Abstract
Purpose :
To evaluate BulbiCam (BulbiTech AS, Oslo, Norway) functional test in glaucoma patients and to assess the correlation of its results with standard perimetry and structural damage.
Methods :
Twenty-two normal eyes, 14 ocular hypertensive eyes (OHT), 10 glaucoma suspects eyes and 25 eyes with glaucoma were included in the study. All subjects underwent a complete ophthalmic examination including standard visual fields (Humprey 24-2, Zeiss-Meditec, San Leandro, CA, USA), OCT nerve fiber layer images (Cirrus, Zeiss-Meditec, San Leandro, CA, USA; or Spectralis, Heidelberg Engineering, Heidelberg, Germany) and 2 BulbiCam 26-point test, and 1 BulbiCam 60-point test. BulbiCam is a new functional test based on virtual reality goggles, eye movement response to stimulus presentation, eye-tracking and unneeded patient clicking after stimulus is shown. All participants had previous perimetric and BulbiCam experience. Receiving Operating Characteristic Curve (ROC) was calculated for mean eye saccadic reaction time (SRT: time of eye movement towards the stimulus and back to fixation). Correlation between SRT and mean defect (MD), visual function index (VFI) and nerve fiber layer thickness (NFLT) was calculated with Spearman Test. The differences in SRT among the groups was analyzed with Kruskal Wallis Test.
Results :
The area under the ROC was 0.812 (0.690 to 0.933, p=0.000) for mean SRT. Best classification accuracy (normal vs. glaucoma) was shown at an SRT of 779,5 ms with a sensitivity of 80% and a specificity of 75%. The number of pathologic BulbiCam tests among OHT was 7 (50%). There was a significant difference (p<0.001) in mean SRT among glaucoma eyes (936.16 ± 22.38 ms), highest among all groups, glaucoma suspects eyes (710.00 ± 55.37 ms), OHT eyes (810.79 ± 129.98 ms) and normal eyes (733.96 ± 100.31 ms). There was a significant correlation between SRT values and MD (Rho -0.552, p<0.001), VFI (-0.498, p<0.001) and NFLT (-0.345, p=0.003).
Conclusions :
This pilot study to evaluate BulbiCam in glaucoma patients showed promising results to classify them from normal eyes and significant correlation with other functional and structural tests. Further and larger studies are needed to establish its usefulness in glaucoma management.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.