Fixational eye movements following concussion

DOI

10.1167/jov.21.13.11

Authors

Bianca T. Leonard, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Anthony P. Kontos, Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
Gregory F. Marchetti, Department of Physical Therapy, Duquesne University, Pittsburgh, PA, USA.
Min Zhang, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Shawn R. Eagle, Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
Hope M. Reecher, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Ethan S. Bensinger, Vision Science Group, University of California, Berkeley, Berkeley, CA, USA.
Valerie C. Snyder, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Cyndi L. Holland, Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
Christy K. Sheehy, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.
Ethan A. Rossi, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Document Type

Journal Article

Publication Date

12-1-2021

Publication Title

Journal of vision

Volume

21

Issue

13

First Page

11

Abstract

The purpose of this study was to evaluate fixational eye movements (FEMs) with high spatial and temporal resolution following concussion, where oculomotor symptoms and impairments are common. Concussion diagnosis was determined using current consensus guidelines. A retinal eye-tracking device, the tracking scanning laser ophthalmoscope (TSLO), was used to measure FEMs in adolescents and young adults following a concussion and in an unaffected control population. FEMs were quantified in two fixational paradigms: (1) when fixating on the center, or (2) when fixating on the corner of the TSLO imaging raster. Fixational saccade amplitude in recent concussion patients (≤ 21 days) was significantly greater, on average, in the concussion group (mean = 1.03°; SD = 0.36°) compared with the controls (mean = 0.82°; SD = 0.31°), when fixating on the center of the imaging raster (t = 2.87, df = 82, p = 0.005). These fixational saccades followed the main sequence and therefore also had greater peak velocity (t = 2.86, df = 82, p = 0.006) and peak acceleration (t = 2.80, df = 82, p = 0.006). These metrics significantly differentiated concussed from controls (AUC = 0.67-0.68, minimum p = 0.005). No group differences were seen for the drift metrics in either task or for any of the FEMs metrics in the corner-of-raster fixation task. Fixational saccade amplitudes were significantly different in the concussion group, but only when fixating on the center of the raster. This task specificity suggests that task optimization may improve differentiation and warrants further study. FEMs measured in the acute-to-subacute period of concussion recovery may provide a quick (<3 >minutes), objective, sensitive, and accurate ocular dysfunction assessment. Future work should assess the impact of age, mechanism of injury, and post-concussion recovery on FEM alterations following concussion.

Open Access

Gold

Repository Citation

Leonard, B. T., Kontos, A. P., Marchetti, G. F., Zhang, M., Eagle, S. R., Reecher, H. M., Bensinger, E. S., Snyder, V. C., Holland, C. L., Sheehy, C. K., & Rossi, E. A. (2021). Fixational eye movements following concussion. Journal of vision, 21 (13), 11. https://doi.org/10.1167/jov.21.13.11