Clinical Ophthalmology (Dec 2018)

Home-based visual field test for glaucoma screening comparison with Humphrey perimeter

  • Tsapakis S,
  • Papaconstantinou D,
  • Diagourtas A,
  • Kandarakis S,
  • Droutsas K,
  • Andreanos K,
  • Brouzas D

Journal volume & issue
Vol. Volume 12
pp. 2597 – 2606

Abstract

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Stylianos Tsapakis, Dimitrios Papaconstantinou, Andreas Diagourtas, Stylianos Kandarakis, Konstantinos Droutsas, Konstantinos Andreanos, Dimitrios Brouzas 1st Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece Purpose: To present a home-based visual field examination method using a PC monitor or virtual reality glasses and evaluate the reliability of the method by comparing the results with those of the Humphrey perimeter, in order to assess the possibility of glaucoma screening through the Internet.Materials and methods: Software implementing a supra-threshold algorithm for the central 24° (52 points) of visual field at three threshold levels: 1) -4 db, 2) -8 db, and 3) -12 db, from the age-expected sensitivity was used for the purpose of testing. The software uses the web camera as a “virtual photometer” in order to detect room luminosity and allows self-testing using a computer monitor or virtual reality glasses using an Android smartphone with a 6-inch display. The software includes an expert system to analyze the visual field image and validate the reliability of the results. It also allows the physician to combine the results from two or more tests into a single test in order to achieve higher statistical accuracy of the final result. A total of ten patients, 20 eyes tested×52 points per eye=1,040 visual field test points, were compared point to point to those obtained using the Humphrey perimeter for the same patients, as they appeared randomly and consecutively at the glaucoma department within hours.Results: Good receiver operating characteristic/area under the curve coefficient was found, ranging from 0.762 to 0.837 (P<0.001). Sensitivity ranged from 0.637 to 0.942, and specificity ranged from 0.735 to 0.497.Conclusion: The home-based visual field test exhibits a reasonable receiver operating characteristic curve when compared to the Humphrey perimeter, without the need of specialized equipment. The test may be useful for glaucoma screening. Keywords: glaucoma, screening, internet, computer monitor, android smart-phone, online visual field, virtual reality, teleophthalmology, telemedicine 

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