基于眼动功能的脑/皮质视觉障碍分类与分类

IF 3.2 Q1 OPHTHALMOLOGY

Ophthalmology science Pub Date : 2025-02-03 DOI:10.1016/j.xops.2025.100728

Melinda Y. Chang MD , Mark S. Borchert MD

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引用次数: 0

摘要

脑/皮质性视力障碍（CVI）是儿童视力障碍的主要原因，通常与眼运动异常有关。眼动追踪以前被用来描述CVI的动眼肌功能。本研究的目的是评估眼动追踪在CVI的诊断、分类和预测中的应用。前瞻性纵向研究。参与者：39名CVI患儿和41名年龄匹配的对照组。方法CVI患儿在1年内进行了4次眼动追踪，年龄匹配的对照组完成了1次眼动追踪。注视和扫视由眼动追踪软件标记，并用于计算眼球运动特征。在患有CVI的儿童中，使用这9个特征进行无监督数据驱动聚类分析，以确定3个CVI眼动追踪动眼肌组。比较眼动组的临床和人口学特征。(1)眼动特征曲线下面积（Area under the curve， AUC）对CVI患者和对照组进行分类；(2) 3个CVI眼动追踪组在临床和人口统计学特征上的差异；(3) 3个CVI眼动追踪组1年内的视敏度变化。结果6项视动特征（注视和扫视潜伏期、频率和离屏比例）对CVI患儿和对照组的AUC≥0.90 (P <；0.0001)。脑/皮质性视觉障碍眼动组VA差异有统计学意义(P <；0.0001)和1年内VA的变化（P = 0.049）。B组VA改善最大的患者更年轻，长期缺氧缺血性脑病的发生率更高。结论眼动功能追踪指标能准确区分CVI患儿与同龄对照组。聚类分析显示3个CVI眼动组具有预后意义。眼动追踪有望作为CVI患者动眼肌功能的一种客观、定量测量方法，未来可能在临床实践（用于纵向评估、预测和指导个体化干预）和研究（作为临床试验中对患者进行分层的结果测量或方法）中都很有用。财务披露专有或商业披露可在本文末尾的脚注和披露中找到。

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Cerebral/Cortical Visual Impairment Classification and Categorization Using Eye Tracking Measures of Oculomotor Function

Purpose

Cerebral/cortical visual impairment (CVI) is a leading cause of pediatric visual impairment and is frequently associated with abnormal ocular motility. Eye tracking has previously been used to characterize oculomotor function in CVI. The purpose of this study was to evaluate the utility of eye tracking in diagnosis, categorization, and prognostication of CVI.

Design

Prospective longitudinal study.

Participants

Thirty-nine children with CVI and 41 age-matched controls.

Methods

Children with CVI underwent 4 eye tracking sessions over 1 year, and age-matched controls completed 1 eye tracking session. Fixations and saccades were labeled by the eye tracking software and used to compute 9 oculomotor features. In children with CVI, unsupervised data-driven clustering analysis using these 9 features was performed to identify 3 CVI eye tracking oculomotor groups. Clinical and demographic characteristics of eye tracking oculomotor groups were compared.

Main Outcome Measures

(1) Area under the curve (AUC) for eye tracking oculomotor features in classifying patients with CVI and controls; (2) differences between 3 CVI eye tracking oculomotor groups on clinical and demographic characteristics; and (3) change in visual acuity (VA) over 1 year in 3 CVI eye tracking oculomotor groups.

Results

Six oculomotor features (fixation and saccade latency, frequency, and off-screen proportion) had an AUC ≥0.90 in classifying children with CVI and controls (P < 0.0001). Cerebral/cortical visual impairment eye tracking oculomotor groups had significantly different VA (P < 0.0001) and change in VA over 1 year (P = 0.049). Patients in group B, who had the greatest improvement in VA, were younger and had higher rates of term hypoxic ischemic encephalopathy.

Conclusions

Eye tracking measures of oculomotor function accurately distinguish between children with CVI and age-matched controls. Clustering analysis revealed 3 CVI eye tracking oculomotor groups with prognostic significance. Eye tracking shows promise as an objective, quantitative measure of oculomotor function in CVI that may in future be useful in both clinical practice (for longitudinal assessment, prognostication, and guiding individualized interventions) and research (as an outcome measure or method to stratify patients in clinical trials).