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Yokoyama H, Takata M, Kanda H, Okita Y, Gomi F. Assessment of silent reading ability among glaucoma patients using an eye tracking system with horizontally scrolling text. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06537-3. [PMID: 39141117 DOI: 10.1007/s00417-024-06537-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 05/11/2024] [Accepted: 05/27/2024] [Indexed: 08/15/2024] Open
Abstract
PURPOSE There have been many reports suggesting that glaucoma patients with visual field defects may have decreased silent reading ability compared with individuals without glaucoma. This study used an eye tracking system to assess the ability of glaucoma patients to silently read horizontally scrolling text. METHODS Glaucoma patients who met the following criteria were recruited: age of ≤ 70 years, at least one eye with a 10 - 2 threshold on standard automated perimetry, a mean deviation value of n 4.0 dB or less, and corrected decimal visual acuity of 0.7 or better in both eyes. Using heat map images created from data from an eye tracking system operating during presentation of a video in which a sentence scrolled horizontally from right to left, reading time, average gaze position, and average fixation time (AFT) were compared between normal eyes (23 individuals, 46 eyes) and glaucomatous eyes (25 patients, 45 eyes). Four styles of sentences (large slow, large fast, small slow, and small fast) were scrolled in the top or bottom sections of the screen. RESULTS Primary open-angle glaucoma was the most common type of glaucoma in 34 eyes (75.6%), followed by secondary glaucoma in six eyes (13.3%). In comparison with normal eyes, the reading time among right eyes was significantly longer in glaucomatous eyes when reading large fast text that was shown in the bottom area and left glaucomatous eyes showed a leftward shift in gaze position in the top, bottom, or both sections with all four sentence types. There was no significant difference in AFT between glaucomatous and normal eyes across the four sentence styles. In the left eye with inferior visual field loss, text presented at the top consistently showed a correlation with leftward shift of the gaze position across all scenarios. CONCLUSION Glaucoma patients with central visual field defects in their left eyes may experience greater difficulty reading horizontally scrolling text than individuals with normal eyes.
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Affiliation(s)
- Hiroshi Yokoyama
- Department of Ophthalmology, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Hyogo, Japan.
| | - Masashi Takata
- Department of Ophthalmology, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Hyogo, Japan
| | - Hiroyuki Kanda
- Department of Ophthalmology, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Hyogo, Japan
| | - Yoichi Okita
- Department of Ophthalmology, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Hyogo, Japan
| | - Fumi Gomi
- Department of Ophthalmology, Hyogo Medical University, 1-1 Mukogawa-cho, Nishinomiya, 663-8501, Hyogo, Japan
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Zhong T, Zhou J, Yan T, Qiu J, Wang Y, Lu W. Pseudo-time Series Structural MRI Revealing Progressive Gray Matter Changes with Elevated Intraocular Pressure in Primary Open-Angle Glaucoma: A Preliminary Study. Acad Radiol 2024:S1076-6332(24)00155-7. [PMID: 38580519 DOI: 10.1016/j.acra.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/05/2024] [Accepted: 03/15/2024] [Indexed: 04/07/2024]
Abstract
RATIONALE AND OBJECTIVES Primary open-angle glaucoma (POAG) is accompanied with gray matter (GM) changes across the brain. However, causal relationships of the GM changes have not been fully understood. Our aim was to investigate the causality of GM progressive changes in POAG using Granger causality (GC) analysis and structural MRI. MATERIALS AND METHODS Structural MRI from 20 healthy controls and 30 POAG patients with elevated intraocular pressure (IOP) were collected. We performed voxel-wise GM volume comparisons between control and POAG groups, and between control and four POAG subgroups (categorized by IOP). Then, we sequenced the structural MRI data of all POAG patients and conducted both voxel-wise and region of interest (ROI)-wise GC analysis to investigate the causality of GM volume changes in POAG brain. RESULTS Compared to healthy controls, reduced GM volumes across the brain were found, GM volume enlargements in the thalamus, caudate nucleus and cuneus were also observed in POAG brain (false discovery rate (FDR) corrected at q< 0.05). As IOP elevated, the reductions of GM volume were more severe in the cerebellum and frontal lobe. GC analysis revealed that the bilateral cerebellum, visual cortices, and the frontal regions served independently as primary hubs of the directional causal network, and projected causal effects to the parietal and temporal regions of the brain (FDR corrected at q<0.05). CONCLUSION POAG exhibits progressive GM alterations across the brain, with oculomotor regions and visual cortices as independent primary hubs. The current results may deepen our understanding of neuropathology of POAG.
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Affiliation(s)
- Tianzheng Zhong
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Taian, China; Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Jian Zhou
- Department of Radiology, Taian City Central Hospital, Taian, China
| | - Tingqin Yan
- Department of Ophthalmology, Taian City Central Hospital, Taian, China
| | - Jianfeng Qiu
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Taian, China; Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Yi Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Weizhao Lu
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Taian, China.
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Yeon JS, Jung HN, Kim JY, Jung KI, Park HYL, Park CK, Kim HW, Kim MS, Kim YC. Deviated Saccadic Trajectory as a Biometric Signature of Glaucoma. Transl Vis Sci Technol 2023; 12:15. [PMID: 37440248 PMCID: PMC10353744 DOI: 10.1167/tvst.12.7.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 05/31/2023] [Indexed: 07/14/2023] Open
Abstract
Purpose To investigate whether the trajectories of saccadic eye movements (SEMs) significantly differ between glaucoma patients and controls. Methods SEMs were recorded by video-based infrared oculography in 53 patients with glaucoma and 41 age-matched controls. Participants were asked to bilaterally view 24°-horizontal, 14°-vertical, and 20°-diagonal eccentric Goldmann III-sized stimuli. SEMs were evaluated with respect to the saccadic reaction time (SRT), the mean velocity, amplitude, and two novel measures: departure angle (DA) and arrival angle (AA). These parameters were compared between the groups and the associations of SEM parameters with glaucoma parameters and integrated visual field defects were investigated. Results Glaucoma patients exhibited increased mean SRT, DA, and AA values compared with controls for 14°-vertical visual targets (P = 0.05, P < 0.01, and P < 0.01, respectively). The SRT, DA, and AA were significantly associated with the mean and pattern standard deviations of perimetry and with the mean RNFL thickness by OCT (all P < 0.001). Glaucoma was associated with the AA (P = 0.05) and both the SRT (P = 0.01) and DA (P = 0.04) were associated with integrated visual field defects. Conclusions The saccadic trajectories of glaucoma patients depart in an erroneous path and compensate the disparity by deviating the trajectory at arrival. Translational Relevance The initial deviation that we observed (despite continuous exposure to the stimulus) suggests the disoriented spatial perception of glaucoma patients which may be relevant to difficulties encountered daily.
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Affiliation(s)
- Ji Su Yeon
- Gangnam St. Mary's One Eye Clinic, Seoul, Republic of Korea
| | - Ha Na Jung
- Gangnam St. Mary's One Eye Clinic, Seoul, Republic of Korea
| | - Jae Young Kim
- Gangnam St. Mary's One Eye Clinic, Seoul, Republic of Korea
| | - Kyong In Jung
- College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hae-Young Lopilly Park
- College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chan Kee Park
- College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyo Won Kim
- Gangnam St. Mary's One Eye Clinic, Seoul, Republic of Korea
| | - Man Soo Kim
- Gangnam St. Mary's One Eye Clinic, Seoul, Republic of Korea
| | - Yong Chan Kim
- College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Ophthalmology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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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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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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Zwierko T, Jedziniak W, Florkiewicz B, Lesiakowski P, Śliwiak M, Kirkiewicz M, Lubiński W. Physical Activity Is Associated with Improved Visuomotor Processing in Older Adults with Moderate and Advanced Glaucomatous Visual Field Defect: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031760. [PMID: 35162783 PMCID: PMC8835176 DOI: 10.3390/ijerph19031760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/28/2022] [Accepted: 02/01/2022] [Indexed: 12/27/2022]
Abstract
Glaucoma affects a wide spectrum of daily essential activities in older adults. This study examined whether older adults with moderate and advanced stages of glaucoma exhibit differences in visuomotor task performance compared with age- and gender-matched ophthalmologically healthy control subjects and estimated the effects of physical activity (PA) levels, age, and severity of visual impairment on patients' visuomotor task performance. Sixty older adults with moderate glaucoma, advanced glaucoma, and normal sight participated in the study. Visuomotor processing was assessed using laboratory-based simple and complex visuomotor reaction tasks. Monocular Humphrey Visual Field and binocular Humphrey Esterman Visual Field tests were used to estimate visual field defect severity. The International Physical Activity Questionnaire was used to assess PA levels. Participants with glaucoma had poorer scores in visuomotor tasks compared to participants with normal sight. Glaucoma patients' PA levels, age, and binocular visual field defect explained 54% of the variation in complex reaction time. Low PA levels were identified as a risk factor for visuomotor processing decline. Compensatory mechanisms to improve the efficiency of visual field scanning in patients with more severe visual field defects may exist.
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Affiliation(s)
- Teresa Zwierko
- Laboratory of Kinesiology, Functional and Structural Human Research Center, Institute of Physical Culture Sciences, University of Szczecin, 70-240 Szczecin, Poland; (W.J.); (B.F.)
- Correspondence:
| | - Wojciech Jedziniak
- Laboratory of Kinesiology, Functional and Structural Human Research Center, Institute of Physical Culture Sciences, University of Szczecin, 70-240 Szczecin, Poland; (W.J.); (B.F.)
| | - Beata Florkiewicz
- Laboratory of Kinesiology, Functional and Structural Human Research Center, Institute of Physical Culture Sciences, University of Szczecin, 70-240 Szczecin, Poland; (W.J.); (B.F.)
| | - Piotr Lesiakowski
- Department of Physical Education and Sport, Pomeranian Medical University, 70-123 Szczecin, Poland;
| | - Marta Śliwiak
- II Department of Ophthalmology, Pomeranian Medical University, 70-111 Szczecin, Poland; (M.Ś.); (M.K.); (W.L.)
| | - Marta Kirkiewicz
- II Department of Ophthalmology, Pomeranian Medical University, 70-111 Szczecin, Poland; (M.Ś.); (M.K.); (W.L.)
| | - Wojciech Lubiński
- II Department of Ophthalmology, Pomeranian Medical University, 70-111 Szczecin, Poland; (M.Ś.); (M.K.); (W.L.)
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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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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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