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Sofía De Arrigunaga, Joyce Kang, Yan Zhao, Sandra Freeman, Ana M. Roldan, Tobias Elze, Michael M. Lin, Daniel Liebman, Dolly Chang, David S Friedman; Learning curve on tablet-based visual field tests during one week of daily testing. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3102.
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© ARVO (1962-2015); The Authors (2016-present)
Frequent home-based visual field (VF) testing using portable perimetry devices, such as the tablet-based Melbourne Rapid Fields (MRF, M&S Technologies, Niles, IL, USA), has been proposed to improve earlier detection of glaucoma progression. This pilot observational study evaluated MRF in terms of test reproducibility.
Subjects who were either glaucoma suspects or who had a glaucoma diagnosis were recruited during regular clinic visits. After a training session in the office with MRF, subjects were loaned tablets with pre-installed MRF software and instructed to take VF tests at home daily for one week as a training period, then weekly thereafter for three months. To assess a learning effect during the first week, longitudinal analysis with a fixed effects model was used to calculate the change of the group mean over time for test performance as measured by mean deviation (MD) and pattern standard deviation (PSD), and an asymptotic regression model was fit to the first five tests.
Fifty-two subjects with a mean age of 62 years (range 30-79) are included in this analysis. There was a significant learning effect between the first and second test, as evidenced by a significant difference in MD (0.63 dB, CI = [0.06, 1.21], P = 0.031) and PSD (-0.58 dB, CI = [-1.05, -0.12] P = 0.013). The average MD and PSD of the second and third tests was similar to that of subsequent tests during the first week. Similarly, in an asymptotic regression model, 99.5% of the asymptote was reached for MD and PSD already after the second test, which indicates that nearly all learning had been completed prior to the second test.
Preliminary results show a strong learning effect from the first MRF test done independently by subjects. As we look to operationalize the use of new VF devices for at home monitoring, these data suggest that an average of the second and third MRF tests can be used as a baseline measure. Participants seem to reach a performance “steady state” starting with their second test.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
Figure 1. Box plot comparing mean MD values for all participants during the week 1 MRF tests. Fifty-two subjects took 5 five tests, 47 took six and 34 took all seven.
Figure 2. Asymptotic model comparing MD values across the first five test days. Numbers show the percentage of the asymptote achieved for each test.
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