목적: Although video head impulse test (vHIT) for vestibulo-ocular reflex (VOR) measurement has become widely used, little is known about the impact of refixation saccades (RS). We wanted to systematically characterize the frequency and amplitudes of RS and its relationship with gain values. 방법:The presence and the peak velocities of covert RS and overt RS, occurring during or after head rotation were analyzed in 59 VN patients. It was considered as abnormal, when vHIT gain < 80% or gain asymmetry(GA) < 8%. We also examined the relationship between the gains and the amplitudes of RS. We considered abnormal when an interaural difference of RS amplitudes > 100/s as new criteria of vHIT abnormality. 결과:Mean ipsilesional vHIT gain (0.61+0.25) was smaller than mean contralesional vHIT gain (1.00+0.12). Pathologic gain was observed in 46 (78%) of 59 patients and pathologic GA was observed in 47 (80%). Overall, 11 (19%) showed normal vHIT results. When ipsilesional vHIT was performed, both overt and covert RS were observed in 45 (76%), overt RS only in 8 (14%), covert RS only in 3 (5%), and no RS in 3 (5%). When contralesional vHIT was performed, overt RS only were observed in 22 (37%), both overt and covert RS in 8 (14%), covert RS only in 3 (5%), and no RS in 26 (44%). When covert RS was dominant during contralesional vHIT, covert RS was also dominant during ipsilesional vHIT (p<0.05). The amplitude of RS showed significant correlation with ipsilesional vHIT gain (p<0.001, R-Sq=0.6). When combining a new criteria using interaural RS amplitude difference, the abnormal rate of vHIT increased to 92% (54 of 59). 결론:Our findings showed that the amplitude of RS showed significant correlation with ipsilesional vHIT gain, suggesting that the more VOR deficit the higher amplitudes of RS are needed to compensate it. When an interaural RS amplitude difference is considered in addition to gain values, the presence of vestibular impairment could be defined more precisely.