Rarebit perimetry: normative values and test-retest variability

Chin, Chee-Fang; Yip, Leonard W.; Sim, Danny C; Yeo, Anna Chwee Hong

doi:10.1111/j.1442-9071.2011.02555.x

Cited by 4 publications

(5 citation statements)

References 15 publications

(44 reference statements)

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“…The present study proposes and evaluates a novel alternative (“Eyecatcher”): a portable, suprathreshold eye-movement perimeter, which uses an inexpensive “clip-on” eye-tracker to detect eye movements toward successive targets (Goldmann III white lights). Unlike traditional SAP—or alternatives such as Frequency Doubling Technology,44–46 Flicker Perimetry,47 or Rarebit Perimetry48–50—this new approach requires minimal task-instructions, and does not require the participant to press a button or maintain fixation on a central marker. And unlike other eye-movement perimeters,12–17 Eyecatcher is intended primarily as a case-finding tool, and can be deployed using only a portable tablet-computer and low cost eye-tracking device (∼$100).…”

Section: Discussionmentioning

confidence: 99%

Portable Perimetry Using Eye-Tracking on a Tablet Computer—A Feasibility Assessment

Jones

Smith

et al. 2019

Trans. Vis. Sci. Tech.

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PurposeVisual field (VF) examination by standard automated perimetry (SAP) is an important method of clinical assessment. However, the complexity of the test, and its use of bulky, expensive equipment makes it impractical for case-finding. We propose and evaluate a new approach to paracentral VF assessment that combines an inexpensive eye-tracker with a portable tablet computer (“Eyecatcher”).MethodsTwenty-four eyes from 12 glaucoma patients, and 12 eyes from six age-similar controls were examined. Participants were tested monocularly (once per eye), with both the novel Eyecatcher test and traditional SAP (HFA SITA standard 24-2). For Eyecatcher, the participant's task was to simply to look at a sequence of fixed-luminance dots, presented relative to the current point of fixation. Start and end fixations were used to determine locations where stimuli were seen/unseen, and to build a continuous map of sensitivity loss across a VF of approximately 20°.ResultsEyecatcher was able to clearly separate patients from controls, and the results were consistent with those from traditional SAP. In particular, mean Eyecatcher scores were strongly correlated with mean deviation scores (r2 = 0.64, P < 0.001), and there was good concordance between corresponding VF locations (∼84%). Participants reported that Eyecatcher was more enjoyable, easier to perform, and less tiring than SAP (all P < 0.001).ConclusionsPortable perimetry using an inexpensive eye-tracker and a tablet computer is feasible, although possible means of improvement are suggested.Translational RelevanceSuch a test could have significant utility as a case finding device.

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Section: Discussionmentioning

confidence: 99%

Portable Perimetry Using Eye-Tracking on a Tablet Computer—A Feasibility Assessment

Jones

Smith

et al. 2019

Trans. Vis. Sci. Tech.

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“…In conclusion, although Rarebit perimetry has been shown to be a repeatable and reliable visual field test when using MHR as a dependent variable [54], the present results suggest that normative data for the adult and pediatric population should be reanalyzed to obtain a more reliable, bias-free, test–retest independent measure of sensitivity. With a bias-free index of sensitivity ( d’ ), children’s performance is reduced with respect to adult performance.…”

Section: Discussionmentioning

confidence: 81%

Testing the visual field of children and adults with Rarebit: The role of task repetition on sensitivity

et al. 2019

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Rarebit is a simple and user-friendly perimetry that tests the visual field by using tiny supra-threshold dot stimuli. It appears to be especially useful for examining the visual field of children who are under 12 years of age. However, previous data showed that the number of errors was higher in children than adults. We ask whether the different number of errors in these two groups depended on task learning and whether it may be accounted for by sensitivity differences or a response bias. Thirty-one children between 9 and 12 years of age and thirty-nine adults were tested three times with Rarebit perimetry. A bias-free sensitivity index, d’ , rather than the simple hit rate, revealed a group difference that remained after extensive task repetition. Indeed, d’ increased with task learning in a similar way in the two groups so that group difference remained after practice. The response bias differed in the two groups, being conservative in the older group (criterion C >0) and liberal in the younger (criterion C < 0). Both biases disappeared with task learning in the third session, suggesting that response bias cannot account for the group difference in sensitivity after practice. When bias-free measures of sensitivity are used and task learning effects are minimized, Rarebit perimetry may be a more valuable method than simple mean hit rate (MHR) to enlighten sensitivity differences in the visual field assessment within the pediatric population.

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“…Martin and Nilsson demonstrated in a small cohort of children that rarebit perimetry is a sensitive and specific way to detect peripheral visual field defects in paediatric populations. Other studies have demonstrated that rarebit perimetry is repeatable and reliable, with less retest variability than traditional perimetry . Some studies have suggested that because rarebit perimetry is similar to a computer game, children actually have fewer fixation losses and fewer false‐positives with rarebit when compared with traditional perimetry.…”

Section: Discussionmentioning

confidence: 99%

“…Other studies have demonstrated that rarebit perimetry is repeatable and reliable, with less retest variability than traditional perimetry . Some studies have suggested that because rarebit perimetry is similar to a computer game, children actually have fewer fixation losses and fewer false‐positives with rarebit when compared with traditional perimetry. Furthermore, patients in these studies reported greater satisfaction with rarebit perimetry .…”

Section: Discussionmentioning

confidence: 99%

“…In these cases, it would be prudent to examine each subject's screening test result (Figure ) to ensure that no focal defects are missed. This cutoff should also be calibrated for age, as studies have shown a predictable decrease in mean hit rate in older patients . To define a better reference range for this population, it would be prudent to select a more even age distribution and perform additional testing.…”

Section: Discussionmentioning

confidence: 99%

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Parallel rarebits: A novel, large‐scale visual field screening method

Lin

Fijalkowski

Lin

et al. 2014

Clinical and Experimental Optometry

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Background: Rarebit perimetry (RBP) is a computer-based perimetric testing program with sensitivity and specificity for detection of visual field defects comparable to traditional automated perimetry. To make large-scale screening more efficient, we developed a parallel rarebit perimetric method to screen groups of subjects simultaneously. We then used this method to report the mean hit rate (MHR) among subjects aged 13 to 19 years. Methods: Rarebit perimetry was installed on computers in an existing school computer laboratory. All subjects provided medical and demographic information and underwent a basic visual examination. Testing instructions were provided to groups of up to 35 subjects and rarebit perimetry was subsequently administered. Two or three test supervisors answered questions and ensured that subjects were well aligned with their test screens. Mean hit rate, reaction times, error rates and testing time were calculated, and time estimates for rarebit, frequency doubling perimetry and Humphrey 24-2 Swedish Interactive Thresholding Algorithm (SITA) fast test were compared. Results: A total of 364 rarebit perimetric tests were conducted on 182 subjects. Of these, 154 subjects met our inclusion criteria for the reference range (three testing errors or less and visual acuity 6/9 or better). The average mean hit rate was 94.3 ± 4.63 per cent. Screening of 500 subjects using this parallel rarebit perimetric method would require approximately nine hours, which is far less than an estimated 77 hours required for frequency doubling perimetry C-20 screening tests or an estimated 127 hours required for Humphrey 24-2 SITA fast tests. Conclusion: Using our methods, rarebit perimetry can be administered in parallel to groups of subjects. The mean hit rate was comparable to that reported in previously published studies. This parallel technique may improve the efficiency of large-scale visual field screenings.

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Rarebit perimetry: normative values and test-retest variability

Abstract: Rarebit perimetry is repeatable and reliable. We have established normative values for two age groups.

Cited by 4 publications

References 15 publications

Portable Perimetry Using Eye-Tracking on a Tablet Computer—A Feasibility Assessment

Portable Perimetry Using Eye-Tracking on a Tablet Computer—A Feasibility Assessment

Testing the visual field of children and adults with Rarebit: The role of task repetition on sensitivity

Parallel rarebits: A novel, large‐scale visual field screening method

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