Elgin Cansu Yuksel
Cerrahpasa Faculty of Medicine, Department of Ophthalmology, Istanbul University, Cerrahpaşa, Koca Mustafapaşa Cd. No:53, Fatih, 34098 İstanbul, Turkey;
J Eye Mov Res. 2025 May 19;18(3):18. doi: 10.3390/jemr18030018. eCollection 2025 Jun.
Glaucoma remains a leading cause of irreversible blindness worldwide, with early detection crucial for preventing vision loss. This study developed and validated a novel eye-tracking algorithm to detect oculomotor abnormalities in primary open-angle glaucoma (POAG). We conducted a case-control study (March-June 2021), recruiting 16 patients with moderate POAG, 16 with preperimetric POAG, and 16 age-matched controls. The participants underwent a comprehensive ophthalmic examination and eye movement recording using a high-resolution infrared tracker during two tasks: saccades to static targets and saccades to moving targets. The patients with POAG exhibited a significantly increased saccadic latency and reduced accuracy compared to the controls, with more pronounced differences in the moving target task. Notably, preperimetric POAG patients showed significant abnormalities despite having normal visual fields based on standard perimetry. Our machine learning algorithm incorporating multiple saccadic parameters achieved an excellent discriminative ability between glaucomatous and healthy subjects (AUC = 0.92), with particularly strong performance for moderate POAG (AUC = 0.97) and good performance for preperimetric POAG (AUC = 0.87). These findings suggest that eye movement analysis may serve as a sensitive biomarker for early glaucomatous damage, potentially enabling earlier intervention and improved visual outcomes.
青光眼仍是全球不可逆性失明的主要原因，早期检测对于预防视力丧失至关重要。本研究开发并验证了一种新型眼动追踪算法，以检测原发性开角型青光眼（POAG）患者的眼球运动异常。我们进行了一项病例对照研究（2021年3月至6月），招募了16例中度POAG患者、16例视野检查前POAG患者和16例年龄匹配的对照者。参与者在两项任务中接受了全面的眼科检查，并使用高分辨率红外追踪器记录了眼动：向静态目标的扫视和向移动目标的扫视。与对照组相比，POAG患者的扫视潜伏期显著延长，准确性降低，在移动目标任务中的差异更为明显。值得注意的是，尽管基于标准视野检查视野正常，但视野检查前POAG患者仍表现出明显异常。我们的机器学习算法结合了多个扫视参数，在青光眼患者和健康受试者之间具有出色的判别能力（AUC = 0.92），对中度POAG的表现尤为突出（AUC = 0.97），对视野检查前POAG的表现也较好（AUC = 0.87）。这些发现表明，眼动分析可能是早期青光眼损伤的敏感生物标志物，有可能实现更早的干预并改善视觉结果。
