Abstract
Purpose :
Infantile nystagmus is a clinical symptom associated with a multitude of diseases ranging from neurological, to ophthalmic, to benign causes. Nystagmus can be clinically described based on its amplitude, frequency, direction of oscillations, and variation with gaze direction. Despite extensive work done to classify nystagmus based on the clinical description, an objective method has yet to be established. This study aims to evaluate the use of eye movement recordings' role in the correct and complete diagnosis of patients with nystagmus.
Methods :
Patients with nystagmus evaluated in our clinic were prospectively enrolled in this study. In addition to their regular clinic workup, patients underwent video recording of their nystagmus. The recordings were analyzed to measure nystagmus direction, frequency, amplitude, intensity, and waveform morphology. The nystagmus characteristics were compared with the etiology as determined by the clinical workup for correlation.
Results :
This is a prospective study that since 2021, has enrolled 40 patients: 22 males and 18 females between the ages of 4 and 18. Nystagmus recordings were obtained and analyzed from all patients. Ten individual waveform morphology patterns were identified. The classification and waveform morphology analysis obtained using eye-tracking recordings was more detailed and reproducible than clinical description. Based on the clinical work up and genetic testing, 4 categories of underlying nystagmus etiology were identified in our cohort; 45% had oculocutaneous albinism, 22.5% had optic nerve anomalies, 20% had retinal dystrophies, and 12.5% had idiopathic motor nystagmus. Visual acuity was grouped into 3 categories: good (20/40 or better), moderately decreased (20/40 to 20/100), or poor (worse than 20/100). The underlying etiology correlated with severity of visual acuity. However, no correlation between the nystagmus waveform morphology or pattern and the underlying diagnosis or visual acuity as a prognosis factor has been established so far in this cohort.
Conclusions :
So far in this study, we demonstrated that automated nystagmus recording and classification is possible and reliable. This study represents a proof of concept and a larger number of recordings are required before drawing final conclusions on these recordings' clinical applicability and usefulness.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.