Acute Hypoxic Hypoxia and Isocapnic Hypoxia Effects on Oculometric Features

Stepanek J, Pradhan GN, Cocco D, Smith BE, Bartlett J, Studer M, Kuhn F, Cevette MJ. Acute hypoxic hypoxia and isocapnic hypoxia effects on oculometric features. Aviat Space Environ Med 2014; 85:700–7.Introduction: Visual performance impairment after hypoxia is well recognized in military and civilian aviation. The aims of this study were: 1) to assess oculometric features such as blink metrics, pupillary dynamics, fixations, and saccades as cognitive indicators of early signs of hypoxia; and 2) to analyze the impact of different hypoxic conditions [“hypoxic hypoxia” (HH) and “isocapnic hypoxia” (IH)] on specified oculometrics during mental workloads. Methods: Oculometric data were collected on 25 subjects under 3 conditions: normoxia, HH (8% O₂ + balance N₂), and IH (7% O₂ + 5% CO₂ + balance N₂). The mental workload task consisted of reading aloud linear arrays of numbers after exposure to gas mixtures. Results: Blink rates were significantly increased under hypoxic conditions (by +100.7% in HH and by +92.8% in IH compared to normoxia). A faster recovery of blink rate was observed in transitioning from IH (23.6% vs. 76.3%) to normoxia. The percentage change in pupil size fluctuation was increased under HH more than under IH (29% vs. 4.4%). Under HH average fixation time and target area size were significantly higher than under IH. Total saccadic times under hypoxic conditions were significantly increased compared with normoxia. Conclusions: These results suggest that oculometric changes are indicators of hypoxia, which can be monitored using compact, portable, noninvasive eye-tracking devices in a cockpit analogous environment to detect hypoxia-induced physiological changes in aircrew. Comparative results between HH and IH support the potential role of carbon dioxide in augmenting cerebral perfusion and hence improved tissue oxygen delivery.