Fixation Stability during Binocular Viewing in Patients with Age-Related Macular Degeneration

Tarita-Nistor, Luminita; Brent, Michael H.; Steinbach, Martin J.; González, Esther G.

doi:10.1167/iovs.10-6059

Cited by 53 publications

(63 citation statements)

References 35 publications

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“…Fixation instability was defined by the size of the bivariate contour ellipse area, an area within which 68% of all the x,y coordinates of the approximately 10,000 samples of fixation position that occurred during the 20-second period. 19 …”

Section: Methodsmentioning

confidence: 99%

Slow reading in children with anisometropic amblyopia is associated with fixation instability and increased saccades

Kelly

Jost

Cruz

et al. 2017

Journal of American Association for Pediatric Ophthalmology and

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Background Previous studies show slow reading in strabismic amblyopia. We recently identified amblyopia, not strabismus, as the key factor in slow reading in children. No studies have focused on reading in amblyopic children without strabismus. We examined reading in anisometropic children and evaluated whether slow reading was associated with ocular motor dysfunction in children with amblyopia. Methods Anisometropic children (7–12 years) with or without amblyopia were compared to age-similar normal controls. Children silently read a grade-appropriate paragraph during binocular viewing. Reading rate (words/min), number of forward and regressive saccades (per 100 words) and fixation duration were recorded with the ReadAlyzer. Binocular fixation instability was also evaluated (EyeLink 1000). Results Amblyopic anisometropic children read more slowly (n = 25; mean with standard deviation, 149 ± 42 words/min) than nonamblyopic anisometropic children (n = 15; 196 ± 80 words/min; P = 0.024) and controls (n = 25; 191 ± 65 words/min; P = 0.020). Nonamblyopic anisometropic children read at a comparable rate to controls (P = 0.81). Slow reading in amblyopic anisometropic children was correlated with increased forward saccades (r = −0.84, P < 0.001), increased regressive saccades (r = −0.85, P < 0.001), and fellow eye instability during binocular viewing (r = −0.52, P = 0.019). Conclusions Slow reading in school-age children with anisometropic amblyopia is related to increased frequency of saccades and fixation instability of the fellow eye. Further research should consider the effects of slower reading on academic performance.

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Section: Methodsmentioning

confidence: 99%

Slow reading in children with anisometropic amblyopia is associated with fixation instability and increased saccades

Kelly

Jost

Cruz

et al. 2017

Journal of American Association for Pediatric Ophthalmology and

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show abstract

“…In addition, we were interested to determine whether there exists a positive correlation between visual acuity and fixation stability. Such a correlation is observed in people with macular disease (Reinhard et al, 2007; Tarita-Nistor, Brent, Steinbach & González, 2011), and there are some recent attempts to test whether such a relationship also exists in amblyopic eyes, with inconsistent results. On one hand, based on the results of 13 adult amblyopes (strabismic [ n = 5], anisometropic [ n = 4] and mixed [ n = 4]), González et al (2012) concluded: “For the amblyopia group, visual acuity and fixation stability did not exhibit significant correlations.” (p. 5391).…”

Section: Introductionmentioning

confidence: 99%

Characteristics of fixational eye movements in amblyopia: Limitations on fixation stability and acuity?

et al. 2015

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Persons with amblyopia, especially those with strabismus, are known to exhibit abnormal fixational eye movements. In this paper, we compared six characteristics of fixational eye movements among normal control eyes (n=16), the non-amblyopic fellow eyes and the amblyopic eyes of anisometropic (n=14) and strabismic amblyopes (n=14). These characteristics include the frequency, magnitude of landing errors, amplitude and speed of microsaccades, and the amplitude and speed of slow drifts. Fixational eye movements were recorded using retinal imaging while observers monocularly fixated a 1° cross. Eye position data were recovered using a cross-correlation procedure. We found that in general, the characteristics of fixational eye movements are not significantly different between the fellow eyes of amblyopes and controls, and that the strabismic amblyopic eyes are always different from the other groups. Next, we determined the primary factors that limit fixation stability and visual acuity in amblyopic eyes by examining the relative importance of the different oculomotor characteristics, adding acuity (for fixation stability) or fixation stability (for acuity), and the type of amblyopia, as predictive factors in a multiple linear regression model. We show for the first time that the error magnitude of microsaccades, acuity, amplitude and frequency of microsaccades are primary factors limiting fixation stability; while the error magnitude, fixation stability, amplitude of drifts and amplitude of microsaccades are the primary factors limiting acuity. A mediation analysis showed that the effects of error magnitude and amplitude of microsaccades on acuity could be explained, at least in part, by their effects on fixation stability.

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“…However, this may be inappropriate for recordings of movements in eyes with retinal disease affecting both eyes differently [27] , as documented in the present study where fixation stability of the worst eye improved when the best eye was included to allow binocular fixation. Therefore, monocular recordings used to diagnose and predict the treatment effect in one eye should be distinguished from binocular recordings that reflect the patient's visual performance.…”

Section: Discussionmentioning

confidence: 84%

Binocular Fixation Reduces Fixational Eye Movements in the Worst Eye of Patients with Center-Involving Diabetic Macular Edema

Jakobsen

Larsen²,

Bek³

2017

Ophthalmic Res

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Purpose: Treatment of diabetic maculopathy with vascular endothelial growth factor inhibitors is in some patients ineffective, and, therefore, parameters predicting visual outcome after treatment should be identified. It has been shown that fixational saccades are increased in patients with reduced visual acuity secondary to diabetic maculopathy, but it is unknown to what extent these saccades in an eye affected by diabetic maculopathy are influenced by the other eye during binocular fixation. Methods: In 57 eyes from 29 diabetic patients with clinically significant macular edema, fixational eye movements were recorded using the iView X™ video-based eye tracker, and quantitative measures of fixation with the worst eye obtained during monocular and binocular fixation were compared. Results: Fixational saccades during monocular fixation had a significantly higher frequency (p = 0.005), a larger amplitude (p = 0.03), and involved a larger retinal area (p = 0.02) than during binocular fixation. There was a significant negative correlation (r² = 0.18, p = 0.02) between visual acuity and the area of fixation during monocular but not during binocular fixation (r² = 0.007, p = 0.68). Conclusion: Binocular fixation can reduce the area of fixation and the amplitude of fixational saccades in the worst eye of patients with diabetic maculopathy. Fixational saccades in diabetic maculopathy should be studied during monocular fixation.

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Fixation Stability during Binocular Viewing in Patients with Age-Related Macular Degeneration

Abstract: Fixational ocular motor control and visual acuity are driven by the better-seeing eye when patients with AMD and large interocular acuity differences perform the tasks binocularly.

Cited by 53 publications

References 35 publications

Slow reading in children with anisometropic amblyopia is associated with fixation instability and increased saccades

Slow reading in children with anisometropic amblyopia is associated with fixation instability and increased saccades

Characteristics of fixational eye movements in amblyopia: Limitations on fixation stability and acuity?

Binocular Fixation Reduces Fixational Eye Movements in the Worst Eye of Patients with Center-Involving Diabetic Macular Edema

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