The goal of this project is to validate an innovative, highly sensitive retinal eye-tracking technology, the tracking scanning laser ophthalmoscope (TSLO), as a prognostic and monitoring tool for neurodegenerative disorders, namely multiple sclerosis (MS). The applications of effective treatments for multiple sclerosis are constrained by (1) the absence of methods for early detection and (2) quantitative, highly sensitive methods monitoring deficits early in disease course when treatment may have a better chance of success. As already demonstrated, the TSLO is capable of rapidly assessing and measuring the extraordinarily fine, microscopic motion of the human eye during fixation in MS patients. Fixational eye movements are neurally-encoded, involuntary movements that require the coordination of many areas of the central nervous system. Given the TSLOs theoretical sensitivity to change (0.2 arcminutes) and its precision of measurement - fixational eye movements have the potential utility for tracking neurodegenerative disease progression at an unprecedented scale. With the advent of the new FDA-approved MS treatment targeting B-cells (ocrelizumab), clinical tools are now desperately needed to not only assess treatment efficacy, but to objectively assess patient disability at the earliest stage of disease in order to cut relapse rates and prevent irrevocable disability. In this project, we will determine the optimal fixational eye motion metrics to distinguish patients from controls, establish the relationship between clinical disease severity measures and fixational eye movement deficits as defined by the TSLO system, and to use machine learning algorithms to further strengthen our fixational metrics.
Public Health Relevance Statement: Narrative The goal of our project is to clinically validate a retinal imaging and eye-tracking technology, the tracking scanning laser ophthalmoscope (TSLO), as a prognostic and monitoring tool for neurodegenerative disorders, particularly Multiple Sclerosis (MS). The TSLO system is capable of rapidly assessing and measuring the extraordinarily fine, microscopic motion of the human eye during fixation with an accuracy of 0.2 arcminutes. Given the numerous brain regions involved with eye motion and the TSLOs precision of measurement - fixational eye movements now have the potential utility for tracking neurodegenerative disease progression for the MS patient population.
Project Terms: Age; Algorithms; Area; B-Lymphocytes; base; Brain; Brain region; Characteristics; Clinical; Cognition; cohort; Color Visions; cost; Databases; Digit structure; disability; Disease; Disease Progression; Early Diagnosis; Early Intervention; effective therapy; Electrocardiogram; Eye; Eye Movements; Fatigue; FDA approved; Fingers; foot; Frequencies; Goals; Hand; Human; Image; Individual; innovation; instrument; Involuntary Movements; Lasers; Machine Learning; Measurement; Measures; Methods; Microscopic; Modality; Monitor; Motion; Movement; Multiple Sclerosis; multiple sclerosis patient; multiple sclerosis treatment; Muscle; Nerve Degeneration; Neuraxis; neuroadaptation; Neurodegenerative Disorders; Neurons; oculomotor; Ophthalmoscopes; outcome forecast; Patient Care Team; patient population; Patients; Physicians; Pilot Projects; Population; Population Control; prevent; prognostic; programs; receptive field; Relapse; relating to nervous system; Retinal; Running; sample fixation; Scanning; Series; Severity of illness; Signal Transduction; Small Business Technology Transfer Research; standard measure; success; System; Techniques; Technology; Testing; Therapeutic; Time; tool; Training; Treatment Efficacy; Vision; Visual Fields; Visual system structure; Walking; walking speed
