Comparison of saccadic reaction time between normal and glaucoma using an eye movement perimeter

Mazumdar, Deepmala; Pel, JJ M; Panday, Manish; Asokan, Rashima; Vijaya, Lingam; Balekudaru, Shantha; George, Ronnie; Steen, J. van der

doi:10.4103/0301-4738.126182

Cited by 27 publications

(26 citation statements)

References 17 publications

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“… 6 , 9 , 10 For example, Mazumdar et al 6 used eye movement perimetry to evaluate saccadic reaction times to stimuli presented at locations corresponding to the 54 test points of SAP. 6 Patients with glaucoma had prolonged saccadic reaction times, with a trend towards increasing reaction times with increasing disease severity. Further work is needed; however, there may be the potential to quantify saccades to provide additional information to assist with diagnosis and monitoring.…”

Section: Discussionmentioning

confidence: 99%

“…Pioneering work by Damato has shown that the visual field could be evaluated by moving the eye rather than the test stimulus (oculokinetic perimetry), 4 but only recently have several groups explored the possiblity of performing perimetry using computerized eye tracking. 5 – 8 Studies using eye tracking also have shown that assessing the speed and accuracy of saccadic eye movements also may be useful for detecting disease, with differences in saccades noted between healthy individuals and those with glaucoma. 9 – 12 Eye tracking can be used to monitor patient gaze responses to peripheral stimuli, with the advantage that it does not require the patient to press a response button.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Threshold Saccadic Vector Optokinetic Perimetry (SVOP) and Standard Automated Perimetry (SAP) in Glaucoma. Part II: Patterns of Visual Field Loss and Acceptability

McTrusty

Cameron

Perperidis

et al. 2017

Trans. Vis. Sci. Tech.

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PurposeWe compared patterns of visual field loss detected by standard automated perimetry (SAP) to saccadic vector optokinetic perimetry (SVOP) and examined patient perceptions of each test.MethodsA cross-sectional study was done of 58 healthy subjects and 103 with glaucoma who were tested using SAP and two versions of SVOP (v1 and v2). Visual fields from both devices were categorized by masked graders as: 0, normal; 1, paracentral defect; 2, nasal step; 3, arcuate defect; 4, altitudinal; 5, biarcuate; and 6, end-stage field loss. SVOP and SAP classifications were cross-tabulated. Subjects completed a questionnaire on their opinions of each test.ResultsWe analyzed 142 (v1) and 111 (v2) SVOP and SAP test pairs. SVOP v2 had a sensitivity of 97.7% and specificity of 77.9% for identifying normal versus abnormal visual fields. SAP and SVOP v2 classifications showed complete agreement in 54% of glaucoma patients, with a further 23% disagreeing by one category. On repeat testing, 86% of SVOP v2 classifications agreed with the previous test, compared to 91% of SAP classifications; 71% of subjects preferred SVOP compared to 20% who preferred SAP.ConclusionsEye-tracking perimetry can be used to obtain threshold visual field sensitivity values in patients with glaucoma and produce maps of visual field defects, with patterns exhibiting close agreement to SAP. Patients preferred eye-tracking perimetry compared to SAP.Translational relevanceThis first report of threshold eye tracking perimetry shows good agreement with conventional automated perimetry and provides a benchmark for future iterations.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of Threshold Saccadic Vector Optokinetic Perimetry (SVOP) and Standard Automated Perimetry (SAP) in Glaucoma. Part II: Patterns of Visual Field Loss and Acceptability

McTrusty

Cameron

Perperidis

et al. 2017

Trans. Vis. Sci. Tech.

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“…The second part to this study demonstrates how a further iteration of the threshold SVOP system can improve on the rates of incomplete testing, which, coupled with positive patient feedback, make the test a useful and acceptable form of perimetry. 17 Additional future work will be necessary to assess other outputs available from threshold SVOP tests, such as saccadic reaction times, which may provide additional diagnostic information, 19 and correlation of threshold SVOP with retinal nerve fiber layer density.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Saccadic Vector Optokinetic Perimetry and Standard Automated Perimetry in Glaucoma. Part I: Threshold Values and Repeatability

Murray

Perperidis

Cameron

et al. 2017

Trans. Vis. Sci. Tech.

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PurposeWe evaluated threshold saccadic vector optokinetic perimetry (SVOP) and compared results to standard automated perimetry (SAP).MethodsA cross-sectional study was done including 162 subjects (103 with glaucoma and 59 healthy subjects) recruited at a university hospital. All subjects underwent SAP and threshold SVOP. SVOP uses an eye tracker to monitor eye movement responses to stimuli and determines if stimuli have been perceived based on the vector of the gaze response. The test pattern used was equivalent to SAP 24-2 and stimuli were presented at Goldmann III. Average and pointwise sensitivity values obtained from both tests were compared using Pearson's correlation coefficient. Two versions of SVOP were evaluated.ResultsA total of 124 tests were performed with SAP and SVOP version 2. There was excellent agreement between mean threshold values obtained using SVOP and SAP (r = 0.95, P < 0.001). Excluding the blind spot, correlation between SVOP and SAP individual test point sensitivity ranged from 0.61 to 0.90, with 48 of 54 (89%) test points > 0.70. Overall SVOP showed good repeatability with a Pearson correlation of 0.88. The repeatability on a point-by-point basis ranged from 0.66 to 0.98, with 45 of 54 points (83%) > 0.80. Repeatability of SAP was 0.87, ranging from 0.69 to 0.96, with 47 of 54 (87%) points > 0.80.ConclusionEye-tracking perimetry is repeatable and compares well with the current gold standard of SAP. The technique has advantages over conventional perimetry and could be useful for evaluating glaucomatous visual field loss, particularly in patients who may struggle with conventional perimetry.Translational RelevanceSuprathreshold SVOP already is in the field. To our knowledge, this is the first report of threshold SVOP and provides a benchmark for future iterations.

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“…Past studies have demonstrated reliable and comparable results between SAP and EMP in terms of ability to detect visual field loss [ 8 ]. A major benefit of this approach is the elimination of the need for testing for false positive responses [ 12 ]. Although a small learning curve exists [ 13 ], EMP has potential to become the standard in perimetry for young children and people who have mental or physical limitations to perform conventional perimetry [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…We have previously shown delayed SRT values in primary glaucoma patients compared to healthy subjects across different eccentricities throughout the tested field of vision [ 12 ]. The protocol included all 54 locations tested on the SITA standard 24–2 test pattern of the Humphrey Visual Field Analyzer (HFA).…”

Section: Introductionmentioning

confidence: 99%

Development of a test grid using Eye Movement Perimetry for screening glaucomatous visual field defects

Meethal¹,

Mazumdar²,

Asokan³

et al. 2017

Graefes Arch Clin Exp Ophthalmol

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Background Eye Movement Perimetry (EMP) uses Saccadic Eye Movement (SEM) responses for visual field evaluation. Previous studies have demonstrated significant delay in initiation of SEMs among glaucoma patients in comparison with healthy subjects. The aim of the current study was to develop an EMP-based screening grid to identify glaucomatous visual field defects. Methods An interactive test consisting of 36 locations and two stimulus contrasts (162 cd/m 2 and 190 cd/m 2 on a background of 140 cd/m 2 ) was evaluated in 54 healthy subjects and 50 primary glaucoma patients. Each subject was presented a central fixation target combined with the random projection of Goldmann size III peripheral targets. Instructions were given to look at each peripheral target on detection and then re-fixate at the central fixation target while the saccades were assessed using an eye tracker. From each seen peripheral target, the Saccadic Reaction Time (SRT) was calculated for contrast level 162 cd/ m 2 . These values were used to plot Receiver Operating Characteristic (ROC) curves for each test locations and the Area Under the Curve (AUC) values were used to identify the locations with highest susceptibility to glaucomatous damage. Each stimulus location with an AUC less than 0.75 along with its mirrored test location around the horizontal axis were eliminated from the grid. Results The mean age was 48.1 ± 16.6 years and 50.0 ± 14.5 years for healthy subjects and glaucoma patients respectively. A significant increase of SRT values by 76.5% (p < 0.001) was found in glaucoma patients in comparison with the healthy subjects. From the ROC analysis, ten out of 36 locations meeting the cut-off criteria of AUC were eliminated resulting in a new grid containing 26 test locations. SRT values were significantly different (p < 0.05) between the healthy subjects and glaucoma irrespective of the grids used. Conclusions The present study resulted in a screening grid consisting of 26 locations predominantly testing nasal, superior and inferior areas of the visual field. An internal validation of the modified grid showed 90.4% of screening accuracy which makes it a potential approach for population based glaucoma screening.

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Comparison of saccadic reaction time between normal and glaucoma using an eye movement perimeter

Cited by 27 publications

References 17 publications

Comparison of Threshold Saccadic Vector Optokinetic Perimetry (SVOP) and Standard Automated Perimetry (SAP) in Glaucoma. Part II: Patterns of Visual Field Loss and Acceptability

Comparison of Threshold Saccadic Vector Optokinetic Perimetry (SVOP) and Standard Automated Perimetry (SAP) in Glaucoma. Part II: Patterns of Visual Field Loss and Acceptability

Comparison of Saccadic Vector Optokinetic Perimetry and Standard Automated Perimetry in Glaucoma. Part I: Threshold Values and Repeatability

Development of a test grid using Eye Movement Perimetry for screening glaucomatous visual field defects

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