Quantifying fixation in patients with Stargardt disease

Reinhard, Jens; Messias, André; Dietz, Klaus; MacKeben, Manfred; Lakmann, Raimund; Scholl, Hendrik P. N.; Apfelstedt-Sylla, Eckart; Weber, Bernhard H. F.; Seeliger, Mathias W.; Zrenner, Eberhart; Trauzettel‐Klosinski, Susanne

doi:10.1016/j.visres.2007.04.012

Cited by 63 publications

(62 citation statements)

References 27 publications

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“…In the late-stage disease, a central atrophic lesion is visible in the photograph, and the OCT shows the total retinal atrophy in the foveal area and the subfoveal lipofuscin accumulation, appearing as highly reflective deposits Open squares indicate points that were not seen and filled squares indicate points that were seen Sunness et al [34] and Rohrschneider et al [29] who also evaluated fixation behavior in STGD patients using SLO microperimetry. More recently, Reinhard et al [28] performed quantitative analysis of SLO videotapes recorded on patients with STGD demonstrating the eccentricity of the fixation locus and fixation stability. The authors found that 77% of the eyes fixated eccentrically, and in 70% of them the preferred retinal locus was located above the central retinal lesion.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of macular abnormalities in Stargardt’s disease using optical coherence tomography and scanning laser ophthalmoscope microperimetry

Berisha

Feke

Aliyeva

et al. 2008

Graefes Arch Clin Exp Ophthalmol

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Section: Discussionmentioning

confidence: 99%

“…Previous studies using SLO Microperimetry in patients with STGD have shown that most patients develop a central absolute scotoma and establish eccentric fixation [24,25,28,29].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of macular abnormalities in Stargardt’s disease using optical coherence tomography and scanning laser ophthalmoscope microperimetry

Berisha

Feke

Aliyeva

et al. 2008

Graefes Arch Clin Exp Ophthalmol

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“…In this context, microperimetry could be more sensitive to detect functional impairment in Kjellin's syndrome, because preserved visual acuity is normally found if the fovea is not involved. However, microperimetry findings show a clear distinction in comparison with eccentric and unstable fixation and the loss of sensitivity found in Stargardt disease (7) . As expected, no changes were recorded on ERG, presumably because of the mild and focal retinal impairment typical of Kjellin's syndrome (8) .…”

Section: Discussionmentioning

confidence: 73%

Macular dystrophy associated with Kjellin’s syndrome: a case report

Castro¹,

Meirelles²,

Arcieri³

et al. 2015

Arquivos Brasileiros De Oftalmologia

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Hereditary spastic paraplegia (HSP) is characterized by weakness and spasticity of the lower extremities. Kjellin's syndrome is a rare syndrome associated with HSP. The syndrome is characterized by the presence of bilateral retinal flecks, similar to the findings in Stargardt disease and fundus flavimaculatus. We report the case of a 34-year-old male who presented with complete features of Kjellin's syndrome, with typical retinal findings observed on multimodal imaging (spectral domain optical coherence tomography [SD-OCT], near-infrared reflectance and autofluorescence imaging). The ophthalmological changes at early stages of the disease may not impair visual acuity. Therefore, the detection of central retinal degeneration requires thorough fundus examination.

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“…[3][4][5] We recently described a method using confocal scanning laser ophthalmoscope (SLO)-based eye tracking during the performance of optical coherence tomography (OCT) to characterize changes in fixation instability and foveation in patients with optic neuropathy. 6 Visual fixation abnormalities, including the presence of square-wave jerks, also are wellrecognized in neurologic disorders, including Alzheimer dementia [7][8][9] and the Parkinsonian syndromes, 10,11 and it is recognized increasingly that changes in microsaccade characteristics also may occur.…”

Section: Results Fixation Instability Was Increased In Ms Wo On Eyesmentioning

confidence: 99%

Visual Fixation Instability in Multiple Sclerosis Measured Using SLO-OCT

Mallery

Poolman

Thurtell

et al. 2018

Invest. Ophthalmol. Vis. Sci.

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Citation: Mallery RM, Poolman P, Thurtell MJ, et al. Visual fixation instability in multiple sclerosis measured using SLO-OCT. Invest Ophthalmol Vis Sci. 2018;59:196-201. https://doi.org/10.1167/iovs.17-22391 PURPOSE. Precise measurements of visual fixation and its instability were recorded during optical coherence tomography (OCT) as a marker of neural network dysfunction in multiple sclerosis (MS), which could be used to monitor disease progression or response to treatment. METHODS.A total of 16 MS patients and 26 normal subjects underwent 30 seconds of scanning laser ophthalmoscope (SLO)-based eye tracking during OCT scanning of retinal layer thickness. Study groups consisted of normal eyes, MS eyes without prior optic neuritis (MS wo ON), and MS eyes with prior optic neuritis (MS þ ON). Kernel density estimation quantified fixation instability from the distribution of fixation points on the retina. In MS wo ON eyes, fixation instability was compared to other measures of visual and neurologic function. RESULTS. Fixation instability was increased in MS wo ON eyes (0.062 deg2 ) compared to normal eyes (0.030 deg 2 , P ¼ 0.015). A further increase was seen for MS þ ON eyes (0.11 deg 2 ) compared to MS wo ON (P ¼ 0.04) and normal (P ¼ 0.006) eyes. Fixation instability correlated weakly with ganglion cell layer (GCL) volume and showed no correlation with lowcontrast letter acuity, EDSS score, or SDMT score.CONCLUSIONS. Fixation instability reflects the integrity of a widespread neural network germane to visual processing and ocular motor control, and is disturbed in MS. Further study of visual fixation, including the contribution of microsaccades to fixation instability, may provide insight into the localization of fixation abnormalities in MS and introduce innovative and easily measured outcomes for monitoring progression and treatment response.

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Quantifying fixation in patients with Stargardt disease

Cited by 63 publications

References 27 publications

Evaluation of macular abnormalities in Stargardt’s disease using optical coherence tomography and scanning laser ophthalmoscope microperimetry

Evaluation of macular abnormalities in Stargardt’s disease using optical coherence tomography and scanning laser ophthalmoscope microperimetry

Macular dystrophy associated with Kjellin’s syndrome: a case report

Visual Fixation Instability in Multiple Sclerosis Measured Using SLO-OCT

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