Abstract
Purpose :
Humphrey visual field testing is considered the gold standard. Yet, the machine is expensive and large and the test is time consuming and difficult for patients. Virtual visual field testing is convenient, cost effective and may offer an alternative to Humphrey testing. This study compares a commercially available virtual reality visual field to the Humphrey automated perimetry in a comprehensive academic practice.
Methods :
During the COVID-19 pandemic, virtual reality visual field testing was implemented in the Department of Ophthalmology at Stony Brook University. This study retrospectively reviewed patients who underwent virtual visual field testing (VVF) using the BOLT strategy from Virtual Field.io from July 2020 through December 2020. Of these patients, those who had a prior Humphrey 24-2 SITA standard visual field (HVF) performed within 12 months were included. All ocular diagnoses were included. Primary outcome data collected included mean deviation, pattern standard deviation, visual field index, fixation losses, test duration, and false positives and negatives.
Results :
A total of 76 patients underwent VVF testing. Of these, 50 eyes of 48 patients had a HVF performed in the prior 12 months and were included in the final analysis (M: 43.75%, F: 56.25%, mean age 55.28). VVF demonstrated no difference in ratio of fixation losses (mean difference -0.08, p=0.45) or number of false negatives (mean difference 2.07%, p=0.05) but had significantly less false positives (mean difference 5.13%, p=0.05). There was no statically significant difference in the mean deviation of the VVF compared to the HVF (mean difference 4.11, p= 0.45). The VVF had a lower pattern deviation (mean difference -0.23, p=0.05) and visual field index (mean difference -2.87, p=0.05) compared to the HVF. Test duration was shorter with the VVF by 2.4 minutes (mean difference 2.43, p=0.05). Pearson’s correlation coefficients for mean deviation, pattern deviation and virtual field index were 0.74 (p<0.01), 0.65 (p<0.01), and 0.71 (p<0.01).
Conclusions :
Virtual visual field testing using the BOLT strategy was similar to the Zeiss Humphrey SITA-Standard 24-2. VVF testing provides advantages over HVF in terms of cost effectiveness, portability and efficiency. However, prospective studies are needed to assess virtual field reproducibility and progression analysis.
This is a 2021 ARVO Annual Meeting abstract.