{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T10:15:12Z","timestamp":1786443312212,"version":"build-2736575974"},"reference-count":25,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: This study aims to investigate the development of oculomotor behavior in children born preterm using a DIVE device (Device for an Integral Visual Examination) equipped with eye-tracking technology. Visual and visuo-cognitive measures obtained through eye-tracking technology provide quantitative and sensitive indicators of early neural development, as visual function is one of the earliest cerebral processes to develop postnatally. Design: This is a cross-sectional study. Participants: The study included 428 children aged 0.5 to 14 years. Of these, 214 were born preterm (78 late preterm, born at 32\u201336 weeks\u2019 gestation, and 136 early preterm, born at less than 32 weeks\u2019 gestation) and 214 were full-term controls, matched by age and gender. Methods: All participants underwent a comprehensive ophthalmological assessment. Oculomotor behavior was analyzed using a DIVE device, focusing on fixation duration, saccadic performance and fixation stability. Fixation stability was quantified by the bivariate contour ellipse area for short tasks (BCEA), which measures (in deg2) the area of the ellipse enclosing a specified percentage of fixation positions\u2014smaller BCEA values indicate greater fixation stability. We performed a cluster analysis on these oculomotor metrics to identify distinct oculomotor control patterns. Results: Preterm children exhibited significantly poorer fixation stability than controls (mean BCEA 0.21 vs. 0.09 logdeg2, p = 0.004), alongside shorter fixation durations and longer saccadic reaction times. Early preterm children showed more unstable fixations compared to late-preterm and control groups (0.26 vs. 0.12 and 0.09 logdeg2, respectively, p = 0.001). Cluster analysis revealed three distinct OMC (oculomotor control) patterns: \u201cgood,\u201d \u201cimpulsive,\u201d and \u201cpoor.\u201d Children classified in the \u201cgood OMC\u201d cluster demonstrated stable fixations and appropriate saccadic reaction times. In contrast, those in the \u201cimpulsive OMC\u201d and \u201cpoor OMC\u201d clusters exhibited more unstable fixations and abnormal saccadic times, with the \u201cpoor\u201d cluster being significantly associated with extreme prematurity, lower birth weights, and a higher incidence of intraventricular hemorrhage (IVH). Conclusions:\u00a0Preterm birth is associated with measurable oculomotor deficits, most pronounced in early preterm infants, affecting their fixation and saccadic abilities. The findings emphasize the need for targeted interventions to support the development of preterm children, particularly those with \u201cpoor\u201d oculomotor control behavior.<\/jats:p>","DOI":"10.3390\/jcm14217742","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T18:21:46Z","timestamp":1762194106000},"page":"7742","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Oculomotor Control in Preterm Infants: Insights from Eye-Tracking Technology"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2797-5011","authenticated-orcid":false,"given":"Mar\u00eda","family":"Romero-Sanz","sequence":"first","affiliation":[{"name":"Ophthalmology Department, Miguel Servet University Hospital, 50009 Zaragoza, Spain"},{"name":"Aragon Institute for Health Research (IIS Aragon), 50009 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3739-8473","authenticated-orcid":false,"given":"Teresa","family":"P\u00e9rez-Roche","sequence":"additional","affiliation":[{"name":"Barbastro Hospital, 22300 Huesca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5592-8442","authenticated-orcid":false,"given":"Marina","family":"Vilella Cenis","sequence":"additional","affiliation":[{"name":"Aragon Institute for Health Research (IIS Aragon), 50009 Zaragoza, Spain"},{"name":"DIVE Medical S.L., 20014 San Sebasti\u00e1n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adri\u00e1n","family":"Alejandre Escriche","sequence":"additional","affiliation":[{"name":"DIVE Medical S.L., 20014 San Sebasti\u00e1n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1788-9128","authenticated-orcid":false,"given":"Eduardo","family":"Esteban-Iba\u00f1ez","sequence":"additional","affiliation":[{"name":"Aragon Institute for Health Research (IIS Aragon), 50009 Zaragoza, Spain"},{"name":"DIVE Medical S.L., 20014 San Sebasti\u00e1n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Ortin Obon","sequence":"additional","affiliation":[{"name":"DIVE Medical S.L., 20014 San Sebasti\u00e1n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7757-2627","authenticated-orcid":false,"given":"Marta","family":"Lacort-Beltr\u00e1n","sequence":"additional","affiliation":[{"name":"Aragon Institute for Health Research (IIS Aragon), 50009 Zaragoza, Spain"},{"name":"DIVE Medical S.L., 20014 San Sebasti\u00e1n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Prieto Calvo","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, Miguel Servet University Hospital, 50009 Zaragoza, Spain"},{"name":"Aragon Institute for Health Research (IIS Aragon), 50009 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olimpia","family":"Castillo Castej\u00f3n","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, Miguel Servet University Hospital, 50009 Zaragoza, Spain"},{"name":"Aragon Institute for Health Research (IIS Aragon), 50009 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1777-0349","authenticated-orcid":false,"given":"Victoria","family":"Pueyo Royo","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, Miguel Servet University Hospital, 50009 Zaragoza, Spain"},{"name":"Aragon Institute for Health Research (IIS Aragon), 50009 Zaragoza, Spain"},{"name":"Department of Microbiology, Pediatrics, Radiology, and Public Health, Faculty of Medicine, University of Zaragoza, 50009 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"j3448","DOI":"10.1136\/bmj.j3448","article-title":"Neurodevelopmental outcome at 2 years for preterm children born at 22 to 34 weeks\u2019 gestation in France in 2011: EPIPAGE-2 cohort study","volume":"358","author":"Pierrat","year":"2017","journal-title":"BMJ"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1136\/archdischild-2023-325928","article-title":"Neurodevelopment at age 5.5 years according to Ages & Stages Questionnaire at 2 years\u2019 corrected age in children born preterm: The EPIPAGE-2 cohort study","volume":"109","author":"Charkaluk","year":"2024","journal-title":"Arch. 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