Prospective Comparison of VisuALL Virtual Reality Perimetry and Humphrey Automated Perimetry in Glaucoma.

Abstract

Automated perimetry plays an important role in the diagnosis and monitoring of glaucoma patients. The purpose of this study is to prospectively determine parity between Humphrey visual field analyzer (HVFA) perimetry (the current gold standard) and the VisuALL virtual reality perimeter (VRP). In this prospective fully paired diagnostic accuracy study, patients with stable, long-term HVFA visual fields (horizontal dots for ≥4 consecutive visits on progression analysis) with preperimetric, mild, moderate, or severe visual field loss were familiarized with the VRP and then tested using its proprietary software. These results were used for point-by-point comparison with a contemporaneous HVFA test. This study was approved by the Institutional Review Board (IRB) of the University of the Incarnate Word, San Antonio, Texas, United States of America (IRB approval #20-06-002). The prospective study analyzed 43 eyes of 24 glaucoma patients. Spearman's correlation of mean deviation (MD) revealed a strong correlation between HVFA and VRP with rs(41) = 0.871, p < 0.001. The overall mean difference in locus-locus sensitivity between the devices was -0.4 ± 1.5 dB but varied for different visual field locations and glaucoma severity. The parity between the VRP and HVFA was remarkably strong for mild and moderate glaucoma. Given its portability, ease of use, space efficiency, and low cost, the VRP presents a viable alternative. Automated perimetry, specifically the HVFA, has been the gold standard for visual field assessment since its introduction. The recent COVID-19 pandemic has illuminated the advantages of the VRP, allowing for safer visual assessment for both patient and clinician alike. Our study hopes to establish parity between these systems, allowing for the efficient integration of a novel head-mounted perimetry system that can safely diagnose and monitor glaucomatous progression in clinical practice. Investigation of parity between Olleyes VisuALL virtual reality perimetry (VRP) and existing standard HVFA perimetry is essential to the diagnosis and management of glaucoma. Linear correlations between the two were established from 43 glaucomatous eyes. Parity was strong for mild and moderate glaucoma, presenting VRP as a viable alternative. Griffin JM, Slagle GT, Vu TA, et al. Prospective Comparison of VisuALL Virtual Reality Perimetry and Humphrey Automated Perimetry in Glaucoma. J Curr Glaucoma Pract 2024;18(1):4-9.