The Usefulness of Gaze Tracking as an Index of Visual Field Reliability in Glaucoma Patients

Background: Compass (CenterVue, Padova, Italy) is a fundus automated perimeter which has been introduced in the clinical practice for glaucoma management in 2014. The aim of the article is to review Compass literature, comparing its performances against Humphrey Field Analyzer (Zeiss Humphrey Systems, Dublin, CA, USA). Results: Analyses on both normal and glaucoma subjects agree on the fact that Humphrey Field Analyzer and Compass are interchangeable, as the difference of their global indices is largely inferior than test -retest variability for Humphrey Field Analyzer. Compass also enables interesting opportunities for the assessment of morphology, and the integration between morphology and function on the same device. Conclusion: Visual field testing by standard automated perimetry is limited by a series of intrinsic factors related to the psychophysical nature of the examination; recent papers suggest that gaze tracking is closely related to visual field reliability. Compass, thanks to a retinal tracker and to the active dislocation of stimuli to compensate for eye movements, is able to provide visual fields unaffected by fixation instability. Also, the instrument is a true colour, confocal retinoscope and obtains high-quality 60° × 60° photos of the central retina and stereo-photos details of the optic nerve. Overlapping the image of the retina to field sensitivity may be useful in ascertaining the impact of comorbidities. In addition, the recent introduction of stereoscopic photography may be very useful for better clinical examination.

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Evidence-based Criteria for Assessment of Visual Field Reliability

Ophthalmology ◽

10.1016/j.ophtha.2017.04.035 ◽

2017 ◽

Vol 124 (11) ◽

pp. 1612-1620 ◽

Cited By ~ 27

Author(s):

Jithin Yohannan ◽

Jiangxia Wang ◽

Jamie Brown ◽

Balwantray C. Chauhan ◽

Michael V. Boland ◽

...

Keyword(s):

Visual Field ◽

Evidence Based ◽

Field Reliability

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Estimating the Reliability of Glaucomatous Visual Field for the Accurate Assessment of Progression Using the Gaze-Tracking and Reliability Indices

Ophthalmology Glaucoma ◽

10.1016/j.ogla.2019.02.001 ◽

2019 ◽

Vol 2 (2) ◽

pp. 111-119 ◽

Cited By ~ 1

Author(s):

Ryo Asaoka ◽

Yuri Fujino ◽

Shuichiro Aoki ◽

Masato Matsuura ◽

Hiroshi Murata

Keyword(s):

Visual Field ◽

Accurate Assessment ◽

Gaze Tracking ◽

Reliability Indices ◽

The Gaze

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The Association Between Visual Field Reliability Indices and Cognitive Impairment in Glaucoma Patients

Journal of Glaucoma ◽

10.1097/ijg.0000000000001269 ◽

2019 ◽

Vol 28 (8) ◽

pp. 685-690 ◽

Cited By ~ 2

Author(s):

Pushpa Raman ◽

Yeap Khy Ching ◽

Premala D. Sivagurunathan ◽

Norlina Ramli ◽

Khairul H. Mohd. Khalid

Keyword(s):

Cognitive Impairment ◽

Visual Field ◽

Reliability Indices ◽

Field Reliability

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Computational Methods for Continuous Eye-Tracking Perimetry Based on Spatio-Temporal Integration and a Deep Recurrent Neural Network

Frontiers in Neuroscience ◽

10.3389/fnins.2021.650540 ◽

2021 ◽

Vol 15 ◽

Author(s):

Alessandro Grillini ◽

Alex Hernández-García ◽

Remco J. Renken ◽

Giorgia Demaria ◽

Frans W. Cornelissen

Keyword(s):

Neural Network ◽

Visual Field ◽

Eye Tracking ◽

Recurrent Neural Network ◽

Temporal Integration ◽

Automated Perimetry ◽

Standard Automated Perimetry ◽

Gaze Tracking ◽

Deep Recurrent Neural Network ◽

Spatio Temporal

The measurement of retinal sensitivity at different visual field locations–perimetry–is a fundamental procedure in ophthalmology. The most common technique for this scope, the Standard Automated Perimetry, suffers from several issues that make it less suitable to test specific clinical populations: it can be tedious, it requires motor manual feedback, and requires from the patient high levels of compliance. Previous studies attempted to create user-friendlier alternatives to Standard Automated Perimetry by employing eye movements reaction times as a substitute for manual responses while keeping the fixed-grid stimuli presentation typical of Standard Automated Perimetry. This approach, however, does not take advantage of the high spatial and temporal resolution enabled by the use of eye-tracking. In this study, we introduce a novel eye-tracking method to perform high-resolution perimetry. This method is based on the continuous gaze-tracking of a stimulus moving along a pseudo-random walk interleaved with saccadic jumps. We then propose two computational methods to obtain visual field maps from the continuous gaze-tracking data: the first is based on the spatio-temporal integration of ocular positional deviations using the threshold free cluster enhancement (TFCE) algorithm; the second is based on using simulated visual field defects to train a deep recurrent neural network (RNN). These two methods have complementary qualities: the TFCE is neurophysiologically plausible and its output significantly correlates with Standard Automated Perimetry performed with the Humphrey Field Analyzer, while the RNN accuracy significantly outperformed the TFCE in reconstructing the simulated scotomas but did not translate as well to the clinical data from glaucoma patients. While both of these methods require further optimization, they show the potential for a more patient-friendly alternative to Standard Automated Perimetry.

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Factors Predicting a Greater Likelihood of Poor Visual Field Reliability in Glaucoma Patients and Suspects

Translational Vision Science & Technology ◽

10.1167/tvst.9.1.4 ◽

2020 ◽

Vol 9 (1) ◽

pp. 4

Author(s):

Inas F. Aboobakar ◽

Jiangxia Wang ◽

Balwantray C. Chauhan ◽

Michael V. Boland ◽

David S. Friedman ◽

...

Keyword(s):

Visual Field ◽

Field Reliability

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Pupillographic campimetry: an objective method to measure the visual field

Biomedical Engineering / Biomedizinische Technik ◽

10.1515/bmt-2017-0029 ◽

2018 ◽

Vol 63 (6) ◽

pp. 729-734 ◽

Cited By ~ 5

Author(s):

Krunoslav Stingl ◽

Tobias Peters ◽

Torsten Strasser ◽

Carina Kelbsch ◽

Paul Richter ◽

...

Keyword(s):

Visual Field ◽

Visual Field Defects ◽

Static Perimetry ◽

Visual Field Examination ◽

Gaze Tracking ◽

Pupil Response ◽

Novel Treatments ◽

Objective Monitoring ◽

Sensitivity Loss ◽

Field Defects

Abstract Pupillographic campimetry allows measuring the visual field objectively by analyzing the pupil response to perimetric stimuli. One of the drawbacks of this technique, similar to static perimetry, is the need of reliable fixation of the subject. By using stimulus sizes comparable to static perimetry and applying gaze tracking, we enable a retinotopic visual field examination regardless of fixation problems and with an increased stability and improved spatial resolution. Here, we present the results of applying the method in eight normal sighted subjects as well as in three patients suffering from diseases usually diagnosed by perimetry. The results in normal sighted subjects show a reduction in the amplitude of the pupil response with increasing eccentricity as expected. We also demonstrate that gaze-controlled campimetry is able to detect organic visual field defects objectively in a patient group and classify the visual field defects without an organic background. Moreover, we show that our method is able to evaluate the visual field sensitivity loss beyond classical perimetry in patients with late-stage retinitis pigmentosa. Thus, gaze-controlled pupil campimetry can be used in addition to classical perimetry, allowing for an objective monitoring of disease progression, rendering it as a biomarker for novel treatments.

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Computational methods for continuous eye-tracking perimetry based on spatio-temporal integration and a deep recurrent neural network

10.1101/2020.05.22.20106401 ◽

2020 ◽

Author(s):

Alessandro Grillini ◽

Alejandro Hernández-García ◽

Remco J. Renken ◽

Giorgia Demaria ◽

Frans W. Cornelissen

Keyword(s):

Neural Network ◽

Visual Field ◽

Eye Tracking ◽

Computational Methods ◽

Temporal Integration ◽

Automated Perimetry ◽

Standard Automated Perimetry ◽

Gaze Tracking ◽

Deep Recurrent Neural Network ◽

Spatio Temporal

Perimetry, the mapping of the sensitivity of different visual field locations, is an essential procedure in ophthalmology. Unfortunately, standard automated perimetry (SAP), suffers from some practical issues: it can be tedious, requires manual feedback and a high level of patient compliance. These factors limit the effectiveness of perimetry in some clinical populations. In an attempt to remove some of these limitations, alternatives to SAP have been tried based on tracking eye movements. These new approaches have attempted to mimic SAP, thus presenting stimuli on a fixed grid, and replacing manual by ocular responses. While this solves some issues of SAP, these approaches hardly exploit the high spatial and temporal resolution facilitated by eye-tracking. In this study, we present two novel computational methods that do tap into this potential: (1) an analytic method based on the spatio-temporal integration of positional deviations by means of Threshold Free Cluster Enhancement (TFCE) and (2) a method based on training a recursive deep artificial neural network (RNN). We demonstrate that it is possible to reconstruct visual field maps based on continuous gaze-tracking data acquired in a relatively short amount of time.

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Role of Visual Field Reliability Indices in Ruling Out Glaucoma

JAMA Ophthalmology ◽

10.1001/jamaophthalmol.2014.3609 ◽

2015 ◽

Vol 133 (1) ◽

pp. 40 ◽

Cited By ~ 12

Author(s):

Harsha L. Rao ◽

Ravi K. Yadav ◽

Viquar U. Begum ◽

Uday K. Addepalli ◽

Nikhil S. Choudhari ◽

...

Keyword(s):

Visual Field ◽

Reliability Indices ◽

Field Reliability

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The association between ocular surface measurements with visual field reliability indices and gaze tracking results in preperimetric glaucoma

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2017-310309 ◽

2017 ◽

Vol 102 (4) ◽

pp. 525-530

Author(s):

Takahiro Arai ◽

Hiroshi Murata ◽

Masato Matsuura ◽

Tomohiko Usui ◽

Ryo Asaoka

Keyword(s):

Eye Movements ◽

Visual Field ◽

Ocular Surface ◽

Open Angle Glaucoma ◽

Surface Condition ◽

Average Frequency ◽

Gaze Tracking ◽

Reliability Indices ◽

Surface Measurements ◽

The Relationship

Background/aimsTo investigate the relationship between gaze tracking (GT) results and ocular surface condition in glaucoma.MethodThe Humphrey 24–2 visual field (VF) was measured in 34 eyes of 30 patients with open-angle glaucoma without VF damage. Tear break-up time, Schirmer’s test, tear meniscus volume (TMV) and presence of superficial punctate keratopathy (SPK) were also measured in order to describe the condition of the ocular surface. Various GT parameters were calculated: the average frequency of eye movements per stimulus between 1° and 2° (move1-2), the average frequency of eye movements per stimulus between 3° and 5° (move3-5), the average frequency of eye movements per stimulus more than 6° (move≥6), the average tracking failure frequency per stimulus (TFF) and the average blinking frequency. The relationship between GT parameters, reliability indices and ocular surface measurements was investigated using linear mixed modelling.ResultsSPK was positively associated with high rates of move3-5 (coefficient=0.12 for SPK+, p=0.003) and move≥6 (coefficient=0.052 for SPK+, p=0.023). High TMV was significantly related to TFF (coefficient=0.37, p=0.023). Fixation losses, false-positives and false-negatives were not significantly associated with any GT parameters or ocular surface measurements.ConclusionSPK is associated with increased frequency of eye movements (move3-5 and move≥6). In addition, large TMV is associated with increased rate of TFF. Careful attention should be paid when interpreting GT parameters in patients with SPK or a large TMV.

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