ArticleBMC ophthalmology2026
Clinically accessible eye-tracking in thyroid-associated ophthalmopathy: exploratory classification modeling and gaze allocation to disease-related periocular images.
Article in BMC ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07381413 (Eye Tracking Study on Eye Movement Function and Visual Attention Patterns in Patients With Thyroid-Associated Ophthalmopathy), which is not on this map. Not yet cited in PubMed.
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Eye Tracking Study on Eye Movement Function and Visual Attention Patterns in Patients With Thyroid-Associated Ophthalmopathy
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6 authors.
Funding
Abstract
backgroundThyroid-associated ophthalmopathy (TAO) is an autoimmune orbital disease that may cause ocular motility abnormalities, altered periocular appearance, and psychosocial burden. However, clinically practical tools for early recognition and objective functional assessment remain limited. This study aimed to evaluate whether clinically accessible eye-tracking could support auxiliary classification of thyroid-associated ophthalmopathy and characterize visual attention patterns toward disease-related periocular images.
methodsIn this cross-sectional study, 229 adults from a tertiary ophthalmology center were enrolled, including 181 patients with TAO and 48 healthy controls. Eye movements were recorded using a clinically accessible eye-tracking system during fixation, smooth pursuit with nine-grid spatial analysis, and image-viewing tasks. Random forest models were developed using nine-grid smooth-pursuit gaze-distribution features. A primary model included eye-tracking features plus age and sex, while a secondary model assessed eye-tracking features after demographic adjustment. Group differences in gaze metrics and region-of-interest allocation were analyzed using regression-based methods.
resultsFixation stability did not differ significantly between groups, but patients with TAO showed increased gaze dispersion. In smooth pursuit, the primary model achieved an AUC of 0.903, and the secondary model achieved an AUC of 0.778. In image-viewing tasks, gaze allocation differed between groups: compared with controls, patients with TAO paid less attention to more obvious pathological periocular features in earlier-stage images and more attention to near-recovery appearances in later-stage images. Distinct viewing patterns were also observed across preoperative and postoperative images from different surgical categories.
conclusionsClinically accessible eye-tracking may provide behavioral markers for auxiliary TAO classification and reveal altered visual attention to TAO-related periocular appearance. Further validation in larger, independent cohorts is needed.
trial registrationClinicalTrials.gov, NCT07381413. Prospectively registered.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.