Abstract
Purpose: There is a need for more intuitive perimetric screening methods, which can also be performed by elderly people and children currently unable to perform standard automated perimetry (SAP). Ideally, these methods should also be easier to administer, such that they may be used outside of a regular clinical environment. We evaluated the suitability of various methodological and analytical approaches for detecting and localizing VFD in glaucoma patients, based on eye movement recordings.Methods: The present study consisted of two experiments. In experiment 1, we collected data from 20 glaucoma patients and 20 age-matched controls, who monocularly viewed 28 1-min video clips while their eyes were being tracked. In experiment 2, we re-analyzed a published dataset, that contained data of 44 glaucoma patients and 32 age-matched controls who had binocularly viewed three longer-duration (3, 5, and 7 min) video clips. For both experiments, we first examined if the two groups differed in the basic properties of their fixations and saccades. In addition, we computed the viewing priority (VP) of each participant. Following a previously reported approach, for each participant, we mapped their fixation locations and used kernel Principal Component Analysis (kPCA) to distinguish patients from controls. Finally, we attempted to reconstruct the location of a patient's VFD by mapping the relative fixation frequency and the VP across their visual field.Results: We found direction dependent saccade amplitudes in glaucoma patients that often differed from those of the controls. Moreover, the kPCA indicated that the fixation maps of the two groups separated into two clusters based on the first two principal components. On average, glaucoma patients had a significantly lower VP than the controls, with this decrease depending on the specific video viewed.Conclusions: It is possible to detect the presence of VFD in glaucoma patients based on their gaze behavior made during video viewing. While this corroborates earlier conclusions, we show that it requires participants to view the videos monocularly. Nevertheless, we could not reconstruct the VFD with any of the evaluated methods, possibly due to compensatory eye movements made by the glaucoma patients.
Highlights
Screening for visual field defects (VFD) as well as monitoring their progression is critical in the management of many ophthalmic diseases, such as glaucoma
When computing the average viewing priority (VP) per trial we found that the group median of the glaucoma patients was significantly lower (p < 002) for 22 out of 28 movie clips
We found a weak correlation between the VP values averaged over all trials and the Integrated Visual Field (IVF) score (Pearson’s r = 0.11) and we found a moderate correlation between the VP values averaged over all trials and the difference in mean deviation (MD) between the measured and the covered eye (Pearson’s r = 0.39)
Summary
Screening for visual field defects (VFD) as well as monitoring their progression is critical in the management of many ophthalmic diseases, such as glaucoma. It requires the tested person to fixate their gaze on a single point and to press a button every time that they perceive a stimulus in the periphery of their visual field. This means that they have to maintain a high level of attention over a prolonged period of time. SAP is rather difficult to perform for children under the age of seven years, many elderly people, and people with attentional problems [1,2,3] This is problematic, as noncompliance will increase test duration and can negatively impact the precision of the measurement [4]. There is a need for screening tests which are easier to perform and more engaging than the current ones
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