Visual fixation instability in multiple sclerosis measured using SLO-OCT

Robert M. Mallery, Pieter Poolman, Matthew J. Thurtell, Jan M. Full, Johannes Ledolter, Dorlan Kimbrough, Elliot Frohman, Teresa C. Frohman, Randy H. Kardon

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

PURPOSE. Precise measurements of visual fixation and its instability were recorded during optical coherence tomography (OCT) as a marker of neural network dysfunction in multiple sclerosis (MS), which could be used to monitor disease progression or response to treatment. METHODS. A total of 16 MS patients and 26 normal subjects underwent 30 seconds of scanning laser ophthalmoscope (SLO)-based eye tracking during OCT scanning of retinal layer thickness. Study groups consisted of normal eyes, MS eyes without prior optic neuritis (MS wo ON), and MS eyes with prior optic neuritis (MS + ON). Kernel density estimation quantified fixation instability from the distribution of fixation points on the retina. In MS wo ON eyes, fixation instability was compared to other measures of visual and neurologic function. RESULTS. Fixation instability was increased in MS wo ON eyes (0.062 deg2) compared to normal eyes (0.030 deg2, P = 0.015). A further increase was seen for MS + ON eyes (0.11 deg2) compared to MS wo ON (P = 0.04) and normal (P = 0.006) eyes. Fixation instability correlated weakly with ganglion cell layer (GCL) volume and showed no correlation with lowcontrast letter acuity, EDSS score, or SDMT score. CONCLUSIONS. Fixation instability reflects the integrity of a widespread neural network germane to visual processing and ocular motor control, and is disturbed in MS. Further study of visual fixation, including the contribution of microsaccades to fixation instability, may provide insight into the localization of fixation abnormalities in MS and introduce innovative and easily measured outcomes for monitoring progression and treatment response.

Original languageEnglish (US)
Pages (from-to)196-201
Number of pages6
JournalInvestigative Ophthalmology and Visual Science
Volume59
Issue number1
DOIs
StatePublished - Jan 2018

Keywords

  • Central visual pathways
  • Fixation instability
  • Multiple sclerosis
  • Optic neuritis
  • Visual fixation

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

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  • Cite this

    Mallery, R. M., Poolman, P., Thurtell, M. J., Full, J. M., Ledolter, J., Kimbrough, D., Frohman, E., Frohman, T. C., & Kardon, R. H. (2018). Visual fixation instability in multiple sclerosis measured using SLO-OCT. Investigative Ophthalmology and Visual Science, 59(1), 196-201. https://doi.org/10.1167/iovs.17-22391