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Yu Xiang George Kong, Lukas Sahhar, Keith R Martin, Mingguang He, Jonathan G Crowston, Algis J Vingrys; Comparison of Perimetry for Glaucoma Using Standard Size iPad and Large Screen iPad Pro with Humphrey Field Analyzer.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5126.
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© ARVO (1962-2015); The Authors (2016-present)
To compare perimetric outcomes of the iPad perimetry application Melbourne Rapid Fields (MRF) using the standard-sized 9.7 inch iPad (MRF-9.7) and the larger 12.5 inch iPad Pro (MRF-12.5) with Humphrey Field Analyzer 24-2 Swedish Interactive Threshold Algorithm-Standard (HFA-SS).
44 eyes of 44 patients with acuity better than 6/12 (20/40) were recruited (9 normal controls, 6 glaucoma suspect, 10 mild glaucoma and 19 moderate-severe glaucoma). Patients received visual field threshold assessment with HFA-SS followed by MRF-9.7 and MRF-12.5 using a 66-point radial test pattern. The order of presentation of MRF-9.7 and MRF-12.5 were randomized. MRF-9.7 required four changes in fixation to complete visual field assessment, while the larger screen MRF-12.5 required only one. Patients were advised to fixate and follow the fixation target as instructed by a voice over. Exclusion criteria included visual acuity worse than 6/12, intraocular surgery in the preceding six months and poor reliability indices on HFA-SS.
MRF-9.7 and MRF-12.5 test times were both significantly faster than HFA-SS (MRF-9.7: 5.29±1.23 min, MRF-12.5: 4.10±1.07 min, HFA-SS: 6.56±2.23 min, p<0.01). MRF-12.5 was on average 1.18±0.60 minutes faster per eye compared to MRF-9.7 and 2.51±2.04 minutes faster than HFA-SS. Similar to our previous published study, Pearson’s correlation of perimetry results between MRF-9.7 and HFA-SS were strong for Mean Deviation (MD) (r2=0.85, slope=0.73) and Pattern Deviation (PD, slope=0.75) (r2=0.75). Correlations were similarly strong for MRF-12.5 with HFA-SS for MD (r2=0.86, slope=0.74) and PD (r2=0.84, slope=1.01). False positive (FP) and false negative (FN) rates for MRF-9.7 was 3+/-7% and 7+/-11% respectively. FP and FN rates for MRF-12.5 was 1+/-5% and 7+/-14% respectively. The 95% Limits of Agreement between MRF-9.7 and MRF-12.5 for MD is [-4.41 dB, 6.23 dB] and for PD is [-5.97 dB, 2.30 dB].
Perimetry results using MRF-12.5 had strong correlations to MRF-9.7 and HFA-SS. Testing time for MRF-12.5 was faster than MRF-9.7 (1.2 min faster) and HFA-SS (2.5 min faster), making the large screen iPad Pro an efficient method of visual field assessment. This is especially important in clinical settings where portability and high throughput is required.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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