ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neuro-Ophthalmology
This article is part of the Research TopicEye Movement Abnormalities in Brain DiseasesView all 7 articles
Cancellation of the Vestibulo-Ocular Reflex during Smooth Pursuit in Patients with Maculopathy
Provisionally accepted
Natela M. Shanidze*
Anca Velisar- Smith-Kettlewell Eye Research Institute, San Francisco, United States
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Macular degeneration is associated with loss of central vision, including the fovea. Central visual field loss is associated with impaired smooth pursuit eye movements, and the associated scotoma can lead to target disappearance which may or may not be transient. While smooth pursuit in and of itself does not require a foveal position signal, suppression of the vestibuloocular reflex (VOR) needed during combined eye and head pursuit relies on the fovea for appropriate calibration. Prior work has shown that target extinction during, or even at the beginning of the trial does not affect the dynamics of the eye or head responses necessary for pursuit. These findings suggest that the potential disappearance of the target into the scotoma during pursuit can be overcome, particularly when both eye and head movements are used. The objective of this study was to test the hypothesis that head-unrestrained smooth pursuit deficits in CFL are at least partially related to individuals’ inability to cancel their VOR. We performed a secondary analysis of a previously published data set of head restrained and unrestrained pursuit of a 10 °/s target in 7 individuals with maculopathy (56-89 years) and 7 age-matched controls (61-78 years). We used a two-parameter linear regression model to quantify they eye-only pursuit (Kfix) and VOR contribution (Kv) to determine whether our participants were able to effectively cancel the VOR to improve pursuit gain. We confirmed that VOR responses to actively generated head movements were similarly intact in both groups. Our analyses of the pursuit data indicate that, regardless of visual function older adults attenuate eye-driven pursuit when the head is unrestrained (as compared to the restrained condition), and those with CFL fail to exploit residual VOR cancellation, helping to explain their persistent gaze-tracking deficits.
Keywords: Macular Degeneration, Central field loss, Vestibuloocular reflex, VOR cancellation, smooth pursuit, eye-head coordination
Received: 21 May 2025; Accepted: 17 Dec 2025.
Copyright: © 2025 Shanidze and Velisar. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Natela M. Shanidze
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