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. 2018 Oct;32(10):1563-1573.
doi: 10.1038/s41433-018-0135-y. Epub 2018 Jun 7.

Detection and characterisation of visual field defects using Saccadic Vector Optokinetic Perimetry in children with brain tumours

Ian C Murray  1 , Conrad Schmoll  2   3 , Antonios Perperidis  1   4 , Harry M Brash  1 , Alice D McTrusty  1   5 , Lorraine A Cameron  1   5 , Alastair G Wilkinson  6 , Alan O Mulvihill  7   6 , Brian W Fleck  1   7   6 , Robert A Minns  1   6
Affiliations

Detection and characterisation of visual field defects using Saccadic Vector Optokinetic Perimetry in children with brain tumours

Ian C Murray et al. Eye (Lond). 2018 Oct.

Abstract

Purpose: To determine the ability of Saccadic Vector Optokinetic Perimetry (SVOP) to detect and characterise visual field defects in children with brain tumours using eye-tracking technology, as current techniques for assessment of visual fields in young children can be subjective and lack useful detail.

Methods: Case-series study of children receiving treatment and follow-up for brain tumours at the Royal Hospital for Sick Children in Edinburgh from April 2008 to August 2013. Patients underwent SVOP testing and the results were compared with clinically expected visual field patterns determined by a consensus panel after review of clinical findings, neuroimaging, and where possible other forms of visual field assessment.

Results: Sixteen patients participated in this study (mean age of 7.2 years; range 2.9-15 years; 7 male, 9 female). Twelve children (75%) successfully performed SVOP testing. SVOP had a sensitivity of 100% and a specificity of 50% (positive predictive value of 80% and negative predictive value of 100%). In the true positive and true negative SVOP results, the characteristics of the SVOP plots showed agreement with the expected visual field. Six patients were able to perform both SVOP and Goldmann perimetry, these demonstrated similar visual fields in every case.

Conclusion: SVOP is a highly sensitive test that may prove to be extremely useful for assessing the visual field in young children with brain tumours, as it is able to characterise the central 30° of visual field in greater detail than previously possible with older techniques.

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Conflict of interest statement

Four authors (ICM, HMB, RAM and BWF) are named on a patent owned by the University of Edinburgh. The remaining authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
The Saccadic Vector Optokinetic Perimetry (SVOP) system components. a Patient display. b Examiner display. c Eye tracker. d Height adjustable surface housing the personal computer
Fig. 2
Fig. 2
Example of eye gaze movements for three different visual field points which were all “seen” and a normal visual field plot. a Blue lines represent eye gaze movements made every 20 ms. Red lines represent a change in fixation (saccade) detected by SVOP. b A normal visual field plot (with all points “seen”). The three numbered points (highlighted with red arrows and circles) correspond to the fixation changes numbered in a
Fig. 3
Fig. 3
Children with abnormal visual fields, who became capable of Goldman perimetry during follow-up. A comparison of Goldmann and SVOP visual fields. a, b Patient 1. Left optic nerve/hypothalamic pilocytic astrocytoma with blind left eye. Goldman (a) and SVOP (b) confirm right temporal hemianopia in only seeing eye with residual right nasal field. On the SVOP plot, (○: seen, ●: unseen) c, d Patient 2. Right optic nerve/hypothalamic pilocytic astrocytoma with blind right eye. Goldman (c) and SVOP (d) confirm left temporal hemianopia in only seeing eye with residual left nasal visual field. e, f Patient 15. Hypothalamic pilocytic astrocytoma with blind right eye. Goldman (e) and SVOP (f) confirm left temporal hemianopia in seeing left eye, with residual left nasal field of vision. g–i Patient 16. Left temporal pilocytic astrocytoma. Goldmann (g, h) and binocular SVOP (i) confirm right-sided hemianopia
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