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Reena Chopra, Padraig Joseph Mulholland, Adam M Dubis, Roger S Anderson, Pearse Andrew Keane; Human Factor and Usability Testing of a Binocular OCT System - EASE Study. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5440.
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A prototype binocular optical coherence tomography (OCT) device has recently been developed that performs ‘whole-eye’ OCT imaging in an automated manner (Envision Diagnostics, Inc. USA). The inclusion of ‘smart technology’ such as customizable display screens and voice recognition also permits the quantitative assessment of visual acuity (VA), visual fields, ocular motility, and pupillometry (Fig. 1). As this device will primarily be used in elderly and visually impaired populations, we performed prospective usability testing of an early prototype with a view to predicting function in a clinical setting, and to identify any potential user errors – EASE Study (ClinicalTrials.gov Identfier: NCT02822612).
Forty-five participants with chronic eye disease (including glaucoma, retinal disease, and strabismus; mean age 62.7 years, range 23-88) and fifteen healthy controls were recruited (mean age 53 years, range 20-67). Participants underwent automated eye examination, including whole-eye OCT, ocular motility, VA, perimetry, and pupillometry. An interview was conducted pre- and post- examination to assess the subjective appeal and ease of use for this cohort of first-time users. Descriptive statistics were used to summarise data.
81% of the chronic eye disease group and 79% of healthy controls found the prototype easier to use than other common technologies such as smartphones. Overall, 86% reported the device to be acceptable for use in a clinical setting. There was no statistically significant difference in the time taken to complete the full suite of tests between participants with glaucoma, retinal disease, strabismus and healthy controls (p=0.81, Kruskal-Wallis). The mean time to complete the full examination was 733.5±172.9 s. Errors included inaccuracies in voice recognition, and in eye tracking secondary to eye movements or blinking.
On their first use, elderly and visually impaired patients were able to follow instructions delivered by the prototype and complete the suite of automated tests without assistance or prior training. Binocular OCT has the potential to perform comprehensive eye examination in an automated manner and thus increase the efficiency of chronic eye disease monitoring and treatment. Validation of individual diagnostic tests is required before the device can be adopted in eye clinics.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
Fig. 1: Automated quantitative pupillometry using the Binocular OCT
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