{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:43:43Z","timestamp":1790700223241,"version":"4.1.0"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T00:00:00Z","timestamp":1737072000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Hum. Neurosci."],"abstract":"<jats:p>Cerebral\/cortical visual impairment (CVI) is a leading cause of pediatric visual impairment in the United States and other developed countries, and is increasingly diagnosed in developing nations due to improved care and survival of children who are born premature or have other risk factors for CVI. Despite this, there is currently no objective, standardized method to quantify the diverse visual impairments seen in children with CVI who are young and developmentally delayed. We propose a method that combines eye tracking and an image-based generative artificial intelligence (AI) model (SegCLIP) to assess higher- and lower-level visual characteristics in children with CVI. We will recruit 40 CVI participants (aged 12\u202fmonths to 12\u202fyears) and 40 age-matched controls, who will watch a series of images on a monitor while eye gaze position is recorded using eye tracking. SegCLIP will be prompted to generate saliency maps for each of the images in the experimental protocol. The saliency maps (12 total) will highlight areas of interest that pertain to specific visual features, allowing for analysis of a range of individual visual characteristics. Eye tracking fixation maps will then be compared to the saliency maps to calculate fixation saliency values, which will be assigned based on the intensity of the pixel corresponding to the location of the fixation in the saliency map. Fixation saliency values will be compared between CVI and control participants. Fixation saliency values will also be correlated to corresponding scores on a functional vision assessment, the CVI Range-CR. We expect that fixation saliency values on visual characteristics that require higher-level processing will be significantly lower in CVI participants compared to controls, whereas fixation saliency values on lower-level visual characteristics will be similar or higher in CVI participants. Furthermore, we anticipate that fixation saliency values will be significantly correlated to scores on corresponding items on the CVI Range-CR. Together, these findings would suggest that AI-enabled saliency analysis using eye tracking can objectively quantify abnormalities of lower- and higher-order visual processing in children with CVI. This novel technique has the potential to guide individualized interventions and serve as an outcome measure in future clinical trials.<\/jats:p>","DOI":"10.3389\/fnhum.2024.1506286","type":"journal-article","created":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T01:52:10Z","timestamp":1737078730000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Method for assessing visual saliency in children with cerebral\/cortical visual impairment using generative artificial intelligence"],"prefix":"10.3389","volume":"18","author":[{"given":"Kate","family":"Matsunaga","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kleanthis","family":"Avramidis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark S.","family":"Borchert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shrikanth","family":"Narayanan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melinda Y.","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1111\/j.1469-8749.1996.tb12143.x","article-title":"Cognitive visual dysfunction in a child with cerebral damage","volume":"38","author":"Ahmed","year":"1996","journal-title":"Dev. Med. Child Neurol."},{"key":"ref2","author":"Avramidis","year":"2024"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"9","DOI":"10.3390\/vision7010009","article-title":"Deficits in face recognition and consequent quality-of-life factors in individuals with cerebral visual impairment","volume":"7","author":"Bauer","year":"2023","journal-title":"Vision (Basel)."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"104391","DOI":"10.1016\/j.ridd.2022.104391","article-title":"Including visual orienting functions into cerebral visual impairment screening: reliability, variability, and ecological validity","volume":"132","author":"Ben Itzhak","year":"2023","journal-title":"Res. Dev. Disabil."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"711873","DOI":"10.3389\/fnhum.2021.711873","article-title":"Higher visual function deficits in children with cerebral visual impairment and good visual acuity","volume":"15","author":"Chandna","year":"","journal-title":"Front. Hum. Neurosci."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1167\/iovs.62.14.12","article-title":"Motion processing deficits in children with cerebral visual impairment and good visual acuity","volume":"62","author":"Chandna","year":"","journal-title":"Invest. Ophthalmol. Vis. Sci."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1016\/j.survophthal.2020.03.001","article-title":"Advances in the evaluation and management of cortical\/cerebral visual impairment in children","volume":"65","author":"Chang","year":"2020","journal-title":"Surv. Ophthalmol."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1097\/WCO.0000000000000877","article-title":"Methods of visual assessment in children with cortical visual impairment","volume":"34","author":"Chang","year":"2021","journal-title":"Curr. Opin. Neurol."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/j.ajo.2023.11.024","article-title":"Comparison of eye tracking and teller acuity cards for visual acuity assessment in pediatric cortical\/cerebral visual impairment","volume":"260","author":"Chang","year":"2024","journal-title":"Am. J. Ophthalmol."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1359","DOI":"10.1016\/j.ophtha.2024.09.017","article-title":"Special commentary: cerebral\/cortical visual impairment working definition: a report from the National Institutes of Health CVI workshop","volume":"131","author":"Chang","year":"2024","journal-title":"Ophthalmology"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/bmjophth-2022-001144","article-title":"Validity and reliability of CVI range assessment for clinical research (CVI range-CR): a longitudinal cohort study","volume":"7","author":"Chang","year":"2022","journal-title":"BMJ Open Ophthalmol."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/j.ridd.2015.10.011","article-title":"Social attention in ASD: a review and meta-analysis of eye-tracking studies","volume":"48","author":"Chita-Tegmark","year":"2016","journal-title":"Res. Dev. Disabil."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1111\/ceo.13443","article-title":"Causes of childhood low vision and blindness in New Zealand","volume":"47","author":"Chong","year":"2019","journal-title":"Clin. Experiment. Ophthalmol."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1111\/j.1469-8749.2008.03257.x","article-title":"'Dorsal stream dysfunction' and 'dorsal stream dysfunction plus': a potential classification for perceptual visual impairment in the context of cerebral visual impairment?","volume":"51","author":"Dutton","year":"2009","journal-title":"Dev. Med. Child Neurol."},{"key":"ref15","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1038\/eye.1996.64","article-title":"Cortical visual dysfunction in children: a clinical study","volume":"10","author":"Dutton","year":"1996","journal-title":"Eye (Lond.)"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"932","DOI":"10.1136\/bjo.2006.095349","article-title":"Visual problems as a result of brain damage in children","volume":"90","author":"Dutton","year":"2006","journal-title":"Br. J. Ophthalmol."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1186\/1866-1955-5-28","article-title":"Eye tracking in early autism research","volume":"5","author":"Falck-Ytter","year":"2013","journal-title":"J. Neurodev. Disord."},{"key":"ref18","first-page":"253","article-title":"Development of a quantitative method to measure vision in children with chronic cortical visual impairment","volume":"99","author":"Good","year":"2001","journal-title":"Trans. Am. Ophthalmol. Soc."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"7730","DOI":"10.1167\/iovs.12-9775","article-title":"Spatial contrast sensitivity vision loss in children with cortical visual impairment","volume":"53","author":"Good","year":"2012","journal-title":"Invest. Ophthalmol. Vis. Sci."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1016\/0039-6257(94)90073-6","article-title":"Cortical visual impairment in children","volume":"38","author":"Good","year":"1994","journal-title":"Surv. Ophthalmol."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1097\/WNO.0000000000000610","article-title":"Factors associated with lack of vision improvement in children with cortical visual impairment","volume":"38","author":"Handa","year":"2018","journal-title":"J. Neuroophthalmol."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"670","DOI":"10.1136\/bjo.83.6.670","article-title":"Chronic cortical visual impairment in children: aetiology, prognosis, and associated neurological deficits","volume":"83","author":"Huo","year":"1999","journal-title":"Br. J. Ophthalmol."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1111\/j.1469-8749.1987.tb08498.x","article-title":"Behavioural characteristics of children with permanent cortical visual impairment","volume":"29","author":"Jan","year":"1987","journal-title":"Dev. Med. Child Neurol."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"790","DOI":"10.1111\/aos.16700","article-title":"Temporal changes in incidence, prevalence and causes of childhood visual impairment - learnings from 45 years with the National Danish Registry of children with visual impairment","volume":"102","author":"Kessel","year":"2024","journal-title":"Acta Ophthalmol."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1016\/j.jaapos.2012.09.004","article-title":"An update on progress and the changing epidemiology of causes of childhood blindness worldwide","volume":"16","author":"Kong","year":"2012","journal-title":"J. AAPOS"},{"key":"ref26","author":"K\u00fcmmerer","year":"2016"},{"key":"ref27","author":"Luo","year":"2023"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1114","DOI":"10.3390\/children9081114","article-title":"Assessing higher-order visual processing in cerebral visual impairment using naturalistic virtual-reality-based visual search tasks","volume":"9","author":"Manley","year":"2022","journal-title":"Children (Basel)."},{"key":"ref29","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1016\/j.spen.2017.04.005","article-title":"Disentangling how the brain is \"wired\" in cortical (cerebral) visual impairment","volume":"24","author":"Merabet","year":"2017","journal-title":"Semin. Pediatr. Neurol."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1111\/j.1469-8749.2011.04147.x","article-title":"Integrity of the inferior longitudinal fasciculus and impaired object recognition in children: a diffusion tensor imaging study","volume":"54","author":"Ortibus","year":"2012","journal-title":"Dev. Med. Child Neurol."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1544","DOI":"10.4103\/ijo.IJO_1850_18","article-title":"Cerebral visual impairment is a major cause of profound visual impairment in children aged less than 3 years: a study from tertiary eye care center in South India","volume":"67","author":"Pehere","year":"2019","journal-title":"Indian J. Ophthalmol."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"iii, ix\u201351","DOI":"10.3310\/hta11500","article-title":"Evaluation of diagnostic tests when there is no gold standard. A review of methods","volume":"11","author":"Rutjes","year":"2007","journal-title":"Health Technol. Assess."},{"key":"ref33","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1136\/bjophthalmol-2017-310694","article-title":"Is there consensus in defining childhood cerebral visual impairment? A systematic review of terminology and definitions","volume":"102","author":"Sakki","year":"2018","journal-title":"Br. J. Ophthalmol."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"137","DOI":"10.3758\/BF03204486","article-title":"Heuristic filtering and reliable calibration methods for video-based pupil-tracking systems","volume":"25","author":"Stampe","year":"1993","journal-title":"Beh Res Meth Instr Comp."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"3074","DOI":"10.1038\/s41598-024-53642-8","article-title":"Visual search patterns during exploration of naturalistic scenes are driven by saliency cues in individuals with cerebral visual impairment","volume":"14","author":"Walter","year":"2024","journal-title":"Sci. Rep."},{"key":"ref36","doi-asserted-by":"publisher","first-page":"730","DOI":"10.1111\/j.1469-8749.1985.tb03796.x","article-title":"Permanent cortical visual impairment in children","volume":"27","author":"Whiting","year":"1985","journal-title":"Dev. Med. Child Neurol."},{"key":"ref37","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1111\/dmcn.14819","article-title":"Cerebral visual impairment-related vision problems in primary school children: a cross-sectional survey","volume":"63","author":"Williams","year":"2021","journal-title":"Dev. Med. Child Neurol."}],"container-title":["Frontiers in Human Neuroscience"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnhum.2024.1506286\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T01:52:12Z","timestamp":1737078732000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnhum.2024.1506286\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,17]]},"references-count":37,"alternative-id":["10.3389\/fnhum.2024.1506286"],"URL":"https:\/\/doi.org\/10.3389\/fnhum.2024.1506286","relation":{},"ISSN":["1662-5161"],"issn-type":[{"value":"1662-5161","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,17]]},"article-number":"1506286"}}