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Multicenter Study
. 2022 Dec 1;22(13):4.
doi: 10.1167/jov.22.13.4.

Development of oculomotor control throughout childhood: A multicenter and multiethnic study

Victoria Pueyo  1   2   3 , Jason C S Yam  4   5 , Teresa Perez-Roche  6   7 , Victoria Balasanyan  8   9 , Marta Ortin  2   10   11 , Gerardo Garcia  12   13 , Esther Prieto  1   2   14 , Chau Pham  15   16 , Diego Gutierrez  2   10   17 , Olimpia Castillo  1   2   18 , Belen Masia  2   10   19 , Adrian Alejandre  10   20 , Mohamed Bakkali  1   2   21 , Marta Ciprés  22   23 , Eduardo Esteban-Ibañez  2   24 , Alvaro Fanlo-Zarazaga  1   2   25 , Inmaculada Gonzalez  1   2   26 , Ivan Z K Gutiérrez-Luna  27   28 , Xian Pan  2   29 , Juan Pinilla  1   2   30 , María Romero-Sanz  1   2   31 , Valeria Sanchez-Huerto  27   32 , Marina Vilella  2   33 , Nguyen Xuan Tinh  15   34 , Nguyen Xuan Hiep  15   35 , XiuJuan Zhang  4   36 ; TrackAI Research Consortium
Affiliations
Multicenter Study

Development of oculomotor control throughout childhood: A multicenter and multiethnic study

Victoria Pueyo et al. J Vis. .

Abstract

Although steady fixation is a key aspect of a proper visual function, it is only subjectively assessed in young and uncooperative children. In the present study, we characterize the development of fixational behavior throughout childhood in a large group of healthy children 5 months of age and up, recruited in five geographically diverse sites. In order to do it, we examined 802 healthy children from April 2019 to February 2020. Their oculomotor behavior was analyzed by means of an automated digital system, based on eye-tracking technology. Oculomotor outcomes were gaze stability, fixation stability and duration of fixations (for both long and short fixational tasks), and saccadic reaction time. Ninety-nine percent of all recruited children were successfully examined. Fixational and saccadic performance improved with age throughout childhood, with more pronounced changes during the first 2 years of life. Gaze and fixation tended to be more stable with age (p < 0.001 for most the outcomes), and saccades tended to be faster. In a multivariate analysis, including age and ethnicity as independent variables and adjusting by data quality, age was related with most fixational outcomes. Our automated digital system and eye-tracking data allow us to quantitatively describe the development of oculomotor control during childhood, assess visual fixation and saccadic performance in children 5 months of age and up, and provide a normative reference of fixational outcomes for clinical practice.

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Figures

Figure 1.
Figure 1.
DIVE being used by a young patient sitting on his mother's lap. DIVE includes a Huawei Matebook E tablet with a 12-in. tactile screen and an integrated X3-120 Tobii eye tracker.
Figure 2.
Figure 2.
Stimuli used during the long fixational task (left) and during the short fixational task (center and right). Note that the stimuli displayed here are not at the same scale as the one used during the visual tests.
Figure 3.
Figure 3.
Comparison of oculomotor behavior in a 14-year-old child (left) and a 9-month-old infant (right). The plotted bivariate contour ellipses show fixation stability (red) and gaze stability (yellow). A lower BCEA (smaller ellipse) indicates more stability. Note how the less stable gaze in the infant is captured by their higher BCEA (larger yellow ellipse).
Figure 4.
Figure 4.
Scatterplots of oculomotor control outcomes versus age for long (A) and short (B) fixation tasks and saccadic performance (C). The gray dots are the observed values, while the curves indicate age-specific fitted percentiles: 5th and 95th (blue), 10th and 90th (green), and 50th percentile (red). Note that lower values of logBCEA correspond to more stable fixations.
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