Abstract
Purpose :
Virtual reality (VR) devices with pupil tracking technology now allow for the assessment of multiple components of the ophthalmic workup, but it is unclear how VR testing compares with the clinical exam. We aim to determine the utility of the Olleyes ETS VR Platform (Olleyes, Inc.; Summit, NJ) for screening abnormalities in visual acuity, extraocular motility, pupillometry testing, and visual field by confrontation.
Methods :
Subjects were recruited from the Eye Clinic at the University of Washington Medical Center in August 2023 and underwent ophthalmic workup by a trained ophthalmic professional (clinical exam) and by the VR platform. The VR testing bundle included visual acuity by tumbling E, extraocular motility (EOM) testing, visual field by confrontation, and a pupil (fast) exam. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for abnormal visual acuity (worse than 20/40), EOM deficit, presence of an afferent pupillary defect (APD), and deficit on visual field by confrontation on the VR platform compared to the clinical exam.
Results :
Data was acquired from 80 eyes of 40 patients, 22 female and 18 male. Average age was 60.5 ± 17.3 years. Average testing time of the VR platform was 10 ± 4 minutes. Nine eyes of 5 patients were excluded from visual acuity analysis because they misunderstood the instructions. Of the remaining eyes, 95% limits of agreement for visual acuity ranged from LogMAR -0.53 to 0.43. When using visual acuity worse than 20/40 as a threshold for decreased acuity, the sensitivity for detection of decreased visual acuity was 75% and the specificity was 82%, with a 45% PPV and 94% NPV. For the detection of an EOM deficit, the sensitivity of the VR platform was 100% and the specificity was 75%, with an 11% PPV and 100% NPV. For visual field abnormality by confrontation, the VR platform detected defects with a sensitivity of 50%, specificity of 98%, PPV of 50%, and NPV of 94%. There were no APDs detected by the virtual reality platform or by the clinical exam in our study population.
Conclusions :
This pilot study illustrates that the Olleyes VR platform may be useful as a negative screening exam for abnormalities in visual acuity, extraocular motility, and visual field by confrontation. Further work will focus on validating this device in patients with abnormal pathology.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.