Cai Yuqing, Strauch Christoph, Van der Stigchel Stefan, Brink Antonia F Ten, Cornelissen Frans W, Naber Marnix
Experimental Psychology, Faculty of Social Sciences, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands.
Laboratory for Experimental Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Graefes Arch Clin Exp Ophthalmol. 2025 Jan 9. doi: 10.1007/s00417-024-06733-1.
Assessing the quality of the visual field is important for the diagnosis of ophthalmic and neurological diseases and, consequently, for rehabilitation. Visual field defects (VFDs) are typically assessed using standard automated perimetry (SAP). However, SAP requires participants to understand instructions, maintain fixation and sustained attention, and provide overt responses. These aspects make SAP less suitable for very young or cognitively impaired populations. Here we investigate the feasibility of a new and less demanding form of perimetry. This method assesses visual sensitivity based on pupil responses while performing the perhaps simplest task imaginable: watching movies.
We analyzed an existing dataset, with healthy participants (n = 70) freely watching movies with or without gaze-contingent simulated VFDs, either hemianopia (left- or right-sided) or glaucoma (large nasal arc, small nasal arc, and tunnel vision). Meanwhile, their gaze and pupil size were recorded. Using a recently published toolbox (Open-DPSM), we modeled the relative contribution of visual events to the pupil responses to indicate relative visual sensitivity across the visual field and to dissociate between conditions with and without simulated VFDs.
Conditions with and without simulated VFDs could be dissociated, with an AUC ranging from 0.85 to 0.97, depending on the specific simulated VFD condition. In addition, the dissociation was better when including more movies in the modeling but the model with as few movies as 10 movies was sufficient for a good classification (AUC ranging from 0.84 to 0.96).
Movie-viewing pupil perimetry is promising in providing complementary information for the diagnosis of VFDs, especially for those who are unable to perform conventional perimetry.
评估视野质量对于眼科和神经疾病的诊断以及康复至关重要。视野缺损（VFD）通常使用标准自动视野计（SAP）进行评估。然而，SAP要求参与者理解指令、保持注视和持续注意力，并做出明显反应。这些因素使得SAP不太适合非常年幼或认知受损的人群。在此，我们研究一种新的、要求较低的视野计形式的可行性。这种方法在执行可能是最简化的任务（观看电影）时，基于瞳孔反应来评估视觉敏感度。
我们分析了一个现有数据集，其中健康参与者（n = 70）在有或没有基于注视的模拟VFD（偏盲，左侧或右侧，或青光眼，大鼻侧弓形、小鼻侧弓形和管状视野）的情况下自由观看电影。同时，记录他们的注视和瞳孔大小。使用最近发布的工具箱（Open-DPSM），我们对视觉事件对瞳孔反应的相对贡献进行建模，以指示整个视野的相对视觉敏感度，并区分有和没有模拟VFD的情况。
有和没有模拟VFD的情况可以区分，曲线下面积（AUC）范围为0.85至0.97，具体取决于特定的模拟VFD情况。此外，在建模中纳入更多电影时，区分效果更好，但仅用10部电影的模型就足以实现良好的分类（AUC范围为0.84至0.96）。
观看电影时的瞳孔视野计有望为VFD的诊断提供补充信息，特别是对于那些无法进行传统视野计检查的人。
