The Repeatability of Mean Deviation Results of Visual Field Tests Performed on a Wearable Head Mounted Display

Abstract

Purpose : The purpose of this study is to investigate the intra-visit and inter-visit repeatability of Heru visual field (VF) tests on a wearable augmented reality headset.

Methods : Twenty-nine subjects over the age of 40 were recruited from 2 private ophthalmology practices and divided into 2 cohorts: normal and glaucoma suspects. Subjects in each cohort had a visual acuity of 20/40 or better. Subjects were determined to be glaucoma suspects based on optic nerve appearance, family history, intraocular pressure less than 22mmHg but had no glaucomatous visual field defects on the Humphrey Visual Field 24-2 testing or damage found on optical coherence tomography. These subjects were tested at 3 separate visits with the Heru re:Vive threshold 24-2 VF test on a Magic Leap 1 (Magic Leap, Plantation, FL), size 2 head mounted device (HMD). Distance spherical equivalent trial lenses were inserted as needed for testing. Two HMDs (Device A and Device B) were used at each site to perform testing and an additional third device (Device C) was provided in the case of malfunction although neither site used this device. The first visit included one 24-2 Heru VF test on Device A, the second visit included 3 tests on Device A to determine intra-visit repeatability, and the third visit was performed on both device A and B to determine inter-visit repeatability. To address patient fatigue, subjects were given at least a 5-minute break in between tests during visit 2 and 3.

Results : Our prospective study included 29 eyes, over the age of 40 with a mean age of 62 (± 12). For the intra-visit retest, the mean standard deviation (SD) was 0.26, the 95% coefficient of repeatability (CoR) was 0.72, and the interclass correlation (ICC) was 0.94. The inter-visit retest results showed a mean SD of 0.69, a CoR of 1.91, and an ICC of 0.72.

Conclusions : These preliminary results suggest that visual field test conducted on the Heru’s wearable device has good repeatability, and an MD change of greater than 1.91dB is likely to be significant from visit to visit. Further work is required to finalize this conclusion and to determine the repeatability in glaucoma patients.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

The intra-visit (green) and the inter-visit (purple) within intra-subject standard deviation of mean deviation (MD) as a function of average MD.

 

Different repeatability metrics for the the intra-visit and the inter-visit retests for the Heru visual field tests.