Abstract
BackgroundTo examine the speed and accuracy of saccadic eye movements during a novel eye tracking threshold visual field assessment and determine whether eye movement parameters may improve ability to detect glaucoma.MethodsA prospective study including both eyes of 31 patients with glaucoma and 23 controls. Standard automated perimetry (SAP) and eye tracking perimetry (saccadic vector optokinetic perimetry, SVOP) was performed. SVOP provided data on threshold sensitivity, saccade latency, and two measures of accuracy of saccades (direction bias and amplitude bias). The relationship between eye movement parameters and severity of glaucoma was examined and Receiver Operating Characteristic curves were used to assess ability to detect glaucoma.ResultsPatients with glaucoma had significantly slower saccades (602.9 ± 50.0 ms versus 578.3 ± 44.6 ms for controls, P = 0.009) and reduced saccade accuracy (direction bias = 7.4 ± 1.8 versus 6.5 ± 1.5 degrees, P = 0.006). There was a significant slowing of saccades and saccades became less accurate with worsening SAP sensitivity. Slower saccades were associated with increased odds of glaucoma; however, the AUC for saccade latency was only 0.635 compared to 0.914 for SVOP sensitivity.ConclusionPatients with glaucoma had significant differences in eye movements compared to healthy subjects, with a relationship between slower and less accurate eye movements and worse glaucoma severity. However, in a multivariable model, eye movement parameters were not of additional benefit in differentiating eyes with glaucoma from healthy controls.
Highlights
To examine the speed and accuracy of saccadic eye movements during a novel eye tracking threshold visual field assessment and determine whether eye movement parameters may improve ability to detect glaucoma
Participants with glaucoma were slightly older than controls (72.3 ± 7.9 compared to 65.9 ± 5.6 years, P < 0.001)
saccadic vector optokinetic perimetry (SVOP) and Standard automated perimetry (SAP) sensitivities were significantly lower in eyes with glaucoma compared to controls (Table 1, Fig. 3A and B)
Summary
To examine the speed and accuracy of saccadic eye movements during a novel eye tracking threshold visual field assessment and determine whether eye movement parameters may improve ability to detect glaucoma. Glaucomatous visual field loss has been shown to affect eye movement patterns during tasks such as reading [5] [6], driving [7], watching television [8], viewing scenes [9, 10], recognizing faces [11], and performing visual search [12]. There is evidence that eye movements may be altered even before visual field loss is detected [13] [14]. There remains uncertainty concerning how exactly eye movements are affected in glaucoma. Whereas some studies have reported patients with glaucoma to have altered saccade rate and amplitudes [7], this has not been a universal finding [12], perhaps due to differences in task, disease severity, and possibly compensatory strategies
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