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Published on: March 17, 2023
The Assessment of Visual Fields in Infants Using Saccadic Vector Optokinetic Perimetry (SVOP): A Feasibility Study
Antonios Perperidis1,2, Alice D McTrusty1,2,3, Lorraine A Cameron1,3
1Department of Child Life and Health, University of Edinburgh, Edinburgh, UK.
Insights
Saccadic vector optokinetic perimetry (SVOP) shows promise for infant visual field (VF) testing. Modified SVOP successfully assessed VFs in most healthy infants, suggesting its potential for early detection of visual impairments.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Vision Science
Background:
- Assessing visual fields (VF) in infants is crucial for early detection of visual impairments.
- Traditional methods can be challenging due to infants' limited cooperation and attention spans.
- Automated eye-tracking perimetry offers a potential solution for objective VF assessment.
Purpose of the Study:
- To evaluate the feasibility of saccadic vector optokinetic perimetry (SVOP) for infant visual field assessment.
- To determine if an adapted SVOP protocol can be successfully implemented in healthy infants.
Main Methods:
- Thirteen healthy infants (3.5-12.0 months) underwent testing with an adapted SVOP protocol.
- Modifications included animated fixation targets, larger stimuli, and a tiered test pattern.
- Binocular confrontation VF testing and visual acuity tests were also performed for comparison.
Main Results:
- 92.3% of infants completed a 4-point screening test, with higher completion rates for more complex tests.
- Performance metrics like completion rate and accuracy were analyzed.
- The adapted SVOP protocol was feasible for assessing binocular visual fields in this cohort.
Conclusions:
- Modified saccadic vector optokinetic perimetry (SVOP) is a feasible method for assessing infant visual fields.
- Further research with larger cohorts is needed to establish normative data and diagnostic accuracy.
- Eye-tracking perimetry holds potential for automated visual field assessment in infants.
Purpose:
To examine the feasibility of saccadic vector optokinetic perimetry (SVOP), an automated eye tracking perimeter, as a tool for visual field (VF) assessment in infants.
Methods:
Thirteen healthy infants aged between 3.5 and 12.0 months were tested binocularly using an adapted SVOP protocol. SVOP uses eye tracking technology to measure gaze responses to stimuli presented on a computer screen. Modifications of SVOP for testing infants included adjusting the fixation target to display a short animation, increasing the stimulus size to equivalent to Goldmann V, and introducing a tiered test pattern strategy. Binocular, single-quadrant confrontation VF testing and Keeler preferential looking cards visual acuity testing was also performed.
Results:
Using multiple test attempts when required, all but the youngest infant (12 of 13 [92.3%]) successfully completed a 4-point screening test. Seven infants (53.8%) successfully completed the 12-point test, four (30.8%) successfully completed the 20-point test, and three (23.1%) successfully completed the 40-point test. The effect of multiple test attempts and the complexity of the test pattern (number of test points) on performance was investigated, including test completion rate, percentage of correctly seen stimuli, and average time per tested stimulus.
Conclusions:
The modified SVOP test strategy allowed successful assessment of binocular VFs in healthy infants. Future data collection from larger cohorts of infants is needed to derive normative limits of detection and assess accuracy in detecting and monitoring infant VF abnormalities.
Translational Relevance:
Eye tracking perimetry may provide a useful method of automated VF assessment in infants.
