Validation of a Head Mounted Virtual Reality Visual Field Screening Device

Lukas Mees, Swati Upadhyaya, Pavan Kumar, Sandal Kotawala, Shankar Haran, Shruthi Rajasekar, David S. Friedman, Rengaraj Venkatesh

Research output: Contribution to journalArticle

Abstract

Précis: The CFA is a moderately reliable perimeter preferred by patients to standard perimetry. While it does not approximate the gold standard, it was sensitive and specific for clinically defined glaucoma (aROC=0.77-0.86). Purpose: Testing the visual field is a vital sign for diagnosing and managing glaucoma. The current gold standard, the Humphrey visual field analyzer (HFA), is large, expensive and can be uncomfortable for some patients. The current study investigated the C3 fields analyzer (CFA), a virtual reality head mounted visual field testing device, as a possible subjective field test for glaucoma screening and eventually glaucoma monitoring. Patients and Methods: The CFA presented stimuli in the same 54 positions as the HFA 24-2 SITA Standard test using a suprathreshold algorithm approximating an 18dB deficit. 157 patients (both controls and glaucoma patients) at the Aravind Eye Hospital, Pondicherry, India, were tested with both devices. Results: The number of stimuli missed on the CFA correlated with HFA mean deviation (r=0.62, P<0.001), and with pattern standard deviation (r=0.36, P<0.001). The area under the receiving operator characteristic curve (AROC) was 0.77±0.06 for mild glaucoma (HFA mean deviation ≥-612;dB) and 0.86±0.04 for moderate-advanced glaucoma (HFA mean deviation <-612;dB). Patients with an 1812;dB or worse deficit at a point in the visual field on the HFA failed to see the CFA stimulus at the same position 38% of the time. Conclusions: While the CFA did not reliably identify deficits that matched the HFA, it was moderately effective at identifying glaucoma subjects. Further refinements to the device will be required to improve point-by-point testing performance and screening performance.

Original languageEnglish (US)
Article number1415
JournalJournal of glaucoma
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Visual Fields
Glaucoma
Head
Equipment and Supplies
Visual Field Tests
Vital Signs
India

Keywords

  • perimetry
  • suprathreshold
  • virtual reality
  • visual fields

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Mees, L., Upadhyaya, S., Kumar, P., Kotawala, S., Haran, S., Rajasekar, S., ... Venkatesh, R. (Accepted/In press). Validation of a Head Mounted Virtual Reality Visual Field Screening Device. Journal of glaucoma, [1415]. https://doi.org/10.1097/IJG.0000000000001415

Validation of a Head Mounted Virtual Reality Visual Field Screening Device. / Mees, Lukas; Upadhyaya, Swati; Kumar, Pavan; Kotawala, Sandal; Haran, Shankar; Rajasekar, Shruthi; Friedman, David S.; Venkatesh, Rengaraj.

In: Journal of glaucoma, 01.01.2019.

Research output: Contribution to journalArticle

Mees L, Upadhyaya S, Kumar P, Kotawala S, Haran S, Rajasekar S et al. Validation of a Head Mounted Virtual Reality Visual Field Screening Device. Journal of glaucoma. 2019 Jan 1. 1415. https://doi.org/10.1097/IJG.0000000000001415
Mees, Lukas ; Upadhyaya, Swati ; Kumar, Pavan ; Kotawala, Sandal ; Haran, Shankar ; Rajasekar, Shruthi ; Friedman, David S. ; Venkatesh, Rengaraj. / Validation of a Head Mounted Virtual Reality Visual Field Screening Device. In: Journal of glaucoma. 2019.
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