Abstract
Purpose :
Perimetry in children is an invaluable modality for assessing afferent function. Current threshold perimeters demonstrate relatively poor reliability and satisfaction. The Olleyes VisuALL (OV) is a commercially available video-game based automated static threshold perimeter that uses a Virtual Reality headset, and a wireless remote.
Methods :
Fifty normal subjects ages 9-17 (mean=13 years, 50% female) performed Humphrey Visual Field (HVF) 24-2 and Olleyes VisuALL pediatric threshold perimetry. Test time, reliability parameters, and effects of age, gender, and ethnicity were evaluated. Normative threshold sensitivities were established by percentile. Patient satisfaction surveys were administered.
Results :
Median time to completion for OV and HVF was 7.06 and 5.25 min/eye respectively. Age-adjusted thresholds were similarly distributed between OV and HVF (Mean sensitivity 31.8± 1.11 dB OV, 31.0 ± 1.53dB HVF), mean inter-subject variability was no different as measured by Gini’s Mean Difference (2.7 +/- 0.4 OV and 2.7 +/- 0.6 HVF, p>0.25). Mild age-effects on threshold sensitivity in OV were similar to HVF (R2 = 0.10 p<0.01 OV; R2 = 0.08 p<0.01 HVF). Mean threshold sensitivities in the same eye were compared by linear regression (R2 = 0.11 p<0.001), and 5th percentile values were derived empirically at each location. Geographic effects on sensitivity and variability were concentric in the HVF as expected, and more sporadic for the OV. Patient satisfaction scores favored the OV device experience (1-5 scale, Wilcoxon matched-pairs signed rank test p<0.01).
Conclusions :
Attention to the task has long been a challenge in pediatric visual field testing. This game-based perimeter has higher patient satisfaction as well as tight correlation to the standard of care perimeter. Direct comparison of the two demonstrates less variability and tighter thresholds with the portable instrument which should translate into better ability to detect defects. The portability of the test allows it to be done in myriad environments lending to flexibility that can benefit children.
This is a 2021 ARVO Annual Meeting abstract.