{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T21:19:52Z","timestamp":1793481592314,"version":"4.5.0"},"reference-count":22,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T00:00:00Z","timestamp":1747612800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JEMR"],"abstract":"<jats:p>Glaucoma remains a leading cause of irreversible blindness worldwide, with early detection crucial for preventing vision loss. This study developed and validated a novel eye-tracking algorithm to detect oculomotor abnormalities in primary open-angle glaucoma (POAG). We conducted a case\u2013control study (March\u2013June 2021), recruiting 16 patients with moderate POAG, 16 with preperimetric POAG, and 16 age-matched controls. The participants underwent a comprehensive ophthalmic examination and eye movement recording using a high-resolution infrared tracker during two tasks: saccades to static targets and saccades to moving targets. The patients with POAG exhibited a significantly increased saccadic latency and reduced accuracy compared to the controls, with more pronounced differences in the moving target task. Notably, preperimetric POAG patients showed significant abnormalities despite having normal visual fields based on standard perimetry. Our machine learning algorithm incorporating multiple saccadic parameters achieved an excellent discriminative ability between glaucomatous and healthy subjects (AUC = 0.92), with particularly strong performance for moderate POAG (AUC = 0.97) and good performance for preperimetric POAG (AUC = 0.87). These findings suggest that eye movement analysis may serve as a sensitive biomarker for early glaucomatous damage, potentially enabling earlier intervention and improved visual outcomes.<\/jats:p>","DOI":"10.3390\/jemr18030018","type":"journal-article","created":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T07:34:03Z","timestamp":1747640043000},"page":"18","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Eye-Tracking Algorithm for Early Glaucoma Detection: Analysis of Saccadic Eye Movements in Primary Open-Angle Glaucoma"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3120-8782","authenticated-orcid":false,"given":"Cansu Yuksel","family":"Elgin","sequence":"first","affiliation":[{"name":"Cerrahpasa Faculty of Medicine, Department of Ophthalmology, Istanbul University, Cerrahpa\u015fa, Koca Mustafapa\u015fa Cd. No:53, Fatih, 34098 \u0130stanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e1221","DOI":"10.1016\/S2214-109X(17)30393-5","article-title":"Global causes of blindness and distance vision impairment 1990\u20132020: A systematic review and meta-analysis","volume":"5","author":"Flaxman","year":"2017","journal-title":"Lancet Glob. Health"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1901","DOI":"10.1001\/jama.2014.3192","article-title":"The pathophysiology and treatment of glaucoma: A review","volume":"311","author":"Weinreb","year":"2014","journal-title":"JAMA"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"6939","DOI":"10.1167\/iovs.12-10345","article-title":"The structure and function relationship in glaucoma: Implications for detection of progression and measurement of rates of change","volume":"53","author":"Medeiros","year":"2012","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Crabb, D.P., Smith, N.D., Rauscher, F.G., Chisholm, C.M., Barbur, J.L., Edgar, D.F., and Garway-Heath, D.F. (2010). Exploring eye movements in patients with glaucoma when viewing a driving scene. PLoS ONE, 5.","DOI":"10.1371\/journal.pone.0009710"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1097\/IJG.0b013e31825c10dc","article-title":"Impaired saccadic eye movement in primary open-angle glaucoma","volume":"23","author":"Lamirel","year":"2014","journal-title":"J. Glaucoma"},{"key":"ref_6","first-page":"913","article-title":"Chronic glaucoma selectively damages large optic nerve fibers","volume":"28","author":"Quigley","year":"1987","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Tapia, M.L., Nascimento-dos-Santos, G., and Park, K.K. (2022). Subtype-specific survival and regeneration of retinal ganglion cells in response to injury. Front. Cell Dev. Biol., 10.","DOI":"10.3389\/fcell.2022.956279"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/S0039-6257(02)00401-0","article-title":"Motion perception in glaucoma patients: A review","volume":"48","author":"Shabana","year":"2003","journal-title":"Surv. Ophthalmol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/S0042-6989(96)00136-8","article-title":"Motion perception thresholds in areas of glaucomatous visual field loss","volume":"37","author":"Bosworth","year":"1997","journal-title":"Vision. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/S0002-9394(14)72205-6","article-title":"Random dot motion perimetry in patients with glaucoma and in normal subjects","volume":"120","author":"Wall","year":"1995","journal-title":"Am. J. Ophthalmol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1038\/nrn986","article-title":"The brainstem control of saccadic eye movements","volume":"3","author":"Sparks","year":"2002","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_12","first-page":"162","article-title":"Comparing machine learning classifiers for diagnosing glaucoma from standard automated perimetry","volume":"43","author":"Goldbaum","year":"2002","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_13","first-page":"3046","article-title":"Psychophysical measurement of neural adaptation abnormalities in magnocellular and parvocellular pathways in glaucoma","volume":"48","author":"McKendrick","year":"2007","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Liversedge, S.P., Gilchrist, I.D., and Everling, S. (2011). The superior colliculus. The Oxford Handbook of Eye Movements, Oxford University Press.","DOI":"10.1093\/oxfordhb\/9780199539789.001.0001"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1772","DOI":"10.1152\/jn.00621.2001","article-title":"Quantitative analysis of catch-up saccades during sustained pursuit","volume":"87","author":"Missal","year":"2002","journal-title":"J. Neurophysiol."},{"key":"ref_16","first-page":"3667","article-title":"Visual contrast detection cannot be predicted from surrogate measures of retinal ganglion cell number and sampling density in healthy young adults","volume":"59","author":"Denniss","year":"2018","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1136\/bjo.2005.086769","article-title":"Human glaucoma and neural degeneration in intracranial optic nerve, lateral geniculate nucleus, and visual cortex","volume":"90","author":"Gupta","year":"2006","journal-title":"Br. J. Ophthalmol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2913","DOI":"10.1167\/iovs.06-0752","article-title":"Sources of motion-sensitivity loss in glaucoma","volume":"48","author":"Falkenberg","year":"2007","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Glen, F.C., Baker, H., and Crabb, D.P. (2014). A qualitative investigation into patients\u2019 views on visual field testing for glaucoma monitoring. BMJ Open, 4.","DOI":"10.1136\/bmjopen-2013-003996"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1001\/archopht.1989.01070010083032","article-title":"The effect of perimetric experience in normal subjects","volume":"107","author":"Heijl","year":"1989","journal-title":"Arch. Ophthalmol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"OCT451","DOI":"10.1167\/iovs.15-18944","article-title":"Optical coherence tomography angiography vessel density in healthy, glaucoma suspect, and glaucoma eyes","volume":"57","author":"Yarmohammadi","year":"2016","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"564131","DOI":"10.1155\/2011\/564131","article-title":"Comparison of photopic negative response of full-field and focal electroretinograms in detecting glaucomatous eyes","volume":"2011","author":"Machida","year":"2011","journal-title":"J. Ophthalmol."}],"container-title":["Journal of Eye Movement Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1995-8692\/18\/3\/18\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:35:09Z","timestamp":1760031309000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1995-8692\/18\/3\/18"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,19]]},"references-count":22,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["jemr18030018"],"URL":"https:\/\/doi.org\/10.3390\/jemr18030018","relation":{},"ISSN":["1995-8692"],"issn-type":[{"value":"1995-8692","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,19]]}}}