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Abstract #74517 Published in IGR 19-1
Performance of iPad-based threshold perimetry in glaucoma and controls
Schulz AM; Graham EC; You Y; Klistorner A; Graham SLClinical and Experimental Ophthalmology 2018; 46: 346-355
IMPORTANCE: Independent validation of iPad visual field testing software Melbourne Rapid Fields (MRF). BACKGROUND: To examine the functionality of MRF and compare its performance with Humphrey SITA 24-2 (HVF). DESIGN: Prospective, cross-sectional validation study. PARICIPANTS: Sixty glaucomas (MD:-5.08±5.22); 17 pre-perimetric, 43 HVF field defects and 25 controls. METHODS: The MRF was compared with HVF for scotoma detection, global indices, regional mean threshold values and sensitivity/specificity. Long-term test-retest variability was assessed after 6 months. MAIN OUTCOME MEASURES: Linear regression and Bland Altman analyses of global indices sensitivity/specificity using ROC curves, intraclass correlations. RESULTS: Using a cluster definition of three points at <1% or two at 0.5% to define a scotoma on HVF, MRF detected 39/54 abnormal hemifields with a similar threshold-based criteria. Global indices were highly correlated between MRF and HVF: MD r2 = 0.80, PSD r2 = 0.77, VFI r2 = 0.85 (all P < 0.0001). For manifest glaucoma patients, correlations of regional mean thresholds ranged from r2 = 0.45-0.78, despite differing array of tested points between devices. ROC analysis of global indices showed reasonable sensitivity/specificity with AUC values of MD:0.89, PSD:0.85 and VFI:0.88. MRF retest variability was low with ICC values at 0.95 (MD and VFI), 0.94 (PSD). However, individual test point variability for mid-range thresholds was higher. CONCLUSIONS AND RELEVANCE: MRF perimetry, despite using a completely different test paradigm, shows good performance characteristics compared to HVF for detection of defects, correlation of global indices and regional mean threshold values. Reproducibility for individual points may limit application for monitoring change over time, and fixation monitoring needs improvement.
Department of Ophthalmology and Vision Science, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia.
Full articleClassification:
6.6.3 Special methods (e.g. color, contrast, SWAP etc.) (Part of: 6 Clinical examination methods > 6.6 Visual field examination and other visual function tests)
