Does eye velocity due to infantile nystagmus deprive visual acuity development?

doi:10.1016/j.jaapos.2017.10.008

Journal of American Association for Pediatric Ophthalmology and Strabismus

Volume 22, Issue 1, February 2018, Pages 50-55.e1

https://doi.org/10.1016/j.jaapos.2017.10.008 Get rights and content

Purpose

To use eye movement recordings of young children to determine whether eye velocity from infantile nystagmus (IN) deprives the developing visual system of normal visual acuity.

Methods

The video-oculography recordings and visual acuity measurements (including Teller cards) of 15 children ≤6.0 years of age with IN without visual sensory disease (idiopathic IN) were reviewed retrospectively. Eye velocity that would limit visual acuity development was predicted from both empirical adult data adjusted for age and a temporal limitation model using published photoreceptor density data with age. Foveal alignment onto a target was measured in 5 subjects using confocal retinal imaging.

Results

All subjects had periods (85–2440 ms) during which eye velocity was below the limit that would reduce age-appropriate visual acuity. The percentage of time eye velocity was below the limit varied by 4%-54% across all eye movement recordings. Eye movement metrics (eye position variability, average eye velocity, maximum duration of foveation, and the nystagmus optimal foveation fraction) correlated poorly with age or with age-corrected visual acuity (r² < 0.27 for each metric). Longitudinal visual acuity development overlapped between subjects with different nystagmus waveforms.

Conclusions

Eye velocity was not predicted to completely deprive visual acuity development in subjects with idiopathic IN. Nystagmus may decrease visual acuity development in children with idiopathic IN by interfering with visual-cortical development in the context of increased visual noise due to image motion with imprecise foveation.

Section snippets

Subjects and Methods

The research followed the tenets of the Declaration of Helsinki and was approved by the Institutional Review Board of Seattle Children's Hospital and conformed to the requirements of the US Health Insurance Portability and Accountability Act of 1996. We retrospectively reviewed records of patients with IN seen at Seattle Children's Hospital, Seattle, Washington. The inclusion criteria were as follows: (1) normal ocular examination, including normal anterior and posterior segments with special

Results

Fifteen children (11 males) met inclusion criteria (eTable 1). Age at the time of eye movement recording was 1.4-6.0 years (mean, 4.1 ± 1.4). Average age-corrected visual acuity at the time of eye movement recording was 0.28 logMAR (20/38 Snellen). Clinical follow-up duration averaged 4.5 years (follow-up was unavailable in 3 patients). At the last eye examination, average age-corrected visual acuity was 0.34 logMAR (20/44 Snellen). Longitudinal visual acuity development <6 years of age was

Discussion

Subjects with idiopathic IN had epochs in which eye velocity did not limit visual acuity development. Analysis of eye movement recording predicted that at least 4% of the time, eye velocity would not limit visual acuity. Therefore, our data are not consistent with nystagmus-related visual deprivation during the critical period in children with idiopathic IN. What factors account for the reduction in visual acuity during development in IN subjects? Previous work has suggested that the limitation

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: Financial support: Supported by an unrestricted grant from grant from the Peter LeHaye, Barbara Anderson, and William O. Rogers Endowment Funds.

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Major ArticleDoes eye velocity due to infantile nystagmus deprive visual acuity development?

Purpose

Methods

Results

Conclusions

Section snippets

Subjects and Methods

Results

Discussion

J AAPOS

J AAPOS

J AAPOS

Vision Res

Vision Res

J AAPOS

Vision Res

Motor and sensory characteristics of infantile nystagmus

Br J Ophthalmol

Acuity development in infantile nystagmus

Invest Ophthalmol Vis Sci

Visual acuity development of children with infantile nystagmus syndrome

Invest Ophthalmol Vis Sci

Visual deprivation and foveation characteristics both underlie visual acuity deficits in idiopathic infantile nystagmus

Invest Ophthalmol Vis Sci

Grating visual acuity in infantile nystagmus in the absence of image motion

Invest Ophthalmol Vis Sci

Major Article
Does eye velocity due to infantile nystagmus deprive visual acuity development?