Home-based visual field test for glaucoma screening comparison with Humphrey perimeter

Abstract

PurposeTo present a home-based visual field examination method using a PC monitor or virtual reality glasses and evaluate the reliability of the method by comparing the results with those of the Humphrey perimeter, in order to assess the possibility of glaucoma screening through the Internet.Materials and methodsSoftware implementing a supra-threshold algorithm for the central 24° (52 points) of visual field at three threshold levels: 1) −4 db, 2) −8 db, and 3) −12 db, from the age-expected sensitivity was used for the purpose of testing. The software uses the web camera as a “virtual photometer” in order to detect room luminosity and allows self-testing using a computer monitor or virtual reality glasses using an Android smartphone with a 6-inch display. The software includes an expert system to analyze the visual field image and validate the reliability of the results. It also allows the physician to combine the results from two or more tests into a single test in order to achieve higher statistical accuracy of the final result. A total of ten patients, 20 eyes tested×52 points per eye=1,040 visual field test points, were compared point to point to those obtained using the Humphrey perimeter for the same patients, as they appeared randomly and consecutively at the glaucoma department within hours.ResultsGood receiver operating characteristic/area under the curve coefficient was found, ranging from 0.762 to 0.837 (P<0.001). Sensitivity ranged from 0.637 to 0.942, and specificity ranged from 0.735 to 0.497.ConclusionThe home-based visual field test exhibits a reasonable receiver operating characteristic curve when compared to the Humphrey perimeter, without the need of specialized equipment. The test may be useful for glaucoma screening.

Smartphone-Based Data Collection in Ophthalmology

“…Glaucoma applications, including screening and monitoring apps, and reminders for repeat eye drop application. The authors consider the option of a smartphone-based visual field examination using virtual reality (VR) headsets as particularly interesting, as the latter could make their way into teleophthalmology in the future [9,37]. 6.…”

“…Furthermore, a clinical trial validated refrac-tion measurements including spherical and cylindrical refractive error [8]. It is also possible to perform perimetry either on a computer monitor or smartphone and VR glasses (VR: Virtual Reality), which may provide evidence of glaucoma [9].…”

The use of smartphones in ophthalmology: technological development and application

“…The smartphone ophthalmoscopy, considering its connectivity and portability, allows the benefit of this technology to be used in the screening of glaucoma, especially in environments with few resources, a place where the early detection of eye diseases is hampered due to the high cost and low portability of devices for fundoscopic evaluation 24 . Devices are also being produced that enable visual field examinations with the use of smartphones aided by adapters, as well as virtual reality glasses, producing results similar to conventional examinations, which may suggest a more practical and economical alternative to assess glaucoma patients 37,38 .…”

Assessment of consumer VR-headsets’ objective and subjective field of view (FoV) and its feasibility for visual field testing

“…Likewise, further experimental possibilities in psychophysics and vision sciences have been opened (Tychsen and Foeller 2020;Mohamed Elias et al 2019;Tieri et al 2018) as these devices became more and more affordable. Moreover, there has been a notable rise in clinical applications of VR, led by telemedicine systems for home-based medical assessments (Bashshur et al 2020;Tatiyosyan et al 2020;Neugebauer et al 2021) where, for example, different ophthalmological (visual-field) tests have been proposed (Hollander et al 2000;Tsapakis et al 2017Tsapakis et al , 2018Mees et al 2020).…”