Abstract
Purpose :
Vivid Vision Perimetry (VVP), a virtual reality (VR) visual field test designed for ease of use, has shown to correlate well with static automated perimetry tests such as Humphrey Visual Field (HVF). However, its feasibility and accuracy for patients with language and socioeconomic barriers is unknown, posing a potential gap in accessibility. Our cross-sectional study assessed VVP’s feasibility and concordance with HVF for non-English speaking patients at a county hospital.
Methods :
Subjects aged 18-85 with glaucomatous VF defects, visual acuity >20/80, and a primary language of Spanish, Cantonese, or Vietnamese were recruited at Zuckerberg San Francisco General Hospital for VVP Swift testing. Training included a translated VR tutorial, later supplemented with customized PowerPoint (PPT) slides to improve and assess understanding with graphics and practice questions. VVP Swift used suprathreshold stimuli to test 54 field locations, deriving a fraction seen score at each. Pearson correlation evaluated concordance between VVP average fraction seen and HVF mean sensitivity (MS). Paired t-tests compared subjects’ discomfort and fatigue Likert ratings (1=none, 5=extremely large amount) for VVP and HVF.
Results :
Of 58 approached subjects, 51 (88%) consented, of whom 40 (78%) completed VVP. Incompletes resulted from inability to see visual elements of the test during training, mostly due to diffuse scotomas. Average (SD) age of completers was 65 (9) years. 50% were female. Primary languages were 73% Spanish, 25% Cantonese, and 2% Vietnamese. Average (SD) HVF MD was -5.89 (6.05) dB. Twelve of the first 16 completers did not respond according to instructions for stimuli near the fixation target, resulting in an artifactual central defect. After introducing supplementary PPT training, 44 eyes of 24 subjects completed VVP, with only one artifactual defect. Correlation between VVP average fraction seen and HVF MS was 0.72, p<0.001. Mean Likert scores for discomfort were 1.6/5 for VVP and 3.2/5 for HVF (p<0.001), and for fatigue, 1.6/5 for VVP and 3.1/5 for HVF (p<0.001).
Conclusions :
With tailored supplementary training in non-English speaking patients’ native language, VVP is a clinically feasible test that correlates strongly with and is deemed more comfortable and less fatiguing than static automated perimetry.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.