Analysis of foveation duration and repeatability at different gaze positions in patients affected by congenital nystagmus.

Abstract

Congenital nystagmus (CN) is a disturbance of the oculomotor centers which develops at birth or in the first months of life. Nystagmus consists essentially in involuntary, conjugated, horizontal rhythmic movements of the eye. Its pathogenesis is still unknown. Current therapies for CN aim to increase the patient’s visual acuity by means of refraction defects correction, drug delivery and ocular muscle surgery. Eye movement recording supports for accurate diagnosis, for patient follow-up and for therapy evaluation. In general, CN patients show a considerable decrease of visual acuity (image fixation on the retina is obstructed by nystagmus continuous oscillations) and severe postural alterations such as the anomalous head position, searched by patient to obtain a better fixation of the target image onto the retina. Often CN presents ‘neutral zones’ corresponding to particular gaze angles, in which nystagmus amplitude minimizes allowing a longer foveation time and a more stable repositioning of foveations, increasing visual acuity. Selected patients’ eye movements were recorded by using EOG or infrared oculography devices. Visual stimulation was delivered by means of an arched LED bar covering a visual field of –30 +30 degrees with respect to the central position. Computation of CN concise parameters allows in-dept analysis of foveations and estimation of visual acuity at different gaze angles. Preliminary results show a maximum of visual acuity at a specific gaze angle; this angle is mostly located at the patient’s right side for the analyzed group.