The Pattern of Visual Fixation Eccentricity and Instability in Optic Neuropathy and Its Spatial Relationship to Retinal Ganglion Cell Layer Thickness

Robert M Mallery; Pieter Poolman; Matthew J Thurtell; Jui-Kai Wang; Mona K Garvin; Johannes Ledolter; Randy H Kardon

doi:10.1167/iovs.15-18916

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The Pattern of Visual Fixation Eccentricity and Instability in Optic Neuropathy and Its Spatial Relationship to Retinal Ganglion Cell Layer Thickness

Journal article

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The Pattern of Visual Fixation Eccentricity and Instability in Optic Neuropathy and Its Spatial Relationship to Retinal Ganglion Cell Layer Thickness

Robert M Mallery, Pieter Poolman, Matthew J Thurtell, Jui-Kai Wang, Mona K Garvin, Johannes Ledolter and Randy H Kardon

Investigative ophthalmology & visual science, Vol.57(9), pp.OCT429-OCT437

07/01/2016

DOI: 10.1167/iovs.15-18916

PMCID: PMC4968926

PMID: 27409502

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Abstract

The purpose of this study was to assess whether clinically useful measures of fixation instability and eccentricity can be derived from retinal tracking data obtained during optical coherence tomography (OCT) in patients with optic neuropathy (ON) and to develop a method for relating fixation to the retinal ganglion cell complex (GCC) thickness. Twenty-nine patients with ON underwent macular volume OCT with 30 seconds of confocal scanning laser ophthalmoscope (cSLO)-based eye tracking during fixation. Kernel density estimation quantified fixation instability and fixation eccentricity from the distribution of fixation points on the retina. Preferred ganglion cell layer loci (PGCL) and their relationship to the GCC thickness map were derived, accounting for radial displacement of retinal ganglion cell soma from their corresponding cones. Fixation instability was increased in ON eyes (0.21 deg2) compared with normal eyes (0.06982 deg2; P < 0.001), and fixation eccentricity was increased in ON eyes (0.48°) compared with normal eyes (0.24°; P = 0.03). Fixation instability and eccentricity each correlated moderately with logMAR acuity and were highly predictive of central visual field loss. Twenty-six of 35 ON eyes had PGCL skewed toward local maxima of the GCC thickness map. Patients with bilateral dense central scotomas had PGCL in homonymous retinal locations with respect to the fovea. Fixation instability and eccentricity measures obtained during cSLO-OCT assess the function of perifoveal retinal elements and predict central visual field loss in patients with ON. A model relating fixation to the GCC thickness map offers a method to assess the structure-function relationship between fixation and areas of preserved GCC in patients with ON.

Nerve Fibers - pathology

Prospective Studies

Follow-Up Studies

Optic Nerve Diseases - physiopathology

Humans

Middle Aged

Optic Nerve Diseases - diagnosis

Fixation, Ocular - physiology

Male

Tomography, Optical Coherence - methods

Visual Acuity

Retinal Ganglion Cells - pathology

Female

Ophthalmoscopy - methods

Optic Disk - pathology

Details

Title: Subtitle: The Pattern of Visual Fixation Eccentricity and Instability in Optic Neuropathy and Its Spatial Relationship to Retinal Ganglion Cell Layer Thickness
Creators: Robert M Mallery - Brigham and Women's Hospital
Pieter Poolman - Iowa City VA Center for the Prevention and Treatment of Visual Loss, Iowa City, Iowa, United States
Matthew J Thurtell - University of Iowa
Jui-Kai Wang - University of Iowa
Mona K Garvin - University of Iowa
Johannes Ledolter - Iowa City VA Center for the Prevention and Treatment of Visual Loss, Iowa City, Iowa, United States
Randy H Kardon - University of Iowa
Resource Type: Journal article
Publication Details: Investigative ophthalmology & visual science, Vol.57(9), pp.OCT429-OCT437
DOI: 10.1167/iovs.15-18916
PMID: 27409502
PMCID: PMC4968926
NLM abbreviation: Invest Ophthalmol Vis Sci
ISSN: 0146-0404
eISSN: 1552-5783
Publisher: United States
Language: English
Date published: 07/01/2016
Academic Unit: Statistics and Actuarial Science; Neurology; Electrical and Computer Engineering; Iowa Neuroscience Institute; Business Analytics; Ophthalmology and Visual Sciences
Record Identifier: 9983980055202771

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