- Blythedale Children's Hospital, Valhalla, NY, USA
| | - N Jeremy Hill
- Burke Neurological Institute, White Plains, NY, USA
- Blythedale Children's Hospital, Valhalla, NY, USA
| | - Glen T Prusky
- Burke Neurological Institute, White Plains, NY, USA
- Blythedale Children's Hospital, Valhalla, NY, USA
- Weill Cornell Medical College, New York, NY, USA
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13
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Vrabič N, Juroš B, Tekavčič Pompe M. Automated Visual Acuity Evaluation Based on Preferential Looking Technique and Controlled with Remote Eye Tracking. Ophthalmic Res 2020; 64:389-397. [PMID: 33080607 DOI: 10.1159/000512395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 10/17/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To establish an automated visual acuity test (AVAT) for infants, based on preferential looking technique and controlled with remote eye tracking. To validate the AVAT in a group of healthy children. To compare AVAT visual acuity (VA) values with corresponding VA values acquired with standard tests (ST). METHODS ST, adapted for age (Keeler Acuity Cards in preverbal children and LEA symbols in verbal children), was performed to obtain monocular VA in a group of 36 healthy children. During AVAT, 9 different stimuli with grating circles that matched spatial frequencies of 9 Keeler Acuity Cards (ranging between 0.29 and 14.5 cycles per degree) were projected on a screen. Three repetitions of each stimulus were shown during 9-s intervals, interchanging with an attention grabber. The remote eye tracker was used to evaluate the proportion of time a child spent looking at each grating circle compared to a homogeneous gray background that matched the grating stimuli in average luminance. From this proportion of time, child's binocular VA was evaluated. RESULTS Ninety-seven percent (35/36) of healthy children successfully completed ST and AVAT. There was an agreement between the results of an ST and AVAT, with Lin's concordance coefficient being 0.53 (95% CI = 0.31-0.72). A tendency was observed toward VA overestimation on AVAT for children with VA >0.4 logMAR on ST and toward VA underestimation on AVAT for children with VA ≤0.4 logMAR on ST. CONCLUSIONS AVAT requires a minimally skilled investigator. The evaluation of better eye monocular VA on ST and binocular VA on AVAT was comparable for healthy children.
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Affiliation(s)
- Nika Vrabič
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | | | - Manca Tekavčič Pompe
- Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia, .,University Eye Clinic, University Medical Centre Ljubljana, Ljubljana, Slovenia,
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14
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Jones PR, Lindfield D, Crabb DP. Using an open-source tablet perimeter (Eyecatcher) as a rapid triage measure for glaucoma clinic waiting areas. Br J Ophthalmol 2020; 105:681-686. [PMID: 32747334 PMCID: PMC8077219 DOI: 10.1136/bjophthalmol-2020-316018] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 05/18/2020] [Accepted: 05/25/2020] [Indexed: 11/05/2022]
Abstract
Background Glaucoma services are under unprecedented strain. The UK Healthcare Safety Investigation Branch recently called for new ways to identify glaucoma patients most at risk of developing sight loss, and of filtering-out false-positive referrals. Here, we evaluate the feasibility of one such technology, Eyecatcher: a free, tablet-based ‘triage’ perimeter, designed to be used unsupervised in clinic waiting areas. Eyecatcher does not require a button or headrest: patients are simply required to look at fixed-luminance dots as they appear. Methods Seventy-seven people were tested twice using Eyecatcher (one eye only) while waiting for a routine appointment in a UK glaucoma clinic. The sample included individuals with an established diagnosis of glaucoma, and false-positive new referrals (no visual field or optic nerve abnormalities). No attempts were made to control the testing environment. Patients wore their own glasses and received minimal task instruction. Results Eyecatcher was fast (median: 2.5 min), produced results in good agreement with standard automated perimetry (SAP), and was rated as more enjoyable, less tiring and easier to perform than SAP (all p<0.001). It exhibited good separation (area under receiver operating characteristic=0.97) between eyes with advanced field loss (mean deviation (MD) < −6 dB) and those within normal limits (MD > −2 dB). And it was able to flag two thirds of false-positive referrals as functionally normal. However, eight people (10%) failed to complete the test twice, and reasons for this limitation are discussed. Conclusions Tablet-based eye-movement perimetry could potentially provide a pragmatic way of triaging busy glaucoma clinics (ie, flagging high-risk patients and possible false-positive referrals).
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Affiliation(s)
- Pete R Jones
- Division of Optometry and Visual Sciences, City University of London, London, UK
| | - Dan Lindfield
- Glaucoma Services, Royal Surrey County Hospital NHS Foundation Trust, Guildford, Surrey, UK
| | - David P Crabb
- Division of Optometry and Visual Sciences, City University of London, London, UK
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15
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16
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Jones PR. An Open-source Static Threshold Perimetry Test Using Remote Eye-tracking (Eyecatcher): Description, Validation, and Preliminary Normative Data. Transl Vis Sci Technol 2020; 9:18. [PMID: 32855865 PMCID: PMC7422828 DOI: 10.1167/tvst.9.8.18] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 05/12/2020] [Indexed: 01/06/2023] Open
Abstract
Purpose To describe, validate, and provide preliminary normative data for an open-source eye-movement perimeter (Eyecatcher). Methods Visual field testing was performed monocularly in 64 normally sighted young adults, using (i) a Humphrey Field Analyzer (HFA) and (ii) the novel Eyecatcher procedure. Eyecatcher used a remote eye-tracker to position stimuli relative to the current point of fixation, and observers responded by looking towards the stimulus. In both tests, Goldman III stimuli were sampled from a 24-2 grid, and were presented against a 10 cd/m2 background. Participants completed each test twice to assess test–retest repeatability. Results Mean Sensitivity (MS) did not differ between Eyecatcher and the HFA (P = 0.086), and both tests exhibited similar test–retest repeatability (CoREyecatcher = ±1.86 dB; CoRHFA = ±1.95 dB). Eyecatcher was also able to detect changes in sensitivity across the normal visual field (the “Hill of Vision”), and could differentiate the physiological blind spot from adjacent retinal locations. Mean sensitivities and 95% limits of agreement are described for each pointwise location. Conclusions Eyecatcher can use eye movements to assess visual fields in young, normally sighted adults. In such observers, it provides results similar to the current gold standard clinical device (HFA). Translational Relevance Given further development, eye movement perimeters such as Eyecatcher could be particularly useful for individuals unable to perform traditional perimetric assessments, such as young children or stroke patients. Full technical details and information on how to freely acquire the source code are included.
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Affiliation(s)
- Pete R Jones
- University College London (UCL), Institute of Ophthalmology, London, UK.,NIHR Moorfields Biomedical Research Centre, London, London, UK.,City, University of London, School of Health Sciences, Division of Optometry and Visual Sciences, London, UK
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17
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van Heerden A, Leppanen J, Rotheram-Borus MJ, Worthman CM, Kohrt BA, Skeen S, Giese S, Hughes R, Bohmer L, Tomlinson M. Emerging Opportunities Provided by Technology to Advance Research in Child Health Globally. Glob Pediatr Health 2020; 7:2333794X20917570. [PMID: 32523976 PMCID: PMC7235657 DOI: 10.1177/2333794x20917570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 02/04/2020] [Accepted: 03/06/2020] [Indexed: 11/15/2022] Open
Abstract
Current approaches to longitudinal assessment of children's developmental and psychological well-being, as mandated in the United Nations Sustainable Development Goals, are expensive and time consuming. Substantive understanding of global progress toward these goals will require a suite of new robust, cost-effective research tools designed to assess key developmental processes in diverse settings. While first steps have been taken toward this end through efforts such as the National Institutes of Health's Toolbox, experience-near approaches including naturalistic observation have remained too costly and time consuming to scale to the population level. This perspective presents 4 emerging technologies with high potential for advancing the field of child health and development research, namely (1) affective computing, (2) ubiquitous computing, (3) eye tracking, and (4) machine learning. By drawing attention of scientists, policy makers, investors/funders, and the media to the applications and potential risks of these emerging opportunities, we hope to inspire a fresh wave of innovation and new solutions to the global challenges faced by children and their families.
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Affiliation(s)
- Alastair van Heerden
- Human Sciences Research Council, Pietermaritzburg, South Africa.,University of the Witwatersrand, Johannesburg, South Africa
| | | | | | | | | | - Sarah Skeen
- Stellenbosch University, Stellenbosch, Western Cape, South Africa
| | | | - Rob Hughes
- The Children's Investment Fund Foundation, London, UK
| | - Lisa Bohmer
- Conrad N. Hilton Foundation, Westlake Village, CA, USA
| | - Mark Tomlinson
- Stellenbosch University, Stellenbosch, Western Cape, South Africa
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18
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Abstract
The developing visual brain is an integrated system, linking analysis of the visual input to visuomotor control, visual cognition, and attention. Major points in human visual development are the presence of rudimentary pathways present at birth which can control fixation behavior, with subsequent development of specific functions. These functions include the emergence of cortical selectivity; the integration of local signals to provide global representations of motion, shape, and space; the development of visuomotor modules for eye movements, manual reaching, and locomotion; and the development of distinct attentional systems. Measures of these processes in infancy and early childhood can provide indicators of broader brain development in the at-risk child. A key system in development is the dorsal cortical stream. Measures of global motion processing, visuomotor actions, and attention suggest that this system is particularly vulnerable in children with a wide range of neurodevelopmental disorders. Early disorders of the eye (strabismus, cataract) reveal the level of plasticity in the developing visual system and the ways in which early experience can affect the course of functional development.
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Affiliation(s)
- Janette Atkinson
- Faculty of Brain Sciences, University College London, London, United Kingdom.
| | - Oliver Braddick
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
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19
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Maurage P, Masson N, Bollen Z, D’Hondt F. Eye tracking correlates of acute alcohol consumption: A systematic and critical review. Neurosci Biobehav Rev 2020; 108:400-422. [DOI: 10.1016/j.neubiorev.2019.10.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 08/30/2019] [Accepted: 10/04/2019] [Indexed: 01/23/2023]
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20
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Barsingerhorn AD, Boonstra FN, Goossens J. Saccade latencies during a preferential looking task and objective scoring of grating acuity in children with and without visual impairments. Acta Ophthalmol 2019; 97:616-625. [PMID: 30734501 PMCID: PMC6767583 DOI: 10.1111/aos.14011] [Citation(s) in RCA: 5] [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: 03/09/2018] [Accepted: 10/26/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE We determined the latencies of orienting responses during a preferential looking task in children with normal vision and in children with visual impairments between 6 and 12 years old, and assessed the feasibility of scoring grating detection in these populations with video-based eye tracking. METHODS Children performed a computerized preferential looking test, while a remote eye tracker measured the children's eye movements. The stimuli consisted of a 2 × 2 grid, with three uniform grey fields and one target field consisting of a black-and-white square wave grating. The grating was presented randomly at one of the four locations. The spatial frequencies (1.05, 2.11 and 7.02 cyc/deg) were randomly interleaved, with 10 trials per spatial frequency. Three different methods were used to score the accuracy of the responses: (1) primary saccade ends on target, (1) gaze 50% of the presentation time on target, and (3) a combination of method 1 and 2 (i.e. primary saccade ends on target, and/or gaze 50% of the presentation time on target). RESULTS The combined scoring method was most reliable to determine whether children could resolve the gratings. Children with visual impairments had significantly lower accuracies than children with normal vision with all three scoring methods. In addition, saccade latencies decreased with age and were significantly longer (62 ± 15 ms) in children with visual impairments. CONCLUSION The use of eye tracking to assess grating detection with a preferential looking task in clinical populations provides valuable additional information, including objective detection measures and developmental delays in saccade latencies.
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Affiliation(s)
- Annemiek D. Barsingerhorn
- Department of Cognitive Neuroscience, Biophysics SectionDonders Institute for Brain, Cognition and BehaviourRadboud University Medical Centre NijmegenNijmegenThe Netherlands
- Department of BiophysicsDonders Institute for Brain, Cognition and BehaviourRadboud University NijmegenNijmegenThe Netherlands
| | - F. Nienke Boonstra
- Department of Cognitive Neuroscience, Biophysics SectionDonders Institute for Brain, Cognition and BehaviourRadboud University Medical Centre NijmegenNijmegenThe Netherlands
- Royal Dutch VisioNational Foundation for the Visually Impaired and BlindHuizenThe Netherlands
- Bartiméus, Institute for the Visually ImpairedZeistThe Netherlands
| | - Jeroen Goossens
- Department of Cognitive Neuroscience, Biophysics SectionDonders Institute for Brain, Cognition and BehaviourRadboud University Medical Centre NijmegenNijmegenThe Netherlands
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21
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Jones PR, Smith ND, Bi W, Crabb DP. Portable Perimetry Using Eye-Tracking on a Tablet Computer-A Feasibility Assessment. Transl Vis Sci Technol 2019; 8:17. [PMID: 30740267 PMCID: PMC6364754 DOI: 10.1167/tvst.8.1.17] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 11/22/2018] [Indexed: 01/13/2023] Open
Abstract
Purpose Visual field (VF) examination by standard automated perimetry (SAP) is an important method of clinical assessment. However, the complexity of the test, and its use of bulky, expensive equipment makes it impractical for case-finding. We propose and evaluate a new approach to paracentral VF assessment that combines an inexpensive eye-tracker with a portable tablet computer (“Eyecatcher”). Methods Twenty-four eyes from 12 glaucoma patients, and 12 eyes from six age-similar controls were examined. Participants were tested monocularly (once per eye), with both the novel Eyecatcher test and traditional SAP (HFA SITA standard 24-2). For Eyecatcher, the participant's task was to simply to look at a sequence of fixed-luminance dots, presented relative to the current point of fixation. Start and end fixations were used to determine locations where stimuli were seen/unseen, and to build a continuous map of sensitivity loss across a VF of approximately 20°. Results Eyecatcher was able to clearly separate patients from controls, and the results were consistent with those from traditional SAP. In particular, mean Eyecatcher scores were strongly correlated with mean deviation scores (r2 = 0.64, P < 0.001), and there was good concordance between corresponding VF locations (∼84%). Participants reported that Eyecatcher was more enjoyable, easier to perform, and less tiring than SAP (all P < 0.001). Conclusions Portable perimetry using an inexpensive eye-tracker and a tablet computer is feasible, although possible means of improvement are suggested. Translational Relevance Such a test could have significant utility as a case finding device.
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Affiliation(s)
- Pete R Jones
- Division of Optometry and Visual Science, School of Health Sciences, City, University of London, London, UK
| | - Nicholas D Smith
- Division of Optometry and Visual Science, School of Health Sciences, City, University of London, London, UK
| | - Wei Bi
- 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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22
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Jones PR. Sit still and pay attention: Using the Wii Balance-Board to detect lapses in concentration in children during psychophysical testing. Behav Res Methods 2019; 51:28-39. [PMID: 29770907 PMCID: PMC6420608 DOI: 10.3758/s13428-018-1045-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
During psychophysical testing, a loss of concentration can cause observers to answer incorrectly, even when the stimulus is clearly perceptible. Such lapses limit the accuracy and speed of many psychophysical measurements. This study evaluates an automated technique for detecting lapses based on body movement (postural instability). Thirty-five children (8-11 years of age) and 34 adults performed a typical psychophysical task (orientation discrimination) while seated on a Wii Fit Balance Board: a gaming device that measures center of pressure (CoP). Incorrect responses on suprathreshold catch trials provided the "reference standard" measure of when lapses in concentration occurred. Children exhibited significantly greater variability in CoP on lapse trials, indicating that postural instability provides a feasible, real-time index of concentration. Limitations and potential applications of this method are discussed.
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Affiliation(s)
- Pete R Jones
- Institute of Ophthalmology, University College London (UCL), 11-43 Bath Street, London, EC1V 9EL, UK.
- NIHR Moorfields Biomedical Research Centre, London, UK.
- City University of London, London, UK.
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23
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Abstract
AbstractAmblyopia can be improved or eliminated more easily when treated early in life. Because amblyopia in older children is generally less responsive to treatment (Holmes et al., 2011), there is a premium on the early identification of amblyopia and its risk factors and the subsequent treatment thereof. Clinical preference is to institute treatment in children before 7 years of age when an optimal visual outcome is typically easier to obtain.
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24
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Effects of two-dimensional versus three-dimensional landmark geometry and layout on young children's recall of locations from new viewpoints. J Exp Child Psychol 2018; 170:1-29. [PMID: 29407185 DOI: 10.1016/j.jecp.2017.12.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 12/12/2017] [Accepted: 12/13/2017] [Indexed: 12/29/2022]
Abstract
Spatial memory is an important aspect of adaptive behavior and experience, providing both content and context to the perceptions and memories that we form in everyday life. Young children's abilities in this realm shift from mainly egocentric (self-based) to include allocentric (world-based) codings at around 4 years of age. However, information about the cognitive mechanisms underlying acquisition of these new abilities is still lacking. We examined allocentric spatial recall in 4.5- to 8.5-year-olds, looking for continuity with navigation as previously studied in 2- to 4-year-olds and other species. We specifically predicted an advantage for three-dimensional landmarks over two-dimensional ones and for recalling targets "in the middle" versus elsewhere. However, we did not find compelling evidence for either of these effects, and indeed some analyses even support the opposite of each of these conclusions. There were also no significant interactions with age. These findings highlight the incompleteness of our overall theories of the development of spatial cognition in general and allocentric spatial recall in particular. They also suggest that allocentric spatial recall involves processes that have separate behavioral characteristics from other cognitive systems involved in navigation earlier in life and in other species.
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25
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Rider AT, Coutrot A, Pellicano E, Dakin SC, Mareschal I. Semantic content outweighs low-level saliency in determining children's and adults' fixation of movies. J Exp Child Psychol 2018; 166:293-309. [PMID: 28972928 PMCID: PMC5710995 DOI: 10.1016/j.jecp.2017.09.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 08/21/2017] [Accepted: 09/05/2017] [Indexed: 12/01/2022]
Abstract
To make sense of the visual world, we need to move our eyes to focus regions of interest on the high-resolution fovea. Eye movements, therefore, give us a way to infer mechanisms of visual processing and attention allocation. Here, we examined age-related differences in visual processing by recording eye movements from 37 children (aged 6-14years) and 10 adults while viewing three 5-min dynamic video clips taken from child-friendly movies. The data were analyzed in two complementary ways: (a) gaze based and (b) content based. First, similarity of scanpaths within and across age groups was examined using three different measures of variance (dispersion, clusters, and distance from center). Second, content-based models of fixation were compared to determine which of these provided the best account of our dynamic data. We found that the variance in eye movements decreased as a function of age, suggesting common attentional orienting. Comparison of the different models revealed that a model that relies on faces generally performed better than the other models tested, even for the youngest age group (<10years). However, the best predictor of a given participant's eye movements was the average of all other participants' eye movements both within the same age group and in different age groups. These findings have implications for understanding how children attend to visual information and highlight similarities in viewing strategies across development.
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Affiliation(s)
- Andrew T Rider
- UCL Institute of Ophthalmology, University College London, London WC1E 6BT, UK.
| | - Antoine Coutrot
- Centre for Mathematics and Physics in Life Sciences and Experimental Biology (CoMPLEX), University College London, London WC1E 6BT, UK
| | - Elizabeth Pellicano
- Centre for Research in Autism and Education (CRAE), Department of Psychology and Human Development, UCL Institute of Education, University College London, London WC1H 0AL, UK; School of Psychology, University of Western Australia, Crawley, Perth, Western Australia 6009, Australia
| | - Steven C Dakin
- UCL Institute of Ophthalmology, University College London, London WC1E 6BT, UK; School of Optometry and Vision Science, University of Auckland, Auckland 1010, New Zealand
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Livingstone I, Butler L, Misanjo E, Lok A, Middleton D, Wilson JW, Delfin S, Kayange P, Hamilton R. Testing Pediatric Acuity With an iPad: Validation of "Peekaboo Vision" in Malawi and the UK. Transl Vis Sci Technol 2018; 8:8. [PMID: 30637178 PMCID: PMC6327755 DOI: 10.1167/tvst.8.1.8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 07/23/2018] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate two builds of the digital grating acuity test, “Peekaboo Vision” (PV), in young (6–60 months) populations in two hospital settings (Malawi and United Kingdom). Methods Study 1 evaluated PV in Blantyre, Malawi (N = 58, mean age 33 months); study 2 evaluated an updated build in Glasgow, United Kingdom (N = 60, mean age 44 months). Acuities were tested-retested with PV and Keeler Acuity Cards for Infants (KACI). Bland-Altman techniques were used to compare results and repeatability. Child engagement was compared between groups. Study 2 included test-time comparison. Results Study 1 (Malawi): The mean difference between PV and KACI was 0.02 logMAR with 95% limits of agreement (LoA) of 0.33 to 0.37 LogMAR. On test-retest, PV demonstrated 95% LoA of −0.283 to 0.198 logMAR with coefficient of repeatability (CR) 0.27. KACI demonstrated 95% LoA of −0.427 to 0.323 logMAR, and larger CR was 0.37. PV evidenced higher engagement scores than KACI (P = 0.0005). Study 2 (UK): The mean difference between PV and KACI was 0.01 logMAR; 95% LoA was −0.413 to 0.437 logMAR. Again, on test-retest, PV had narrower LoA (−0.344 to 0.320 logMAR) and lower CR (0.32) versus KACI, with LoA −0.432 to 0.407 logMAR, CR 0.42. The two tests did not differ in engagement score (P = 0.5). Test time was ∼1 minute shorter for PV (185 vs. 251 s, P = 0.0021). Conclusions PV gives comparable results to KACI in two pediatric populations in two settings, with benefits in repeatability indices and test duration. Translational Relevance Leveraging tablet technology extends reliable infant acuity testing to bedside, home, and rural settings, including areas where traditional equipment cannot be financed.
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Affiliation(s)
- Iain Livingstone
- Falkirk Community Hospital, NHS Forth Valley, Falkirk, UK.,Glasgow Centre for Ophthalmic Research, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Laura Butler
- Tennent Institute of Ophthalmology, Gartnavel General Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Esther Misanjo
- Lions First Sight Eye Unit, Queen Elizabeth University Hospital, Blantyre, Malawi.,Ophthalmology Department, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Alan Lok
- Tennent Institute of Ophthalmology, Gartnavel General Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK.,University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
| | - Duncan Middleton
- Medical Devices Unit, West Glasgow Ambulatory Care Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK
| | | | - Silvija Delfin
- Inverclyde Royal Hospital, NHS Greater Glasgow and Clyde, Greenock, UK
| | - Petros Kayange
- Lions First Sight Eye Unit, Queen Elizabeth University Hospital, Blantyre, Malawi.,Ophthalmology Department, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Ruth Hamilton
- Royal Hospital for Children, NHS Greater Glasgow and Clyde, Glasgow, UK.,College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
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Affiliation(s)
| | - Ashley Rizzieri
- Department of Brain and Cognitive Sciences University of Rochester
| | - Richard N. Aslin
- Department of Brain and Cognitive Sciences University of Rochester
- Rochester Center for Brain Imaging
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Abstract
The biological basis of the commonality in color lexicons across languages has been hotly debated for decades. Prior evidence that infants categorize color could provide support for the hypothesis that color categorization systems are not purely constructed by communication and culture. Here, we investigate the relationship between infants' categorization of color and the commonality across color lexicons, and the potential biological origin of infant color categories. We systematically mapped infants' categorical recognition memory for hue onto a stimulus array used previously to document the color lexicons of 110 nonindustrialized languages. Following familiarization to a given hue, infants' response to a novel hue indicated that their recognition memory parses the hue continuum into red, yellow, green, blue, and purple categories. Infants' categorical distinctions aligned with common distinctions in color lexicons and are organized around hues that are commonly central to lexical categories across languages. The boundaries between infants' categorical distinctions also aligned, relative to the adaptation point, with the cardinal axes that describe the early stages of color representation in retinogeniculate pathways, indicating that infant color categorization may be partly organized by biological mechanisms of color vision. The findings suggest that color categorization in language and thought is partially biologically constrained and have implications for broader debate on how biology, culture, and communication interact in human cognition.
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Forssman L, Ashorn P, Ashorn U, Maleta K, Matchado A, Kortekangas E, Leppänen JM. Eye-tracking-based assessment of cognitive function in low-resource settings. Arch Dis Child 2017; 102:301-302. [PMID: 27551061 PMCID: PMC5466915 DOI: 10.1136/archdischild-2016-310525] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 07/20/2016] [Accepted: 07/29/2016] [Indexed: 12/24/2022]
Abstract
BACKGROUND Early development of neurocognitive functions in infants can be compromised by poverty, malnutrition and lack of adequate stimulation. Optimal management of neurodevelopmental problems in infants requires assessment tools that can be used early in life, and are objective and applicable across economic, cultural and educational settings. OBJECTIVE AND DESIGN The present study examined the feasibility of infrared eye tracking as a novel and highly automated technique for assessing visual-orienting and sequence-learning abilities as well as attention to facial expressions in young (9-month-old) infants. Techniques piloted in a high-resource laboratory setting in Finland (N=39) were subsequently field-tested in a community health centre in rural Malawi (N=40). RESULTS Parents' perception of the acceptability of the method (Finland 95%, Malawi 92%) and percentages of infants completing the whole eye-tracking test (Finland 95%, Malawi 90%) were high, and percentages of valid test trials (Finland 69-85%, Malawi 68-73%) satisfactory at both sites. Test completion rates were slightly higher for eye tracking (90%) than traditional observational tests (87%) in Malawi. The predicted response pattern indicative of specific cognitive function was replicated in Malawi, but Malawian infants exhibited lower response rates and slower processing speed across tasks. CONCLUSIONS High test completion rates and the replication of the predicted test patterns in a novel environment in Malawi support the feasibility of eye tracking as a technique for assessing infant development in low-resource setting. Further research is needed to the test-retest stability and predictive validity of the eye-tracking scores in low-income settings.
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Affiliation(s)
- Linda Forssman
- Tampere Center for Child Health Research, School of Medicine, University of Tampere, Tampere, Finland
| | - Per Ashorn
- Tampere Center for Child Health Research, School of Medicine, University of Tampere, Tampere, Finland
- Department of Paediatrics, Tampere University Hospital, Tampere, Finland
| | - Ulla Ashorn
- Tampere Center for Child Health Research, School of Medicine, University of Tampere, Tampere, Finland
| | - Kenneth Maleta
- School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Andrew Matchado
- School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Emma Kortekangas
- Tampere Center for Child Health Research, School of Medicine, University of Tampere, Tampere, Finland
| | - Jukka M Leppänen
- Tampere Center for Child Health Research, School of Medicine, University of Tampere, Tampere, Finland
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Huurneman B, Boonstra FN. Assessment of near visual acuity in 0-13 year olds with normal and low vision: a systematic review. BMC Ophthalmol 2016; 16:215. [PMID: 27931205 PMCID: PMC5146813 DOI: 10.1186/s12886-016-0386-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 11/10/2016] [Indexed: 11/16/2022] Open
Abstract
Background The inclusion for rehabilitation of visually impaired children is partly based on the measurement of near vision, but guidelines for near visual acuity assessment are currently lacking. The twofold purpose of this systematic review was to: (i) provide an overview of the impact of the chart design on near visual acuity measured, and (ii) determine the method of choice for near vision assessments in children of different developmental ages. Methods A literature search was conducted by using the following electronic databases: PubMed, Cochrane Library, and EMBASE. The last search was run on March 26th 2016. Additional studies were identified by contacting experts and searching for relevant articles in reference lists of included studies. Search terms were: vision test(s), vision assessment(s), visual acuity, chart(s) and near. Results For children aged 0–3 years the golden standard is still the preferential looking procedure. Norms are available for this procedure for 6–36 month old children. For 4–7 year olds, we recommend using the LEA symbols, because these symbols have been properly validated and can be used in preliterate children. Responses can be verbal or by matching the target symbol. In children aged 8–13 years, the recommended method is the ETDRS letter chart, because letter acuity is more predictive for functional vision and reading than symbol acuity. In 8–13 year olds, letter acuity is 0.1–0.2 logMAR poorer than symbol acuity. Conclusions Chart design, viewing distance, and threshold choice have a serious impact on near visual acuity measurements. Near visual acuity measured with symbols is lower than near visual acuity measured with gratings, and near visual acuity measured with letters is lower than near visual acuity measured with symbols. Viewing distance, chart used, and letter spacing should be adapted to the child’s development and reported in order to allow comparisons between measurements.
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Affiliation(s)
- Bianca Huurneman
- Department Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands. .,Bartiméus, Institute for the Visually Impaired, Zeist, The Netherlands.
| | - F Nienke Boonstra
- Department Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands.,Bartiméus, Institute for the Visually Impaired, Zeist, The Netherlands
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Evidence for spared attention to faces in 7-month-old infants after prenatal exposure to antiepileptic drugs. Epilepsy Behav 2016; 64:62-68. [PMID: 27732918 DOI: 10.1016/j.yebeh.2016.09.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Revised: 08/16/2016] [Accepted: 09/11/2016] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Prenatal antiepileptic drug (AED) exposure is associated with an increased risk of cognitive impairment and autism spectrum disorders detected mainly at the age of two to six years. We examined whether the developmental aberrations associated with prenatal AED exposure could be detected already in infancy and whether effects on visual attention can be observed at this early age. MATERIAL AND METHODS We compared a prospective cohort of infants with in utero exposure to AED (n=56) with infants without drug exposures (n=62). The assessments performed at the age of seven months included standardized neurodevelopmental scores (Griffiths Mental Developmental Scale and Hammersmith Infant Neurological Examination) as well as a novel eye-tracking-based test for visual attention and orienting to faces. Background information included prospective collection of AED exposure data, pregnancy outcome, neuropsychological evaluation of the mothers, and information on maternal epilepsy type. RESULTS Carbamazepine, oxcarbazepine, and valproate, but not lamotrigine or levetiracetam, were associated with impaired early language abilities at the age of seven months. The general speed of visuospatial orienting or attentional bias for faces measured by eye-tracker-based tests did not differ between AED-exposed and control infants. DISCUSSION Our findings support the idea that prenatal AED exposure may impair verbal abilities, and this effect may be detected already in infancy. In contrast, the early development of attention to faces was spared after in utero AED exposure.
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Kooiker MJG, Pel JJM, Verbunt HJM, de Wit GC, van Genderen MM, van der Steen J. Quantification of visual function assessment using remote eye tracking in children: validity and applicability. Acta Ophthalmol 2016; 94:599-608. [PMID: 27130515 DOI: 10.1111/aos.13038] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 01/28/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE Measurements of visual and oculomotor functions are essential for providing tailored support to visually impaired children. In young or intellectually disabled children these measurements can be difficult or even impossible to perform. Recordings of orienting gaze in response to specific visual information, made with eye tracking, may offer a solution. The aim of this study was to observe and quantify eye tracking (ET)-based gaze responses to provide information about visual and oculomotor functioning, and to compare this information with standard visual function assessments (VFA). METHODS One hundred and twenty-six visually impaired children from 1-14 years underwent a VFA. Next they underwent a remote ET test. Four aspects of oculomotor control (nystagmus, fixation, saccades, pursuit) and three visual functions (visual field, contrast, colour) were selected to compare both methods. Performance was assessed (1) during VFA using standard behavioural observation and test scores and (2) after ET by observing and scoring the eye movement recordings. Validity, in terms of agreement between results, was measured by correlation analyses. From the orienting gaze responses, quantitative parameters (gain, fixation duration and directional saccades) were calculated to characterize visual performance. RESULTS Good agreement between the two test methods was found for observational assessment of oculomotor control and visual functions (correlations ranging from rs = 0.39 to rs = 0.69). The quantitative parameters of visual performance showed distinct results between children with and without specific functional impairments, both in children aged 1-6 and 7-14 years. CONCLUSION Eye tracking-based gaze recordings are a promising tool to assess oculomotor and visual performance in a communication-free manner. Calculating quantitative parameters from specific gaze responses could assist in the characterization of functional visual performance in children, independent of age. Gaze responses are a useful addition to standard VFA in clinical practice.
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Affiliation(s)
- Marlou J. G. Kooiker
- Vestibular and oculomotor research group; Department of Neuroscience; Erasmus Medical Center; Rotterdam the Netherlands
| | - Johan J. M. Pel
- Vestibular and oculomotor research group; Department of Neuroscience; Erasmus Medical Center; Rotterdam the Netherlands
| | - Hélène J. M. Verbunt
- Royal Dutch Visio; Centre of Expertise for Blind and Partially Sighted People; Huizen the Netherlands
| | - Gerard C. de Wit
- Bartiméus; Diagnostic Centre for Complex Visual Disorders; Zeist the Netherlands
| | | | - Johannes van der Steen
- Vestibular and oculomotor research group; Department of Neuroscience; Erasmus Medical Center; Rotterdam the Netherlands
- Royal Dutch Visio; Centre of Expertise for Blind and Partially Sighted People; Huizen the Netherlands
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Kooiker MJG, Pel JJM, van der Steen-Kant SP, van der Steen J. A Method to Quantify Visual Information Processing in Children Using Eye Tracking. J Vis Exp 2016:54031. [PMID: 27500922 PMCID: PMC4993407 DOI: 10.3791/54031] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Visual problems that occur early in life can have major impact on a child's development. Without verbal communication and only based on observational methods, it is difficult to make a quantitative assessment of a child's visual problems. This limits accurate diagnostics in children under the age of 4 years and in children with intellectual disabilities. Here we describe a quantitative method that overcomes these problems. The method uses a remote eye tracker and a four choice preferential looking paradigm to measure eye movement responses to different visual stimuli. The child sits without head support in front of a monitor with integrated infrared cameras. In one of four monitor quadrants a visual stimulus is presented. Each stimulus has a specific visual modality with respect to the background, e.g., form, motion, contrast or color. From the reflexive eye movement responses to these specific visual modalities, output parameters such as reaction times, fixation accuracy and fixation duration are calculated to quantify a child's viewing behavior. With this approach, the quality of visual information processing can be assessed without the use of communication. By comparing results with reference values obtained in typically developing children from 0-12 years, the method provides a characterization of visual information processing in visually impaired children. The quantitative information provided by this method can be advantageous for the field of clinical visual assessment and rehabilitation in multiple ways. The parameter values provide a good basis to: (i) characterize early visual capacities and consequently to enable early interventions; (ii) compare risk groups and follow visual development over time; and (iii), construct an individual visual profile for each child.
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Mohan KM, Miller JM, Harvey EM, Gerhart KD, Apple HP, Apple D, Smith JM, Davis AL, Leonard-Green T, Campus I, Dennis LK. Assessment of Grating Acuity in Infants and Toddlers Using an Electronic Acuity Card: The Dobson Card. J Pediatr Ophthalmol Strabismus 2016; 53:56-9. [PMID: 26836005 DOI: 10.3928/01913913-20160113-09] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 12/07/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine if testing binocular visual acuity in infants and toddlers using the Acuity Card Procedure (ACP) with electronic grating stimuli yields clinically useful data. METHODS Participants were infants and toddlers ages 5 to 36.7 months referred by pediatricians due to failed automated vision screening. The ACP was used to test binocular grating acuity. Stimuli were presented on the Dobson Card. The Dobson Card consists of a handheld matte-black plexiglass frame with two flush-mounted tablet computers and is similar in size and form to commercially available printed grating acuity testing stimuli (Teller Acuity Cards II [TACII]; Stereo Optical, Inc., Chicago, IL). On each trial, one tablet displayed a square-wave grating and the other displayed a luminance-matched uniform gray patch. Stimuli were roughly equivalent to the stimuli available in the printed TACII stimuli. After acuity testing, each child received a cycloplegic eye examination. Based on cycloplegic retinoscopy, patients were categorized as having high or low refractive error per American Association for Pediatric Ophthalmology and Strabismus vision screening referral criteria. Mean acuities for high and low refractive error groups were compared using analysis of covariance, controlling for age. RESULTS Mean visual acuity was significantly poorer in children with high refractive error than in those with low refractive error (P = .015). CONCLUSIONS Electronic stimuli presented using the ACP can yield clinically useful measurements of grating acuity in infants and toddlers. Further research is needed to determine the optimal conditions and procedures for obtaining accurate and clinically useful automated measurements of visual acuity in infants and toddlers.
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Jones PR, Kalwarowsky S, Braddick OJ, Atkinson J, Nardini M. Optimizing the rapid measurement of detection thresholds in infants. J Vis 2015; 15:2. [PMID: 26237298 DOI: 10.1167/15.11.2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Accurate measures of perceptual threshold are difficult to obtain in infants. In a clinical context, the challenges are particularly acute because the methods must yield meaningful results quickly and within a single individual. The present work considers how best to maximize speed, accuracy, and reliability when testing infants behaviorally and suggests some simple principles for improving test efficiency. Monte Carlo simulations, together with empirical (visual acuity) data from 65 infants, are used to demonstrate how psychophysical methods developed with adults can produce misleading results when applied to infants. The statistical properties of an effective clinical infant test are characterized, and based on these, it is shown that (a) a reduced (false-positive) guessing rate can greatly increase test efficiency, (b) the ideal threshold to target is often below 50% correct, and (c) simply taking the max correct response can often provide the best measure of an infant's perceptual sensitivity.
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