Diagnostic accuracy of an iPad application for detection of visual field defects

Abstract

Purpose : To determine the diagnostic accuracy of iPad perimetry using the visualFields Easy (VFE) application for glaucoma screening.

Methods : This was a prospective, cross-sectional study that enrolled patients undergoing their first Humphrey Field Analyzer (HFA) visual field test at the glaucoma clinic at a tertiary eye hospital in India between October 2014 and September 2015. Patients were excluded if they had undergone intraocular surgery within 2 weeks of enrollment. Participants received 24-2 SITA Standard HFA testing followed by iPad perimetry with the visualFields Easy application. The diagnostic accuracy of iPad perimetry was assessed for visual field defects relative to HFA results and for glaucoma relative to ophthalmologist diagnosis.

Results : iPad perimetry showed an area under the receiver operating characteristic (AUROC) curve of 0.67 (0.61-0.74) for visual field defect detection. This is in contrast with 0.86 (0.81-0.91) using 24-2 HVF. For detection of any glaucoma, VFE had an AUROC of 0.66 (0.58-0.73) while HVF had 0.89 (0.84-0.93). Sensitivities for glaucoma detection were 66.7% (48.7-78.5) and 80.2% (69.6-90.1) for VFE and HVF, respectively.

Conclusions : Our findings suggest that iPAD perimetry using the VFE application is inferior to 24-2 Standard HVF testing in detecting any visual field defects and glaucoma. The limited sensitivity of VFE minimizes its utility as an optimal tool for a glaucoma screening.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.