June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Optimal optokinetic parameters to distinguish young children with abnormal comprehensive eye exams from normals
Author Affiliations & Notes
  • Monte Mills
    Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
    Ophthalmology, Scheie Eye Institute, Philadelphia, Pennsylvania, United States
  • Elise Ciner
    Salus University, Pennsylvania College of Optometry, Elkins Park, Pennsylvania, United States
  • Gui-Shuang Ying
    Ophthalmology, Scheie Eye Institute, Philadelphia, Pennsylvania, United States
  • Ebenezer Daniel
    Ophthalmology, Scheie Eye Institute, Philadelphia, Pennsylvania, United States
  • Elizabeth DeSouza
    Vifant LLC, Philadelphia, Pennsylvania, United States
  • E Revel Martin
    Ophthalmology, Scheie Eye Institute, Philadelphia, Pennsylvania, United States
  • Siva Meiyeppen
    Salus University, Pennsylvania College of Optometry, Elkins Park, Pennsylvania, United States
  • Jenny Myung
    Salus University, Pennsylvania College of Optometry, Elkins Park, Pennsylvania, United States
  • Erin Jenewein
    Salus University, Pennsylvania College of Optometry, Elkins Park, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Monte Mills, Vifant LLC (P), Vifant LLC (S), Vifant LLC (I); Elise Ciner, None; Gui-Shuang Ying, None; Ebenezer Daniel, None; Elizabeth DeSouza, Vifant LLC (I), Vifant LLC (S); E Revel Martin, None; Siva Meiyeppen, None; Jenny Myung, None; Erin Jenewein, None
  • Footnotes
    Support  NSF SBIR Phase 1 Grant 1746353
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 231. doi:
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      Monte Mills, Elise Ciner, Gui-Shuang Ying, Ebenezer Daniel, Elizabeth DeSouza, E Revel Martin, Siva Meiyeppen, Jenny Myung, Erin Jenewein; Optimal optokinetic parameters to distinguish young children with abnormal comprehensive eye exams from normals. Invest. Ophthalmol. Vis. Sci. 2020;61(7):231.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose :
Measurement of vision and detection of vision disorders in preverbal children is challenging. Optokinetic nystagmus (OKN), is an early reflexive visual response, with saccadic and pursuit eye movements that can be measured over a range of spatial frequencies. OKN response may distinguish children with a risk of vision abnormality from normals, but optimal parameters and cut-points for detection are not known.

Methods :
69 children from 9 to 36 months of age (mean 19.7 +9.4), had comprehensive eye examinations (CEE) to determine presence or absence of ocular or visual disorders. Subjects were tested with Vifant VISTA OKN binocularly and monocularly. Vifant VISTA uses OKN stimulus of black and white gratings varying in 4 increments from 0.2 - 2.4 cycles per degree (CPD) for 5 seconds each, at a rate of 10 degrees per second at 44 cm, using a commercial tablet computer screen and video capture. Trained video readers quantified pursuit and saccadic eye movements. Cut-points of response parameters (number of saccade and pursuit movements detected at each spatial frequency) for three age groups (<12 months, 13-24 months, and 25-36 months) were considered for calculating sensitivity and specificity for detection of abnormal CEE.

Results : 43 children had no abnormality, and 26 (37.7%) had abnormality on CEE. Optimizing sensitivity at 80% or greater, specificity of 31-50% was achieved using either pursuit or saccade movements, using >0, >1, >2, and >3 movements in each age group, when testing monocularly (Table 1) or binocularly (Table 2). Specificity of 34-53% was achieved using total movements with all stimulus frequencies (Tables 1, 2). Combining pursuit and saccadic measurements did not improve specificity substantially.

Conclusions :
Age-specific cut-points of OKN parameters across a range of spatial frequencies demonstrated moderate specificity, when optimizing sensitivity to > 80%. OKN response at frequencies below visual threshold differentiated children with abnormal CEE. Models using OKN responses across a range of spatial frequency may be the most effective to identify children at risk for vision disorders.

This is a 2020 ARVO Annual Meeting abstract.

 

 

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