By Marcello Cherchi, MD PhD
For clinicians
Saccades in children
Salman and colleagues (Salman et al. 2006) studied horizontal and vertical saccades in 39 healthy children (21 males) aged 8 – 19 years (mean 13.7 years, SD 3.5 years) using videonystagmography and reported:
|
Direction and amplitude of saccade |
Mean latency in ms (SD) |
Mean gain (SD) |
Mean asymptotic peak velocity in deg/sec (SD) |
|
Rightward 10˚ |
248.7 (20.5) |
0.96 (0.08) |
521.2 (90.7) |
|
Leftward 10˚ |
253.6 (27.4) |
0.96 (0.08) |
537.4 (83.6) |
|
Upward 10˚ |
243.3 (29.4) |
0.93 (0.15) |
466.9 (117.5) |
|
Upward 5˚ |
240.3 (22.6) |
0.95 (0.15) |
|
|
Downward 10˚ |
247.0 (24.2) |
0.90 (0.16) |
435.7 (111.5) |
|
Downward 5˚ |
268.3 (23.5) |
0.96 (0.16) |
Sinno and colleagues (Sinno et al. 2019) studied 120 healthy children age 5 – 17 years with videonystagmography. With respect to horizontal saccades they reported:
|
Age range |
Saccadic latency in ms (95% CI) |
|
5 – 8 year olds |
305 ± 48 |
|
9 – 11 year olds |
276 ± 22 |
|
12 – 14 year olds |
252 ± 34 |
|
15 – 17 year olds |
256 ± 33 |
They also observed that saccade velocity and accuracy/precision did not change significantly from ages 5 – 8 years to ages 15 – 17 years.
Saccades in young to middle age adults
Kang and Kim(Kang and Kim 2015) studied 25 healthy Korean subjects (9 men) age 21 – 38 years using videonystagmography. After manual correction for “errors such as wrong detection of the inflection point, missing movement, and prediction,” they found that for saccades at 15˚ horizontal:
|
Mean peak velocity in deg/sec (95% CI) |
Mean latency in ms (95% CI) |
Mean accuracy in percent |
|
|
Left eye, leftward saccade (abduction) |
329.5 (281.8 – 377.1) |
208.0 (174.4 – 241.6) |
82.0 (74.5 – 89.6) |
|
Right eye, leftward saccade (adduction) |
311.9 (270.1 – 353.7) |
193.0 (165.7 – 220.2) |
77.8 (69.1 – 86.4) |
|
Left eye, rightward saccade (adduction) |
319.7 (356.5 – 282.9) |
192.8 (166.1 – 219.5) |
75.3 (67.8 – 82.8) |
|
Right eye, rightward saccade (abduction) |
324.0 (352.7 – 295.3) |
190.4 (159.7 – 221.2) |
81.9 (74.7 – 89.0) |
They found that for saccades at 30˚ horizontal:
|
Mean peak velocity in deg/sec (95% CI) |
Mean latency in ms (95% CI) |
Mean accuracy in percent |
|
|
Left eye, leftward saccade (abduction) |
408.2 (336.4 – 480.1) |
233.8 (188.6 – 279.0) |
75.4 (66.8 – 84.0) |
|
Right eye, leftward saccade (adduction) |
337.7 (297.9 – 377.4) |
211.1 (163.0 – 259.2) |
71.4 (63.7 – 79.0) |
|
Left eye, rightward saccade (adduction) |
405.5 (485.2 – 325.9) |
196.3 (163.6 – 229.1) |
76.5 (67.3 – 85.7) |
|
Right eye, rightward saccade (abduction) |
368.1 (406.8 – 329.4) |
191.4 (153.1 – 229.7) |
78.6 (70.9 – 86.4) |
Saccades in the middle age and elderly
Van der Stappen and colleagues (Van Der Stappen, Wuyts, Van De Heyning 2000) studied 40 healthy individuals (15 male) age 35 – 72 years (average 45 years) using electronystagmography. Regarding saccades at 20˚ they reported:
|
Maximum velocity in dec/sec (95% CI) |
Latency in ms (95% CI) for both eyes |
Dysmetry/accuracy in percent (95% CI) |
|
|
Right eye, rightward saccade (abduction) |
367 (283 – 542) |
192 (129 – 255) |
98.2 (88 – 108) |
|
Left eye, rightward saccade (adduction) |
458 (336 – 581) |
99.1 (89 – 110) |
|
|
Right eye, leftward saccade (adduction) |
458 (336 – 581) |
100.1 (89 – 111) |
|
|
Left eye, leftward saccade (abduction) |
367 (283 – 542) |
98.2 (88 – 108) |
Saccades in the elderly
Hajioff and colleagues (Hajioff et al. 2000) studied 96 healthy subjects (56 men) age 66 – 89 years (median age 76 years) using electronystagmography. For random saccades presented at 6˚ – 30˚ jumps they reported a latency with a lower reference limit of 121.5 ms (95% CI 110.3 – 132.7 ms) and an upper reference limit of 303.6 ms (95% CI 292.4 – 314.9 ms). They reported percent accuracy with a lower reference limit of 57.9 (95% CI 52.8 – 63.0) and an upper reference limit of 120.7 (95% CI 115.6 – 125.8).
Saccades over a broad age range
Warabi and colleagues (Warabi, Kase, Kato 1984) used a horizontal saccade protocol in which LEDs were placed at 10-degree intervals, extending 20 degrees to each side. They state in the text of their article that they studied 8 healthy subjects age 19 – 26 years, and 24 healthy subjects age 59 – 82 years using electronystagmography, though in the analysis they end up breaking the subjects into three groups: (a) age 16 (not 19) – 26 years, (b) age 59 – 82 years and (c) 67 – 78 years because, “Four of the elderly subjects exhibited large variations in reaction times (standard deviation more than 110 ms), whereas the variations in the 20 other elderly subjects differed little from those in the young subjects. Therefore, the elderly subjects were classified into groups b and c.” They report that the mean reaction times for these groups were (a) 235 ms, (b) 337 ms and (c) 468 ms.
|
Saccade target amplitude |
||||
|
Reaction time (latency) in ms |
10˚ amplitude, velocity in deg/sec (mean±SD) |
20˚ amplitude, velocity in deg/sec (mean±SD) |
40˚ amplitude, velocity in deg/sec (mean±SD) |
|
|
Group a, 19 – 26 years |
235 |
306±51 |
408±57 |
508±76 |
|
Group b, 59 – 82 years |
337 |
300±63 |
391±65 |
464±89 |
|
Group c, 67 – 78 years |
468 |
|||
Hopf and colleagues (Hopf et al. 2018) studied horizontal and vertical reflexive saccades in 102 healthy subjects (46 male) age 6 – 76 using videonystagmography. At variance with many prior studies they concluded that, “We found no relevant effect of age on peak velocity, gain and latency in a fitted linear mixed model;” they added that, “However, latency becomes shorter during childhood and adolescence, while in adulthood it is relatively stable with a slight trend to increase in the elderly.” The found that the, “Mean peak velocity of saccades was 213°/s (± 29°/s), 352°/s (± 50°/s) and 455°/s (± 67°/s) to a target position 5°, 15°and 30° horizontally, respectively, and 208°/s (± 36°/s), 303°/s (± 50°/s) and 391°/s (± 71°/s) to a target position 5°, 10° and 20° vertically.”
Irving and colleagues (Irving et al. 2006) studied horizontal saccades in 195 healthy subjects (93 male) age 3 – 86 years using videonystagmography. They observed that, “Mean saccadic latency decreased from 439 ms at 3 years to 172 ms at 14 years, followed by a period of relative stability to age 50 and finally, gradually increased to 264 ms at ≥80 years. For saccadic accuracy (amplitude gain), there was a statistically significant (P < 0.05) interaction between saccade size and age. Participants made increasingly hypometric saccades as age and saccade size increased. Average age group saccadic asymptotic peak velocity (Vmax) increased childhood from 446 deg/s at age 3, to a peak of 610 deg/s at 14 years and then gradually declined with age to approximately 345 deg/s for participants ≥80 years.”
Seferlis and colleagues (Seferlis et al. 2015) studied 250 healthy subjects (87 male) age 18 – 70 years using videonystagmography. They reported:
|
Age range (years) |
Number of subjects |
Mean (95% CI) |
|
|
Saccades latency leftwards in ms |
Group A, 18 – 30 |
50 |
237.24 (232.06 – 242.42) |
|
Group B, 31 – 40 |
50 |
241.44 (234.39 – 248.49) |
|
|
Group C, 41 – 50 |
50 |
255.86 (243.15 – 268.57) |
|
|
Group D, 51 – 60 |
50 |
260.12 (247.18 – 273.06) |
|
|
Group E, 61 – 70 |
50 |
290.42 (275.47 – 305.37) |
|
|
Total |
250 |
257.02 (251.61 – 262.43) |
|
|
Saccades velocity leftwards in dec/sec |
Group A, 18 – 30 |
50 |
245.30 (223.07 – 267.53) |
|
Group B, 31 – 40 |
50 |
228.28 (209.44 – 247.12) |
|
|
Group C, 41 – 50 |
50 |
236.28 (212.24 – 260.32) |
|
|
Group D, 51 – 60 |
50 |
231.50 (212.06 – 250.94) |
|
|
Group E, 61 – 70 |
50 |
169.52 (152.25 – 186.79) |
|
|
Total |
250 |
222.18 (212.65 – 231.71) |
|
|
Saccades accuracy leftwards |
Group A, 18 – 30 |
50 |
100.28 (95.31 – 105.25) |
|
Group B, 31 – 40 |
50 |
91.40 (87.34 – 95.46) |
|
|
Group C, 41 – 50 |
50 |
88.92 (81.87 – 95.97) |
|
|
Group D, 51 – 60 |
50 |
91.24 (87.63 – 94.85) |
|
|
Group E, 61 – 70 |
50 |
70.42 (63.70 – 77.14) |
|
|
Total |
250 |
88.45 (85.78 – 91.12) |
|
Age range (years) |
Number of subjects |
Mean (95% CI) |
|
|
Saccades latency rightwards in ms |
Group A, 18 – 30 |
50 |
265.34 (255.15 – 275.53) |
|
Group B, 31 – 40 |
50 |
252.26 (241.56 – 262.96) |
|
|
Group C, 41 – 50 |
50 |
273.82 (259.99 – 287.65) |
|
|
Group D, 51 – 60 |
50 |
264.12 (252.50 – 275.74) |
|
|
Group E, 61 – 70 |
50 |
292.56 (274.72 – 310.40) |
|
|
Total |
250 |
269.62 (263.67 – 275.57) |
|
|
Saccades velocity rightwards in dec/sec |
Group A, 18 – 30 |
50 |
237.52 (216.02 – 259.92) |
|
Group B, 31 – 40 |
50 |
226.50 (207.44 – 245.56) |
|
|
Group C, 41 – 50 |
50 |
236.28 (212.24 – 260.32) |
|
|
Group D, 51 – 60 |
50 |
233.20 (214.34 – 251.06) |
|
|
Group E, 61 – 70 |
50 |
190.30 (172.03 – 208.57) |
|
|
Total |
250 |
224.76 (215.60 – 233.92) |
|
|
Saccades accuracy rightwards |
Group A, 18 – 30 |
50 |
93.20 (89.26 – 97.14) |
|
Group B, 31 – 40 |
50 |
91.40 (87.34 – 95.46) |
|
|
Group C, 41 – 50 |
50 |
89.56 (82.63 – 96.49) |
|
|
Group D, 51 – 60 |
50 |
91.86 (88.49 – 95.23) |
|
|
Group E, 61 – 70 |
50 |
78.22 (73.39 – 83.05) |
|
|
Total |
250 |
88.45 (85.78 – 91.12) |
Spooner and colleagues (Spooner, Sakala, Baloh 1980) studied 25 healthy subjects aged 22 – 64 years (mean 42 years), and 14 healthy subjects age 50 – 85 years (mean 65 years) with electronystagmography. The overlap in age between the groups is apparently because the first group “had served as normal controls in our laboratory for several years.” They used a horizontal saccade protocol in which, “the target moved in a series of random stepwise jumps from 3 to 36˚ in amplitude in each direction for a total of 66 jumps.” They reported:
|
Maximum velocity in deg/sec ± SD |
Delay time (latency) in msec |
|
|
Age 22 – 64 years |
551±65.0 |
179±27.4 |
|
Age 50 – 85 years |
487±85.5 |
219±32.2 |
References
Hajioff D, Barr-Hamilton RM, Colledge NR, Lewis SJ, Wilson JA (2000) Re-evaluation of normative electronystagmography data in healthy ageing. Clin Otolaryngol Allied Sci 25: 249-52. doi: coa361 [pii]
Hopf S, Liesenfeld M, Schmidtmann I, Ashayer S, Pitz S (2018) Age dependent normative data of vertical and horizontal reflexive saccades. PLoS One 13: e0204008. doi: 10.1371/journal.pone.0204008
Irving EL, Steinbach MJ, Lillakas L, Babu RJ, Hutchings N (2006) Horizontal saccade dynamics across the human life span. Invest Ophthalmol Vis Sci 47: 2478-84. doi: 10.1167/iovs.05-1311
Kang S, Kim US (2015) Normative data of videonystagmography in young healthy adults under 40 years old. Korean J Ophthalmol 29: 126-30. doi: 10.3341/kjo.2015.29.2.126
Salman MS, Sharpe JA, Eizenman M, Lillakas L, Westall C, To T, Dennis M, Steinbach MJ (2006) Saccades in children. Vision Res 46: 1432-9. doi: 10.1016/j.visres.2005.06.011
Seferlis F, Chimona TS, Papadakis CE, Bizakis J, Triaridis S, Skoulakis C (2015) Age related changes in ocular motor testing in healthy subjects. J Vestib Res 25: 57-66. doi: 10.3233/VES-150548
Sinno S, Najem F, Smith Abouchacra K, Perrin P, Dumas G (2019) Normative Values of Saccades and Smooth Pursuit in Children Aged 5 to 17 Years. J Am Acad Audiol: 0. doi: 10.3766/jaaa.19049
Spooner JW, Sakala SM, Baloh RW (1980) Effect of aging on eye tracking. Arch Neurol 37: 575-6. doi: 10.1001/archneur.1980.00500580071012
Van Der Stappen A, Wuyts FL, Van De Heyning PH (2000) Computerized electronystagmography: normative data revisited. Acta Otolaryngol 120: 724-30. doi: 10.1080/000164800750000243
Warabi T, Kase M, Kato T (1984) Effect of aging on the accuracy of visually guided saccadic eye movement. Ann Neurol 16: 449-54. doi: 10.1002/ana.410160405
