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Runjie Bill Bill Shi, Rini Saha, Yan Li, Willy Wong, Yvonne Buys, Graham Trope, Moshe Eizenman; Novel Home Monitoring of Visual Fields with the Toronto Portable Perimeter. Invest. Ophthalmol. Vis. Sci. 2021;62(8):3483.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate home visual field monitoring with the Toronto Portable Perimeter (TPP) by glaucoma patients in a prospective cohort study.
Patients with reliable visual fields on the Humphrey Field Analyzer (HFA) were recruited from the Glaucoma Clinic at Toronto Western Hospital. Each participant was instructed in a 20-min session on using the TPP and performed a bilateral TPP-Standard 24-2 protocol. Then, participants were instructed to perform bilateral tests at least twice monthly at home with a personal TPP. Mean deviation (MD), pattern standard deviation (PSD) and test duration of reliable visual fields on the TPP were compared with the most recent reliable HFA SITA-Standard results. A reliable test was defined as: false positive < 20%, false negative < 20%, fixation loss < 33%. Inter-test variability was measured by calculating the root mean squared error (RMSE) of MDs and PSDs in consecutive visual field tests of the same eye.
To date 148 reliable home TPP visual field tests were performed by 8 patients (mean age: 70 years; range: 53 to 81) on 16 eyes (mean HFA MD: −6.05 dB; −13.19 to +0.54). Patients completed home TPP visual field tests at an average rate of 2.8 tests per 30 days (0.9 to 4.3). Compared to HFA there were no significant differences in MD (mean±std: +0.61±1.74 dB, p=0.18); PSD (−0.79±1.43 dB, p=0.04) were significantly lower and test durations (−30.11±46.11 seconds, p=0.02) shorter with TPP. Inter-test variability of MD was similar between the TPP and HFA (1.23 vs. 1.47 dB, p=0.50) while inter-test variability of PSD (0.59 vs. 1.64 dB, p<0.01) was better (lower RMSE) with TPP. In 14 eyes with 5 reliable home tests, the standard error of the mean estimates of MD and PSD in each eye was reduced to 0.32 dB and 0.22 dB, respectively.
Our preliminary results showed that glaucoma patients can perform TPP visual fields reliably at home. Results from the TPP were similar to the HFA. Consecutive tests at home exhibited less variability than consecutive tests on the HFA. Testing on the TPP took less time than HFA (on average 5.6 min on the TPP vs. 6.0 min on the HFA, and no requirement to visit a testing center). Patients also found home tests to be more convenient and relaxing. Frequent testing over short periods of time appears to improve MD and PSD precision and thus may potentially enable earlier detection of change.
This is a 2021 ARVO Annual Meeting abstract.
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