Alpha Omega Alpha Honor Medical Society

2014 Research Abstract

Eye Movement Tracking in Shunted Hydrocephalus and Suspected Shunt Malfunction

Investigator: ByoungJun Han, New York University School of Medicine

Mentor: Uzma Samadani, MD, PhD

Introduction: Ocular motility dysfunction is one of the most common manifestations of hydrocephalus. We have developed a novel algorithm for eye movement tracking while watching a short film clip that reveals subclinical palsies of cranial nerves III and VI. The purpose of this study was to determine (1) whether chronically shunted well patients had differences in tracking relative to healthy unshunted control subjects and (2) whether shunt malfunction results in abnormal tracking metrics.

Methods: Subjects were eye tracked while watching a 220 second film clip moving inside an aperture on a computer monitor. A total of 78 eye tracking metrics were calculated in normal healthy controls and chronically shunted well subjects. In addition, 10 patients were evaluated with 11 suspected shunt malfunctions, 6 of whom underwent 7 subsequent revisions.

Results: There were no statistically significant differences among 78 metrics between normal control subjects (n=240; ages 4-84, mean 38; 59% female)) and chronically shunted developmentally intact healthy subjects (n=31; ages 7 to 76, mean 30; 41% female) (Wilcoxon analysis). The 7 cases of suspected malfunction that underwent shunt revision had a mean of 13.7 and range of 1-45 abnormal tracking metrics (>2SD’s from mean). The 4 patients assessed for shunt malfunction but not requiring revision had a mean of 2.3 and range of 0-6 abnormal tracking metrics.

Conclusion: Eye movement tracking of developmentally intact chronically shunted patients resembles normal healthy controls. Eye tracking may potentially be a useful non-invasive, non-radiographic adjunct for detecting shunt malfunction upon validation by additional studies and further clinical trials.

Last modified: 5/29/2015

Updated on May 29, 2015.

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