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Algis J Vingrys, Jessica Kate Healey, Sheryl Liew, Veeravah Saharinen, Michael Tran, William Wu, Yu Xiang George Kong; Clinical validation of a tablet perimeter.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3936.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the performance of a portable perimeter (Melbourne Rapid Field, MRF) developed on an Apple iPad tablet using innovative design concepts.
The MRF tests 66 optimised locations over 34x25 degrees with a rapid Bayes logic. It adopts a fixed spatial summation with eccentricity that results in a flat hill of vision. Five young (age 22-28 yrs) participants were extensively tested on the MRF to establish the effects of: miosis, blur (+3 DS), viewing distance (25, 75 cm), ambient light and retest reliability (1 week between sessions). Forty-one clinical patients (aged 26-87 yrs) comprising 21 who had glaucoma related visual field loss (59-87 yrs) and 20 age-similar participants (50-83 yrs) with normal visual fields were also tested. All patients performed a Humphrey Field Analyser (HFA) 24-2 Sita-standard test followed by 2 tests on the MRF (same day). Testing was on the eye with the least MD on the HFA. Comparisons between the HFA and MRF were in terms of Mean Defect (MD) and Bland-Altman analysis to return Limits of Agreement (95% LoA). Data are given as group mean [SEM]. The study was approved by our local HEC (15/1220H) and all subjects provided informed consent to participate.
Test time was similar for the MRF and HFA. Variation in viewing distance (25 cm = 29.8 [0.88] dB; 75 cm =28.9 [0.55] dB, p=NS) and ambient light do not significantly alter thresholds (dim, 29.8 [0.79] dB vs ambient 29.5 [1.03] dB p = NS). Miosis and blur (+3 DS) give small reductions of sensitivity significant at peripheral (miosis, -1.2 dB, p<0.05) or central locations (blur, -1.5 dB p<0.05) only. The 95% LoA for MRF retest was 6.7 dB in participants with normal fields and 14.8 dB in cases with field loss. MRF MD correlated with the HFA MD (r = 0.57) showing a bias of +0.6 dB in those with normal fields and -1.9 dB in cases with field loss indicating that the HFA returns larger MD values.
Tablet technology can be designed to yield efficient and reliable central visual field outcomes that compare to those found with the HFA.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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