VR-SFT: Reproducing Swinging Flashlight Test in Virtual Reality to Detect Relative Afferent Pupillary Defect

Sarker, Prithul; Zaman, Nasif; Tavakkoli, Alireza

doi:10.1007/978-3-031-20716-7_15

Cited by 3 publications

(7 citation statements)

References 19 publications

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“…Одним из критериев тяжести поражения глаза при глазной травме является наличие или отсутствие афферентной реакции зрачка [19]. В данной работе у всех пациентов нарушение фотореакции оценивали как при поступлении, так и на момент выписки.…”

Section: Discussionunclassified

Clinical Features of Patients with Penetrating Eye Injury and Foreign Body Complicated by Endophthalmitis

Abakarov,

Loskutov

2024

Oftalʹmologiâ

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Purpose: to study the clinical features of patients with penetrating eye injury and foreign body, complicated by endophthalmitis.Methods. 68 patients (68 eyes) with penetrating injury and ocular foreign body were included in the retrospective study, including 91.2 % males and 8.8 % females. The mean age was 50.00 [32.00; 60.00] years. The patients were divided into 2 groups: with endophthalmitis — 24 patients, without inflammation — 44 patients. All patients underwent standard ophthalmologic methods of examination.Results. The age of patients with endophthalmitis was significantly greater compared to patients without inflammation — 51.50 [46.25; 63.25] years and 36.50 [31.25; 58.50] years, respectively (p = 0.0446). In the first day after injury, only 25 % of patients asked for medical care (p = 0.0071). In patients with endophthalmitis according to biomicroscopy data on admission the following were significantly more frequent: eyelid edema (p < 0.0001), purulent discharge (p < 0.0001), total hyphema (p = 0.029), hypopyon (p < 0.0001), iris edema (p < 0.0001), fibrin in vitreous body (p = 0.0014), as well as its destruction (p = 0.0005). 87.5 % of patients with endophthalmitis showed absence of fundus reflex (p = 0.0105), and 25 % of patients with inflammation showed increased intraocular pressure (p = 0.0019). In patients with endophthalmitis, surgical treatment was performed: cataract phacoemulsification in 91.7 % of patients (p < 0.0001), vitreoectomy in 87.5 % (p = 0.0098), enucleation of the eye in 12.5 % (p = 0.0165) and evisceration in 12.5 % (p = 0.0165). Bacterial culture in patients with endophthalmitis revealed Gram-positive microflora in 100 % of cases. There were also significant differences between the groups in the intravitreal, systemic and subconjunctival antibiotic therapy used.Conclusion. Patients with penetrating eye injury and foreign body, complicated by endophthalmitis, are characterized by more signs of inflammation, pronounced damage to the eye and its structures.

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Section: Discussionunclassified

Clinical Features of Patients with Penetrating Eye Injury and Foreign Body Complicated by Endophthalmitis

Abakarov,

Loskutov

2024

Oftalʹmologiâ

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“…For our experiments, we followed the implementation method of VR-SFT. 23 We used reduced light illumination to invoke artificial RAPD in the participants’ eyes. To eliminate the effects of accommodative response, visual stimuli were presented to make the illusion of the stimuli appearing from close to far distance.…”

Section: Methodsmentioning

confidence: 99%

“…We used three different protocols to measure the RAPD in controls. For protocols 1 and 2, we used 50% and 25% of the initial light intensity, which matched 0.3 and 0.6 log units for neutral density filters, respectively 23 ( Fig. 1 ).…”

Section: Methodsmentioning

confidence: 99%

“…More protocol details can be found in our previous work. 23 Detailed specifications of the protocols are given in Table 3 .…”

Section: Methodsmentioning

confidence: 99%

“…Similar to the methods of Sarker et al, 23 we applied an RAPD score to quantify asymmetric pupillary responses in participants. Cohen et al 9 utilized the RAPD score with the RAPDx pupillometer (Konan Medical USA, Inc., Irvine, CA, USA).…”

Section: Methodsmentioning

confidence: 99%

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Test–Retest Reliability of Virtual Reality Devices in Quantifying for Relative Afferent Pupillary Defect

Sarker

Zaman

Ong

et al. 2023

Trans. Vis. Sci. Tech.

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Background The swinging flashlight test (SFT) is one of the most prominent clinical tests for detecting the relative afferent pupillary defect (RAPD). A positive RAPD localizes the lesion to the affected afferent pupil pathway and is a critical part of any ophthalmic exam. Testing for an RAPD, however, can be challenging (especially when small), and there is significant intrarater and interrater variability. Methods Prior studies have shown that the pupillometer can improve the detection and measurement of RAPD. In our previous research, we have demonstrated an automatic SFT by utilizing virtual reality (VR), named VR-SFT. We applied our methods to two different brands of VR headsets and achieved comparable results by using a metric, called RAPD score, for differentiating between patients with and without (control) RAPD. We also performed a second VR-SFT on 27 control participants to compare their scores with their first assessments and measure test–retest reliability of VR-SFT. Results Even in the absence of any RAPD positive data, the intraclass correlation coefficient produces results between 0.44 and 0.83 that are considered of good to moderate reliability. The same results are echoed by the Bland–Altman plots, indicating low bias and high accuracy. The mean of the differences of measurements from test–retest ranges from 0.02 to 0.07 for different protocols and different devices. Conclusions As variability among various VR devices is an important factor that clinicians should consider, we discuss the test–retest reliability of VR-SFT and the variability among various assessments and between two devices. Translational Relevance Our study demonstrates the critical necessity of establishing test–retest reliability measures when bridging virtual reality technology into the clinical setting for relevant afferent pupillary defect.

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Meta smart glasses—large language models and the future for assistive glasses for individuals with vision impairments

Waisberg,

Ong,

Masalkhi

et al. 2023

Eye

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VR-SFT: Reproducing Swinging Flashlight Test in Virtual Reality to Detect Relative Afferent Pupillary Defect

Cited by 3 publications

References 19 publications

Clinical Features of Patients with Penetrating Eye Injury and Foreign Body Complicated by Endophthalmitis

Clinical Features of Patients with Penetrating Eye Injury and Foreign Body Complicated by Endophthalmitis

Test–Retest Reliability of Virtual Reality Devices in Quantifying for Relative Afferent Pupillary Defect

Meta smart glasses—large language models and the future for assistive glasses for individuals with vision impairments

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