Abstract
Purpose :
The COVID-19 pandemic significantly disrupted non-urgent healthcare services, including essential eye screenings critical for detecting blinding diseases before irreversible visual impairment occurs. This disruption spurred the development of innovative solutions urgently required to address the backlog in screening. These include novel solutions developed for remote visual field assessment (VFA) including perimetry using virtual reality (VR). In this pilot study, we investigated the clinical performance, provider acceptance, and potential barriers to adoption such as legal implications of a novel remote VR perimetry application.
Methods :
This is a prospective observational study conducted at a tertiary referral eye care center in Singapore. Participants underwent comprehensive ophthalmologic history, examinations, HVF (24-2, SITA Fast) perimetry, and completed perispace, a novel VR-based VFA application. The primary outcome measure was agreement in the classification of VFA result normality between the HVF and Perispace. Secondary outcome measures include clinical end user acceptance and potential barriers to adoption based on provider survey.
Results :
39 eyes of 39 patients are analysed in this study. Patient age ranged from 22 to 81 with a mean of 59.9.The Perispace VR perimetry test had high agreement and accuracy of over 80% when compared with the HVF gold-standard. Clinical end users reported high acceptance for the novel VR solution. In terms of potential barriers to adoption, legal implications were highlighted that need to be addressed with the acquisition and handling of patient data remotely, such as patient consent and compliance with data privacy regulations.
Conclusions :
This novel VR-based functional vision test had clinically acceptable accuracy of over 80% when compared against the gold-standard HVF test. Clinicians reported high acceptance for Perispace and identified medico-legal implications as potential barriers to adoption. Therefore, adequate legal professional expertise is required for the drafting of terms and conditions for user acknowledgement of data handling and transmission. The urgency to adopt novel innovations must be balanced with due diligence to ensure patient safety through clinical trials such as these, legal compliance with regulations, and ethical considerations such as informed consent.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.