Abstract
Purpose :
Recent studies approximate that nearly 900,000 individuals suffer from vision-threatening retinopathy in the United States alone. Early detection of retinal disease matters for timely interventions, however, access to vision screening continues to be a limiting factor. Advancements in virtual reality (VR) technologies allow for the digitalization of several tests used in vision screening. In the present clinical study, our group assessed the viability of VR in administering perimetry, color vision, and Amsler grid exams.
Methods :
We performed a non-inferiority trial at the Mount Sinai 102nd street Ophthalmology Practice, in which patients received a 24-2 Humphrey Visual Field Analyzer (HVFA) exam, Ishihara Tile test, and an Amsler Grid along with the VR (VIVE Pro and PICO headset) analogues in a randomized fashion. The perimetry analogue is a 24-2 vision field exam with 25 Apostilibs. The Ishihara analogue consisted of a standard 9-plate screen for red-green color deficiencies. The Amsler analogue is a virtual grid to free-draw visually distorted areas. The primary outcome measure (POM) for perimetry was percent agreement of each stimulus point across all patients. The POM for Ishihara Tiles is number of correct tiles. The POM for Amsler grid is the percent agreement area of grid squares. Secondary outcomes are time to complete the test and the patient experience survey.
Results :
Form 69 patients recruited, 57 patients underwent color blindness testing for VR and non-VR and demonstrated no significant difference between the two (p = 0.9692 in Wilcoxon rank-sum test with VR tests reporting sensitivity = 100% & specificity = 76%. 50 patients took the Amsler grid, demonstrating no significant difference for the right eye (p = 0.3092) sensitivity = 100% & sensitivity = 95% and for the left eye (p = 0.6546) and sensitivity = 100% & sensitivity = 98%. 24-2 perimetry analog had a 78% overall agreement in the left eye and 76% overall agreement in the right eye with 46 and 42 eyes respectively. The time required to complete the HVFA was significantly longer compared to the VR, p < 0.0001.
Conclusions :
Our preliminary data suggest that VR can serve as a platform to deliver rapid vision screening exams, particularly perimetry, color blindness, and Amsler tests. The low cost of VR technologies, increased testing speeds with comparable results, user-friendliness for both operators and the patients presents a high-impact solution.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.