Determining fixation stability of amd patients using predictive eye estimation regression

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Adelore, Temilade Adediwura
Schumacher, Eric H.
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Patients with macular degeneration (MD) often fixate with a preferred retinal locus (PRL). Eye movements made while fixating with the PRL (in MD patients) has been observed to be maladaptive compared to those made while fixating with the fovea (normal sighted individuals). For example, in MD patients, PRL eye movements negatively affect fixation stability and re-fixation precision; consequently creating difficulty in reading and limits to their execution of other everyday activities. Abnormal eye movements from the PRL affect research on the physiological adaptations to MD. Specifically, previous research on cortical reorganization using functional magnetic resonance imaging (fMRI), indicates a critical need to accurately determine a MD patient's point of gaze in order to better infer existence of cortical reorganization. Unfortunately, standard MR compatible hardware eye-tracking systems do not work well with these patients. Their reduction in fixation stability often overwhelms the tracking algorithms used by these systems. This research investigates the use of an existing magnetic resonance imaging (MRI) based technique called Predictive Eye Estimation Regression (PEER) to determine the point of gaze of MD patients and thus control for fixation instability. PEER makes use of the fluctuations in the MR signal caused by eye movements to identify position of gaze. Engineering adaptations such as temporal resolution and brain coverage were applied to tailor PEER to MD patients. Also participants were evaluated on different fixation protocols and the results compared to that of the micro-perimeter MP-1 to test the efficacy of PEER. The fixation stability results obtained from PEER were similar to that obtained from the eye tracking results of the micro-perimeter MP-1. However, PEER's point of gaze estimations was different from the MP-1's in the fixation tests. The difference in this result cannot be concluded to be specific to PEER. In order to resolve this issue, advancements to PEER by the inclusion of an eye tracker in the scanner to run concurrently with PEER could provide more evidence of PEER's reliability. In addition, increasing the diversity of AMD patients in terms of the different scotoma types will help provide a better estimate of PEER flexibility and robustness.
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