A Virtual Reality-Based Automated Perimeter, Device, and Pilot Study

Mario Montelongo, Alberto Gonzalez, Freddy Morgenstern, Sean P Donahue, Sylvia L Groth, Mario Montelongo, Alberto Gonzalez, Freddy Morgenstern, Sean P Donahue, Sylvia L Groth

Abstract

Purpose: The purpose of this study was to describe a novel, virtual reality (VR)-based platform for evaluating visual fields.

Methods: Three subjects were tested on the VisuALL VR headset. Data collected included test duration per eye, total fixation losses (FLs), total false positives (FPs), and total false negatives (FNs). Mean threshold values were collected from the superior temporal (ST), superior nasal (SN), inferior nasal (IN), inferior temporal (IT) quadrants, and from the central 12 degrees (central), 12 to 24 degrees (pericentral), and from all testing loci (global).

Results: Six eyes of 3 subjects (2 men, 1 woman; mean age 30 years) were tested using the T-24 protocol (a Humphrey visual field [HVF] 24-2 equivalent). Mean test duration was 4.43 ± (SD) 0.11 minutes/eye. Mean threshold values ± SD for ST, SN, IN, IT, global, central, and pericentral were 31.1 ± 0.95 decibel (dB), 31.9 ± 0.3 dB, 32.0 ± 0.3 dB, 32.0 ± 1.1 dB, 31.9 ± 0.5 dB, 32.8 ± 0.5 dB, and 31.5 ± 0.5 dB, respectively.

Conclusions: This work describes the technical aspects of the VisuALL. Participants were able to complete the test and generate threshold values at each of 50 locations in the central 24 degrees of visual field. This VR-based visual field test shows potential to become an alternative to analog, stationary standard automated perimetry tests.

Translational relevance: The VisuALL is an immersive, VR-based, automated perimeter that effectively addresses some of the limitations inherent to other popular perimetric devices. Potential advantages of the VisuALL are its adaptability, portability, and efficiency for patients. This device may be able to fill the gap present in at-home glaucoma monitoring and expand the reach of glaucoma management.

Conflict of interest statement

Disclosure: M. Montelongo, None; A. Gonzalez, Olleyes (I, E, P); F. Morgenstern, Olleyes (I, E, P); S.P. Donahue, Olleyes (C, I); S. Groth, None

Figures

Figure 1.
Figure 1.
The VisuALL head mounted device (HMD) and Bluetooth connected handpiece.
Figure 2.
Figure 2.
VisuALL screen luminance (cd/m2) versus RBG (gray scale) values.
Figure 3.
Figure 3.
Report generated after completion of a test using the VisuALL.

References

    1. Bengtsson B, Olsson J, Heijl A, Rootzén H.. A new generation of algorithms for computerized threshold perimetry, SITA. Acta Ophthalmol Scand. 1997; 75(4): 368–375.
    1. Bengtsson B, Heijl A, Olsson J.. Evaluation of a new threshold visual field strategy, SITA, in normal subjects. Acta Ophthalmol Scand. 1998; 76(2): 165–169.
    1. Morales J, Weitzman ML, González De La Rosa M. Comparison between tendency-oriented perimetry (TOP) and octopus threshold perimetry. Ophthalmology. 2000; 107(1): 134–142.
    1. Tanna AP, Budenz DL, Bandi J, et al. .. Glaucoma progression analysis software compared with expert consensus opinion in the detection of visual field progression in glaucoma. Ophthalmology. 2012; 119(3): 468–473.
    1. Gardiner SK, Crabb DP.. Examination of different pointwise linear regression methods for determining visual field progression. Investig Ophthalmol Vis Sci. 2002; 43(5): 1400–1407.
    1. Castro DPE, Kawase J, Melo LAS Jr. Learning effect of standard automated perimetry in healthy individuals. Arq Bras Oftalmol. 2008; 71(4): 523–528.
    1. Myers L, Hu R, Morgan LS, Hoop JS, Racette L. A comparison of learning effects for standard automated perimetry, short-wavelength automated perimetry and frequency-doubling technology perimetry in healthy subjects. Investig Ophthalmol Vis Sci. 2014; 55(13): 5612.
    1. Gardiner SK, Demirel S.. Assessment of patient opinions of different clinical tests used in the management of glaucoma. Ophthalmology. 2008; 115(12): 2127–2131.
    1. Heijl A, Krakau C.. An automatic static perimeter, design and pilot study. Acta Ophthalmol. 1975; 53(3): 293–310.
    1. Heijl A, Patella VM, Chong LX, et al. .. A new SITA perimetric threshold testing algorithm: construction and a multicenter clinical study. Am J Ophthalmol. 2019; 198: 154–165.
    1. Moro C, Stromberga Z, Stirling A.. Virtualisation devices for student learning: comparison between desktop-based (Oculus Rift) and mobile-based (Gear VR) virtual reality in medical and health science education. Australas J Educ Technol. 2017; 33(6): 1–10.
    1. Dourado AO, Martin CA.. New concept of dynamic flight simulator, part I. Aerosp Sci Technol. 2013; 30(1): 79–82.
    1. Gerardi M, Cukor J, Difede J, Rizzo A, Rothbaum BO.. Virtual reality exposure therapy for post-traumatic stress disorder and other anxiety disorders. Curr Psychiatry Rep. 2010; 12(4): 298–305.
    1. Kim O, Pang Y, Kim JH.. The effectiveness of virtual reality for people with mild cognitive impairment or dementia: a meta-analysis. BMC Psychiatry. 2019; 19(1): 219.
    1. Pulijala Y, Ma M, Pears M, Peebles D, Ayoub A.. Effectiveness of immersive virtual reality in surgical training—a randomized control trial. J Oral Maxillofac Surg. 2018; 76(5): 1065–1072.
    1. Rathi S, Tsui E, Mehta N, Zahid S, Schuman JS.. The current state of teleophthalmology in the United States. Ophthalmology. 2017; 124(12): 1729–1734.
    1. Horton MB, Silva PS, Cavallerano JD, Aiello LP.. Clinical components of telemedicine programs for diabetic retinopathy. Curr Diab Rep. 2016; 16(12): 129.
    1. Bliziotis IA, Destounis A, Stergiou GS.. Home versus ambulatory and office blood pressure in predicting target organ damage in hypertension: a systematic review and meta-analysis. J Hypertens. 2012; 30(7): 1289–1299.
    1. Pronin S, Brown L, Megaw R, Tatham AJ.. Measurement of intraocular pressure by patients with glaucoma. JAMA Ophthalmol. 2017; 135(10): 1030–1036.
    1. Chauhan BC, Garway-Heath DF, Goñi FJ, et al. .. Practical recommendations for measuring rates of visual field change in glaucoma. Br J Ophthalmol. 2008; 92(4): 569–573.
    1. Tsapakis S, Papaconstantinou D, Diagourtas A, et al. .. Visual field examination method using virtual reality glasses compared with the Humphrey perimeter. Clin Ophthalmol. 2017; 11: 1431–1443.

Source: PubMed

3
Subskrybuj