Clinical report: Virtual reality enables comparable contrast sensitivity measurements to in-office testing (pilot study)

Abstract

SIGNIFICANCE Vision health disparities largely stem from inaccessibility to vision specialists. To improve patient access to vision tests and to expedite clinical workflows, it is important to assess the viability of virtual reality (VR) as a modality for evaluating contrast sensitivity. PURPOSE This study aimed to assess the validity of a VR version of the Pelli-Robson contrast sensitivity test by comparing its results with those of the corresponding in-office test. METHODS Twenty-eight participants (mean ± standard deviation age, 37.3 ± 20.5 years) with corrected vision were recruited for testing on a voluntary basis with randomized administration of the in-office test followed by the VR analog or vice versa. Nineteen participants took each test twice to assess test-retest consistency in each modality. Virtual reality tests were conducted on a commercial Pico Neo Eye 2 VR headset, which has a 4K screen resolution. The environment for both tests was controlled by the participant for location and lighting. RESULTS Similar sensitivity scores were obtained between testing modalities in both the right (n = 28 participants; Wilcoxon match-paired signed rank [SR], p=0.7) and left eyes (n = 28 participants; Wilcoxon match-paired SR, p=0.7). In addition, similar test-retest scores were found for VR (n = 19 participants; Wilcoxon match-paired SR, p=1.0) or in-office (n = 19 participants; Wilcoxon match-paired SR, p=1.0) tests. Virtual reality Pelli-Robson results correlated well with in-office test results in variably diseased participants (n = 14 eyes from 7 participants, R 2 = 0.93, p<0.0001). CONCLUSIONS In this pilot trial, we demonstrated that VR Pelli-Robson measurements of corrected vision align with those of in-office modalities, suggesting that this may be a reliable method of implementing this test in a more interactive and accessible manner.