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Fabio Bernardi Daga, Masaki Nakanishi, Yu-Te Wang, Tzyy-Ping Jung, John Zao, Nara G. Ogata, Ivan Maynart Tavares, Felipe Medeiros; Comparison between the nGoggle and Optical Coherence Tomography for Detecting Glaucoma. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4746.
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© ARVO (1962-2015); The Authors (2016-present)
The nGoggle (nGoggle, Inc., San Diego, CA) is a portable device capable of objectively assessing visual function loss through the assessment of multifocal steady-state visual evoked potentials (mfSSVEP) associated with visual field stimulation (Figure 1). In a previous study, the nGoggle has been shown to be able to identify functional losses in eyes with glaucomatous visual field defects on standard automated perimetry (SAP). In this study we further investigate the ability of the nGoggle in detecting glaucomatous damage, by comparing its diagnostic accuracy to that of RNFL thickness measurements obtained with Spectral-Domain Optical Coherence Tomography (SDOCT).
80 eyes of 42 glaucomatous patients and 33 eyes of 18 healthy controls were included. Glaucoma was diagnosed based on masked grading of optic disc stereophotographs. The nGoggle is a portable device that integrates wearable, wireless, dry electroencephalogram and electrooculogram systems, and a head-mounted display (HMD). Visual stimuli eliciting mfSSVEP signals in 20 sectors over the field of vision were presented on the nGoggle’s cell phone-based HMD. The area under the receiver operating characteristic curve (AUC) was used to compare the diagnostic accuracies of the different parameters investigated in the study.
Average SAP MD was -4.2 ± 6.3 dB in glaucoma eyes vs. -0.9 ± 2.8 dB in controls (P = 0.002). Average RNFL thickness measurements were thinner in glaucoma compared to healthy eyes (74.0 ± 15.4 μm vs. 93.2 ± 12.3 μm, respectively; P < 0.001). The global nGoggle mfSSVEP parameter also showed a significant difference between glaucoma and healthy eyes (0.294 ± 0.021 vs. 0.335 ± 0.028, P < 0.001). The nGoggle global parameter had AUC of 0.879 (95% CI: 0.817 – 0.941), which was comparable to the AUC for SDOCT RNFL (0.831; 95% CI: 0.753 – 0.908; P = 0.340) (Figure 2). The nGoggle performed better than SAP MD (AUC = 0.684; P = 0.002) and Pattern Standard Deviation (AUC = 0.667; P < 0.001).
The nGoggle, a portable and objective device for assessment of functional loss, performed better than SAP and had diagnostic accuracy comparable to OCT for detecting glaucomatous damage.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
Receiver operating characteristic curves for the nGoggle global parameter, SDOCT average retinal nerve fiber layer (RNFL) thickness, and Pattern Standard Deviation (PSD)
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