Retinal eye-tracking for the prognosis and monitoring of multiple sclerosis

Abstract The goal of this project is to validate an innovativehighly sensitive retinal eye tracking technologythe tracking scanning laser ophthalmoscopeTSLOas a prognostic and monitoring tool for neurodegenerative disordersnamely multiple sclerosisMSThe applications of effective treatments for multiple sclerosis are constrained bythe absence of methods for early detection andquantitativehighly sensitive methods monitoring deficits early in disease course when treatment may have a better chance of successAs already demonstratedthe TSLO is capable of rapidly assessing and measuring the extraordinarily finemicroscopic motion of the human eye during fixation in MS patientsFixational eye movements are neurally encodedinvoluntary movements that require the coordination of many areas of the central nervous systemGiven the TSLO s theoretical sensitivity to changearcminutesand its precision of measurementfixational eye movements have the potential utility for tracking neurodegenerative disease progression at an unprecedented scaleWith the advent of the new FDA approved MS treatment targeting B cellsocrelizumabclinical tools are now desperately needed to not only assess treatment efficacybut to objectively assess patient disability at the earliest stage of disease in order to cut relapse rates and prevent irrevocable disabilityIn this projectwe will determine the optimal fixational eye motion metrics to distinguish patients from controlsestablish the relationship between clinical disease severity measures and fixational eye movement deficits as defined by the TSLO systemand to use machine learning algorithms to further strengthen our fixational metrics Narrative The goal of our project is to clinically validate a retinal imaging and eye tracking technologythe tracking scanning laser ophthalmoscopeTSLOas a prognostic and monitoring tool for neurodegenerative disordersparticularly Multiple SclerosisMSThe TSLO system is capable of rapidly assessing and measuring the extraordinarily finemicroscopic motion of the human eye during fixation with an accuracy ofarcminutesGiven the numerous brain regions involved with eye motion and the TSLO s precision of measurementfixational eye movements now have the potential utility for tracking neurodegenerative disease progression for the MS patient population