McDonald Matthew A, Stevenson Clark H, Kersten Hannah M, Danesh-Meyer Helen V
Department of Ophthalmology, University of Auckland, Auckland, New Zealand.
School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand.
Eye Brain. 2022 Sep 8;14:83-114. doi: 10.2147/EB.S361946. eCollection 2022.
Glaucoma is a common condition that relies on careful clinical assessment to diagnose and determine disease progression. There is growing evidence that glaucoma is associated not only with loss of retinal ganglion cells but also with degeneration of cortical and subcortical brain structures associated with vision and eye movements. The effect of glaucoma pathophysiology on eye movements is not well understood. In this review, we examine the evidence surrounding altered eye movements in glaucoma patients compared to healthy controls, with a focus on quantitative eye tracking studies measuring saccades, fixation, and optokinetic nystagmus in a range of visual tasks. The evidence suggests that glaucoma patients have alterations in several eye movement domains. Patients exhibit longer saccade latencies, which worsen with increasing glaucoma severity. Other saccadic abnormalities include lower saccade amplitude and velocity, and difficulty inhibiting reflexive saccades. Fixation is pathologically altered in glaucoma with reduced stability. Optokinetic nystagmus measures have also been shown to be abnormal. Complex visual tasks (eg reading, driving, and navigating obstacles), integrate these eye movements and result in behavioral adaptations. The review concludes with a summary of the evidence and recommendations for future research in this emerging field.
青光眼是一种常见病症，需要通过仔细的临床评估来进行诊断并确定疾病进展。越来越多的证据表明，青光眼不仅与视网膜神经节细胞的丧失有关，还与与视觉和眼球运动相关的皮质及皮质下脑结构的退化有关。青光眼病理生理学对眼球运动的影响尚未得到充分理解。在这篇综述中，我们研究了与健康对照相比，青光眼患者眼球运动改变的相关证据，重点关注在一系列视觉任务中测量扫视、注视和视动性眼球震颤的定量眼动追踪研究。证据表明，青光眼患者在几个眼球运动领域存在改变。患者表现出更长的扫视潜伏期，且随着青光眼严重程度的增加而恶化。其他扫视异常包括较低的扫视幅度和速度，以及抑制反射性扫视的困难。青光眼患者的注视在病理上发生改变，稳定性降低。视动性眼球震颤测量结果也显示异常。复杂的视觉任务（如阅读、驾驶和避开障碍物）整合了这些眼球运动，并导致行为适应。综述最后总结了证据，并对这一新兴领域的未来研究提出了建议。
