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Barbieri M, Albanese GA, Merello A, Crepaldi M, Setti W, Gori M, Canessa A, Sabatini SP, Facchini V, Sandini G. Assessing REALTER simulator: analysis of ocular movements in simulated low-vision conditions with extended reality technology. Front Bioeng Biotechnol 2024; 12:1285107. [PMID: 38638317 PMCID: PMC11024368 DOI: 10.3389/fbioe.2024.1285107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 03/14/2024] [Indexed: 04/20/2024] Open
Abstract
Immersive technology, such as extended reality, holds promise as a tool for educating ophthalmologists about the effects of low vision and for enhancing visual rehabilitation protocols. However, immersive simulators have not been evaluated for their ability to induce changes in the oculomotor system, which is crucial for understanding the visual experiences of visually impaired individuals. This study aimed to assess the REALTER (Wearable Egocentric Altered Reality Simulator) system's capacity to induce specific alterations in healthy individuals' oculomotor systems under simulated low-vision conditions. We examined task performance, eye movements, and head movements in healthy participants across various simulated scenarios. Our findings suggest that REALTER can effectively elicit behaviors in healthy individuals resembling those observed in individuals with low vision. Participants with simulated binocular maculopathy demonstrated unstable fixations and a high frequency of wide saccades. Individuals with simulated homonymous hemianopsia showed a tendency to maintain a fixed head position while executing wide saccades to survey their surroundings. Simulation of tubular vision resulted in a significant reduction in saccade amplitudes. REALTER holds promise as both a training tool for ophthalmologists and a research instrument for studying low vision conditions. The simulator has the potential to enhance ophthalmologists' comprehension of the limitations imposed by visual disabilities, thereby facilitating the development of new rehabilitation protocols.
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Affiliation(s)
- Mattia Barbieri
- Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genova, Italy
- Department of Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Genoa, Italy
| | - Giulia A. Albanese
- Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genova, Italy
| | - Andrea Merello
- Electronic Design Laboratory, Istituto Italiano di Tecnologia, Genova, Italy
| | - Marco Crepaldi
- Electronic Design Laboratory, Istituto Italiano di Tecnologia, Genova, Italy
| | - Walter Setti
- Unit for Visually Impaired People, Istituto Italiano di Tecnologia, Genova, Italy
| | - Monica Gori
- Unit for Visually Impaired People, Istituto Italiano di Tecnologia, Genova, Italy
| | - Andrea Canessa
- Department of Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Genoa, Italy
| | - Silvio P. Sabatini
- Department of Informatics, Bioengineering, Robotics and Systems Engineering, University of Genoa, Genoa, Italy
| | | | - Giulio Sandini
- Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genova, Italy
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Yang B, Su M, Wang Q, Qu X, Wang H, Chen W, Sun Y, Li T, Wang Y, Wang N, Xian J. Altered stability of dynamic brain functional architecture in primary open-angle glaucoma: a surface-based resting-state fMRI study. Brain Imaging Behav 2024; 18:44-56. [PMID: 37857914 PMCID: PMC10844345 DOI: 10.1007/s11682-023-00800-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 10/21/2023]
Abstract
Delineating the neuropathological characteristics of primary open-angle glaucoma (POAG) is critical for understanding its pathophysiology. While temporal stability represents a crucial aspect of the brain's functional architecture, the specific patterns underlying its contribution to POAG remain unclear. This study aims to analyze the brain functional abnormalities in POAG using functional stability, a dynamic functional connectivity (DFC) approach based on resting-state functional magnetic resonance imaging (rs-fMRI). Seventy patients with POAG and forty-five healthy controls underwent rs-fMRI and ophthalmological examinations. The stability of DFC was calculated as the concordance of DFC over time using a sliding-window approach, and the differences in stability between the two groups were compared. Subsequently, Spearman's correlation analyses were conducted to examine the relationship between functional stability and clinical indicators. Compared with healthy controls, patients with POAG exhibited significantly decreased functional stability in the visual network, including the early visual center, ventral and dorsal stream visual cortex in both hemispheres. Conversely, stability values increased in the bilateral inferior parietal gyrus and right inferior frontal cortex. In POAG patients, the dynamic stability of the left early visual cortex and ventral stream visual cortex correlated with the mean deviation of visual field defects (r = 0.251, p = 0.037). The evidence from this study suggests that functional stability may provide a new understanding of brain alterations in the progression of POAG.
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Affiliation(s)
- Bingbing Yang
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, No.1 of Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China
| | - Mingyue Su
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, No.1 of Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China
| | - Qian Wang
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, No.1 of Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China
| | - Xiaoxia Qu
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, No.1 of Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China
| | - Huaizhou Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No.1 of Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China
| | - Weiwei Chen
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No.1 of Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China
| | - Yunxiao Sun
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No.1 of Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China
| | - Ting Li
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, No.1 of Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China
| | - Yang Wang
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, No.1 of Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China
| | - Junfang Xian
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, No.1 of Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China.
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Tahri Sqalli M, Aslonov B, Gafurov M, Mukhammadiev N, Sqalli Houssaini Y. Eye tracking technology in medical practice: a perspective on its diverse applications. FRONTIERS IN MEDICAL TECHNOLOGY 2023; 5:1253001. [PMID: 38045887 PMCID: PMC10691255 DOI: 10.3389/fmedt.2023.1253001] [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: 07/04/2023] [Accepted: 11/06/2023] [Indexed: 12/05/2023] Open
Abstract
Eye tracking technology has emerged as a valuable tool in the field of medicine, offering a wide range of applications across various disciplines. This perspective article aims to provide a comprehensive overview of the diverse applications of eye tracking technology in medical practice. By summarizing the latest research findings, this article explores the potential of eye tracking technology in enhancing diagnostic accuracy, assessing and improving medical performance, as well as improving rehabilitation outcomes. Additionally, it highlights the role of eye tracking in neurology, cardiology, pathology, surgery, as well as rehabilitation, offering objective measures for various medical conditions. Furthermore, the article discusses the utility of eye tracking in autism spectrum disorders, attention-deficit/hyperactivity disorder (ADHD), and human-computer interaction in medical simulations and training. Ultimately, this perspective article underscores the transformative impact of eye tracking technology on medical practice and suggests future directions for its continued development and integration.
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Affiliation(s)
- Mohammed Tahri Sqalli
- Department of Economics, School of Foreign Services, Georgetown University in Qatar, Doha, Qatar
- Department of Engineering, New York University, Abu Dhabi, United Arab Emirates
| | - Begali Aslonov
- Department of Control and Computer Engineering, Polytechnic University of Turin, Turin, Italy
| | - Mukhammadjon Gafurov
- Department of Business Administration, Carnegie Mellon University in Qatar, Doha, Qatar
| | | | - Yahya Sqalli Houssaini
- Department of Medicine, Faculty of Medecine and Pharmacy, Mohammed V University, Rabat, Morocco
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Muñoz Sarmiento DM, Rodríguez Montaño ÓL, Alarcón Castiblancoa JD, Cortés Rodríguez CJ. The impact of horizontal eye movements versus intraocular pressure on optic nerve head biomechanics: A tridimensional finite element analysis study. Heliyon 2023; 9:e13634. [PMID: 36865452 PMCID: PMC9970910 DOI: 10.1016/j.heliyon.2023.e13634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 01/31/2023] [Accepted: 02/06/2023] [Indexed: 02/13/2023] Open
Abstract
It has been proposed that eye movements could be related to glaucoma development. This research aimed to compare the impact of intraocular pressure (IOP) versus horizontal duction on optic nerve head (ONH) strains. Thus, a tridimensional finite element model of the eye including the three tunics of the eye, all of the meninges, and the subarachnoid space (SAS) was developed using a series of medical tests and anatomical data. The ONH was divided into 22 subregions, and the model was subjected to 21 different eye pressures, as well as 24 different degrees of adduction and abduction ranging from 0.5° to 12°. Mean deformations were documented along anatomical axes and in principal directions. Additionally, the impact of tissue stiffness was assessed. The results show no statistically significant differences between the lamina cribrosa (LC) strains due to eye rotation and IOP variation. However, when assessing LC regions some experienced a reduction in principal strains following a 12° duction, while after the IOP reached 12 mmHg, all LC subzones showed an increase in strains. From an anatomical perspective, the effect on the ONH following 12° duction was opposite to that observed after a rise in IOP. Moreover, high strain dispersion inside the ONH subregions was obtained with lateral eye movements, which was not observed with increased IOP and variation. Finally, SAS and orbital fat stiffness strongly influenced ONH strains during eye movements, while SAS stiffness was also influential under ocular hypertension. Even if horizontal eye movements cause large ONH deformations, their biomechanical effect would be markedly distinct from that induced by IOP. It could be predicted that, at least in physiological conditions, their potential to cause axonal injury would not be so relevant. Thus, a causative role in glaucoma does not appear likely. By contrast, an important role of SAS would be expectable.
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Affiliation(s)
- Diana Marcela Muñoz Sarmiento
- Grupo de Investigación en Biomecánica, Universidad Nacional de Colombia, Colombia,Sociedad de Oftalmología Eduardo Arenas Archila, Colombia,Laboratorio de Anatomía y Fisiología, Grupo de Ciencias Básicas y Laboratorios, Universidad Manuela Beltrán, Colombia,Corresponding author. Grupo de Investigación en Biomecánica, Universidad Nacional de Colombia, Colombia.
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