Repeatability of a Virtual Reality Headset Perimeter in Glaucoma and Ocular Hypertensive Patients

Overview

Journal Transl Vis Sci Technol

Specialties Biomedical Engineering
Ophthalmology

Date 2024 Jun 20

PMID 38899952

Authors

Rafaella Nascimento E Silva

Julia A Kim

Yihao Li

Chen Chen

Anisa F Chaudhry

Andrew R Berneshawi

Miao Zhang

Adam Villarreal

Jocelyn Liu

Ann Shue

Dolly S Chang

Robert T Chang

Affiliations

Soon will be listed here.

Abstract

Purpose: The VisuALL S is an automated, static threshold, virtual reality-based perimeter for mobile evaluation of the visual field. We examined same-day and 3-month repeatability.

Methods: Adult participants with a diagnosis of glaucoma or ocular hypertension underwent two VisuALL 24-2 Normal T- Full threshold strategy tests at baseline and one additional exam at 3 months for each eligible eye. Spearman, intraclass correlation coefficients (ICCs), and Bland-Altman plots were used to assess the correlation of individual point sensitivities and mean deviation (MD) among three tests.

Results: Eighty-eight eyes (44 participants) were included. Average age was 68.1 ± 14.3 years, and 60.7% were male. VisuALL MD was highly correlated between tests (intravisit: r = 0.89, intervisit: r = 0.82; P < 0.001 for both). Bland-Altman analysis showed an average difference in intravisit MD of -0.67 dB (95% confidence interval [CI], -6.04 to 4.71 dB) and -0.15 dB (95% CI, -8.04 to 7.73 dB) for intervisit exams. Eight-five percent of pointwise intravisit ICCs were above 0.75 (range, 0.63 to 0.93), and 65% of pointwise intervisit ICCs were above 0.75 (range, 0.55 to 0.91).

Conclusions: VisuALL demonstrated high correlation of MD between tests and good repeatability for individual point sensitivities among three tests in 3 months, except at the points around the blind spot and superiorly.

Translational Relevance: The preliminary reproducibility results for VisuALL are encouraging. Its portable design makes it a potentially useful tool for patients with glaucoma, enabling more frequent assessments both at home and in clinical settings.

References

Elze T, Pasquale L, Shen L, Chen T, Wiggs J, Bex P . Patterns of functional vision loss in glaucoma determined with archetypal analysis. J R Soc Interface. 2014; 12(103). PMC: 4305414. DOI: 10.1098/rsif.2014.1118. View

Koo T, Li M . A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research. J Chiropr Med. 2016; 15(2):155-63. PMC: 4913118. DOI: 10.1016/j.jcm.2016.02.012. View

Gardiner S . Differences in the Relation Between Perimetric Sensitivity and Variability Between Locations Across the Visual Field. Invest Ophthalmol Vis Sci. 2018; 59(8):3667-3674. PMC: 6054428. DOI: 10.1167/iovs.18-24303. View

Haefliger I, Flammer J . Increase of the short-term fluctuation of the differential light threshold around a physiologic scotoma. Am J Ophthalmol. 1989; 107(4):417-20. DOI: 10.1016/0002-9394(89)90667-3. View

Artes P, Iwase A, Ohno Y, Kitazawa Y, Chauhan B . Properties of perimetric threshold estimates from Full Threshold, SITA Standard, and SITA Fast strategies. Invest Ophthalmol Vis Sci. 2002; 43(8):2654-9. View

Montelongo M, Gonzalez A, Morgenstern F, Donahue S, Groth S . A Virtual Reality-Based Automated Perimeter, Device, and Pilot Study. Transl Vis Sci Technol. 2021; 10(3):20. PMC: 7991920. DOI: 10.1167/tvst.10.3.20. View

Weinreb R, Perlman J . The effect of refractive correction on automated perimetric thresholds. Am J Ophthalmol. 1986; 101(6):706-9. DOI: 10.1016/0002-9394(86)90774-9. View

Turpin A, McKendrick A . What reduction in standard automated perimetry variability would improve the detection of visual field progression?. Invest Ophthalmol Vis Sci. 2011; 52(6):3237-45. DOI: 10.1167/iovs.10-6255. View

Wang M, Shen L, Boland M, Wellik S, De Moraes C, Myers J . Impact of Natural Blind Spot Location on Perimetry. Sci Rep. 2017; 7(1):6143. PMC: 5522496. DOI: 10.1038/s41598-017-06580-7. View

10.

Heijl A, Buchholz P, Norrgren G, Bengtsson B . Rates of visual field progression in clinical glaucoma care. Acta Ophthalmol. 2012; 91(5):406-12. PMC: 3798127. DOI: 10.1111/j.1755-3768.2012.02492.x. View

11.

Kelly S, Bryan S, Crabb D . Does eye examination order for standard automated perimetry matter?. Acta Ophthalmol. 2019; 97(6):e833-e838. PMC: 6767463. DOI: 10.1111/aos.14069. View

12.

Jampel H, Singh K, Lin S, Chen T, Francis B, Hodapp E . Assessment of visual function in glaucoma: a report by the American Academy of Ophthalmology. Ophthalmology. 2011; 118(5):986-1002. DOI: 10.1016/j.ophtha.2011.03.019. View

13.

Lau L, Liu C, Chou J, Hsu W, Liu J . Patterns of visual field defects in chronic angle-closure glaucoma with different disease severity. Ophthalmology. 2003; 110(10):1890-4. DOI: 10.1016/S0161-6420(03)00666-3. View

14.

Taniguchi A, Yunoki T, Otsuka M, Hayashi A . Visual field changes in glaucoma patients after blepharoptosis surgery. Eur J Ophthalmol. 2022; 32(6):3353-3357. DOI: 10.1177/11206721211073254. View

15.

Gardiner S, Demirel S . Assessment of patient opinions of different clinical tests used in the management of glaucoma. Ophthalmology. 2008; 115(12):2127-31. PMC: 3704561. DOI: 10.1016/j.ophtha.2008.08.013. View

16.

Lin F, Chen S, Song Y, Li F, Wang W, Zhao Z . Classification of Visual Field Abnormalities in Highly Myopic Eyes without Pathologic Change. Ophthalmology. 2022; 129(7):803-812. PMC: 10866199. DOI: 10.1016/j.ophtha.2022.03.001. View

17.

Chauhan B, Malik R, Shuba L, Rafuse P, Nicolela M, Artes P . Rates of glaucomatous visual field change in a large clinical population. Invest Ophthalmol Vis Sci. 2014; 55(7):4135-43. DOI: 10.1167/iovs.14-14643. View

18.

Boeglin R, Caprioli J, Zulauf M . Long-term fluctuation of the visual field in glaucoma. Am J Ophthalmol. 1992; 113(4):396-400. DOI: 10.1016/s0002-9394(14)76161-6. View

19.

Keltner J, Johnson C, Cello K, Edwards M, Bandermann S, Kass M . Classification of visual field abnormalities in the ocular hypertension treatment study. Arch Ophthalmol. 2003; 121(5):643-50. DOI: 10.1001/archopht.121.5.643. View

20.

Choi E, Li D, Fan Y, Pasquale L, Shen L, Boland M . Predicting Global Test-Retest Variability of Visual Fields in Glaucoma. Ophthalmol Glaucoma. 2020; 4(4):390-399. PMC: 8192590. DOI: 10.1016/j.ogla.2020.12.001. View