Home Monitoring of Glaucoma Using a Home Tonometer and a Novel Virtual Reality Visual Field Device

Hu, Galen; Prasad, Jaideep; Chen, Dinah; Alcantara-Castillo, Jennifer C; Patel, Vipul; Al-Aswad, Lama A.

doi:10.1016/j.ogla.2022.05.001

Cited by 23 publications

(13 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…32,33 Finally, although VVP-10 contained 10 sessions, subjects on average did not rate VVP-10 as more fatiguing or uncomfortable than a single HVF test. The finding that patients are amenable to taking tests more regularly has previously been described by various groups, 15,16,34,35 but we consider it extraordinary, and an indication of our success in devising a usable test, that 95% of patients successfully completed the training and that all trained patients completed their 10 sessions without further prompting.…”

Section: Discussionsupporting

confidence: 54%

“…In studies of those tests, most patients completed tests remotely, noted the advantages of greater accessibility, and reported feeling that they were playing an active role in their healthcare. 16,26 Patients enrolled in a study using the tablet-based Melbourne Rapid Fields test had good compliance to weekly monitoring over a 12 month period, with 32% of enrolled subjects completing the trial. 27 To the best of our knowledge, our study is the first to demonstrate the feasibility of training subjects using video conferencing so that the entire process of training and data collection can be completed remotely.…”

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 99%

“…One logical alternative to in-clinic visual field testing is at-home testing which patients are amenable to because it enables closer monitoring of their visual function through clustered testing and allows them to undergo testing at their convenience. 15,16 Vivid Vision Perimetry (VVP, Vivid Vision Inc., San Francisco, CA) has designed a variety of portable and mobile virtual reality-based visual field tests that are configured to run on off-the-shelf head mounted displays using the principle of multi-fixation, 17,18 multiple-choice perimetry. The patient's task during VVP was designed to reduce fatigue as compared to the button-press task in conventional in-clinic perimetry, with the aim of collecting more data and thus more precise measurements of sensitivity in patients with moderate to severe loss.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Assessment of the Feasibility of Remote Training, At-Home Testing, and Test-Retest Variability of Clustered Virtual Reality Perimetry

Chia

Kong

Turner

et al. 2022

Preprint

View full text Add to dashboard Cite

Objective: To assess the feasibility of remotely training glaucoma patients to take a ten-session clustered virtual reality (VR) visual field test (VVP-10) at home, analyze results for test-retest variability, and assess correspondence with conventional perimetry. Design: Cross-sectional study. Subjects: 21 subjects with glaucoma were enrolled and included in the feasibility assessment of remote training. 36 eyes were used for test-retest analysis and determination of concordance with Humphrey Visual Field (HVF) testing. Methods: Subjects were provided with a mobile VR headset containing the VVP-10 test software and trained remotely via video conferencing. Subjects were instructed to complete ten sessions over a 14-day period. Main Outcome Measures: Feasibility was determined by the number of subjects who were able to independently complete VVP-10 over the 14-day period after one remote training session. Intraclass correlation coefficient (ICC) of average fraction seen across ten sessions and standard error (SE) for the mean were primary outcome measures for assessing test-retest variability. Correlation with HVF mean sensitivity (MS) across eyes, was a secondary outcome measure. Results: 20 subjects (95%) successfully completed the VVP-10 test series after one training session. ICC of VVP-10 was 0.95 (95% CI [0.92, 0.97]). Mean SE in units of fraction seen was 0.012. The Spearman correlations of VVP-10 average fraction seen versus HVF MS were 0.88 (95% CI [0.66, 0.99]) for moderate to advanced glaucoma eyes, and decreased to 0.68 (95% CI [0.29, 0.94]) when all eyes were included. Conclusions: Remote training of patients at home is feasible and subsequent remote clustered visual field testing using VVP-10 by patients on their own without any further interactions with caregivers or study staff was possible. At-home VVP-10 results demonstrated low test-retest variability. Future studies must be conducted to determine if VVP-10, taken at home as convenient for the patient, may be a viable supplement to provide equivalent or complementary results to that of standard in-clinic assessment of visual function in glaucoma.

show abstract

Section: Discussionsupporting

confidence: 54%

Section: (Which Was Not Certified By Peer Review)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Assessment of the Feasibility of Remote Training, At-Home Testing, and Test-Retest Variability of Clustered Virtual Reality Perimetry

Chia

Kong

Turner

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…A small short‐term study using a virtual reality goggle‐based visual field test (Virtual Field) (VF) over 1 week was conducted by Hu et al 40 The study examined the acceptability and feasibility of the home‐based test. They found that all 20 patients in the study group felt the VF device was easy to use, and most (94.8%) would use the VF as part of future telehealth visits.…”

Section: Home Monitoringmentioning

confidence: 99%

Visual fields in glaucoma: Where are we now?

Lee

Kong

Liu

2023

Clinical Exper Ophthalmology

View full text Add to dashboard Cite

Visual fields are an integral part of glaucoma diagnosis and management. COVID has heightened the awareness of the potential for viral spread with the practice of visual fields modified. Mask artefacts can occur due to fogging of the inferior rim of the trail lens. Fortunately, the risk of airborne transmission when field testing is low. The 24‐2c may be useful to detect early disease and the 10‐2 more sensitive to detect advanced loss. The SITA faster test algorithm is able to reduce testing time thereby improving clinic efficiency, however, may show milder results for moderate or severe glaucoma. The technician has an important role of supervising the visual field performance to achieve reliable output. Home monitoring can provide earlier detection of progression and thus improve monitoring of glaucoma as well as reduce the burden of in‐clinic assessments. Artificial Intelligence has been found to have high sensitivity and specificity compared to expert observers in detecting field abnormalities and progression as well as integrating structure with function. Although these advances will improve efficiency and guide accuracy, there will remain a need for clinicians to interpret the results and instigate management.

show abstract