Preliminary Report on a Novel Virtual Reality Perimeter Compared With Standard Automated Perimetry

Abstract

Precis: The VisuALL head-mounted perimetry in normal subjects and glaucoma patients had a moderate to strong correlation with the Humphrey Field Analyzer (HFA). Purpose: Visual field testing has a vital role in diagnosing and managing glaucoma. The current clinical practice relies on large, table-based testing units. This study investigated the performance of a novel virtual reality head-mounted visual perimetry device (VisuALL), in normal and glaucoma patients. Methods: This prospective observational study was conducted on 50 eyes of 25 healthy subjects (normal group) and 52 eyes of 26 patients with a controlled mild or moderate stage of glaucoma (glaucoma group). All participants had visual field testing with VisuALL and the HFA (24-2, Swedish Interactive Threshold Algorithm). The mean sensitivity of the whole visual field and each quadrant were compared between both machines and the receiver operating characteristic was used to compare the diagnostic abilities and the Bland-Altman plot to evaluate the agreement of the 2 perimeters. Results: The global mean sensitivity of the VisuALL and the HFA correlated significantly in both normal (r=0.5, P=0.001) and glaucoma (r=0.8, P<0.001) groups. The mean sensitivity of all quadrants also correlated significantly in both groups. The VisuALL mean sensitivity had a greater (0.98) receiver operating characteristic curve than HFA (0.93) mean sensitivity (P=0.06) in discriminating normal versus glaucoma. Conclusion: There was an excellent correlation between the VisuALL and the Standard Automated Perimetry in normal and glaucoma patients and VisuALL showing high diagnostic performance.

Patients Prefer a Virtual Reality Approach Over a Similarly Performing Screen-Based Approach for Continuous Oculomotor-Based Screening of Glaucomatous and Neuro-Ophthalmological Visual Field Defects

“…These limitations of SAP have been studied in glaucoma (Glen et al, 2014) and neuro-ophthalmic case findings (Szatmáry et al, 2002). Consequently, approaches using eye-movements (Murray et al, 2009;Mazumdar et al, 2014;Leitner et al, 2021b;Mao et al, 2021;Soans et al, 2021;Tatham et al, 2021) including tablet-based (Jones et al, 2019(Jones et al, , 2021 and VR perimetry techniques (Deiner et al, 2020;Leitner and Hawelka, 2021;Leitner et al, 2021a;Narang et al, 2021;Razeghinejad et al, 2021) have been developed.…”

Home-Based Perimetry for Glaucoma: Where Are We Now?

“…Their publication dates ranged between 2005 and 2021. The majority were cross-sectional clinical-based studies and were conducted in USA, 29,37,40,41 India, 27,30 UK, 26,31 Australia, 33,36 Singapore, 24 Greece, 34 Nepal, 35 Denmark, 38 and Philippines. 39 Two home-based longitudinal studies were conducted in UK 25 and Australia 28 , while one was a multicenter clinical-based study conducted in UK and India.…”

New Strategies for Automated Perimetry: Historical Perspective and Future Innovations

“…There are many VRP devices commercially available or in development. 12 – 17 It is unclear what device(s) are going to emerge as the preferred system ( Table 1 ). One example is the Olleyes VisuALL (Olleyes, Inc., Summit, NJ, USA).…”

“…1 ). 12 One strength of the Olleyes system is an included pediatric-specific test algorithm. The VisuaALL K utilizes a game-based format the engage the attention of children; 13 the HFA has neither such a format nor a normative database for children.…”