Virtual Reality Perimetry in a Filipino Population: Assessing the Clinical Validity and Patient Preference of the RVF100 vs. Humphrey Visual Field Analyzer - 5469
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Author’s Disclosure Block: Abdullah Al-Ani: none; Michael Sibulo: none; Khaldon Abbas: none; Maria de Guzman: none; Andrew Crichton: none
Abstract Body
Purpose:Automated perimetry is essential for assessing ophthalmic and medical conditions associated with visual field defects and tracking their progression over time. The Humphrey Visual Field Analyzer (HFA) is recognized as the gold standard for automated perimetry but has limitations, including high cost, lack of portability, discomfort, and resource demands. Virtual reality (VR) devices, like RetinaLogik’s RVF100, offer a potential solution. This study investigates the clinical validity and patient experience of RVF100 compared to the HFA. Study Design: A diagnostic accuracy study assessing the reliability and usability of the RetinaLogik RVF100 compared to the HFA in a Filipino population. Methods: This six-months study took place at two St. Luke’s Medical Center locations in the Philippines, recruited 76 eyes from 46 Filipino adults aged 23 to 83 (mean age:51.5), who required visual field testing. Participants underwent testing with the HFA and RVF100 on separate days in alternating order, using similar algorithms and the 30-2 grid. Tests with a false-positivity rate above 15% or deemed low reliability by the HFA were excluded. Collected data included global mean deviation (MD), pattern standard deviation (PSD), mean sensitivity (MS), and pointwise sensitivity. Linear regression was applied to evaluate MD and PSD data, and Bland-Altman plots assessed the mean difference and agreement between the devices. Post-exam questionnaires measured patient usability, focusing on learning curve, comfort, ability to focus, engagement, and overall performance using a 4-point Likert scale. Results: Of the participants, 63% female and 37% males, with a mean age of 51.5 years. Linear regression analysis yielded a strong Pearson correlation coefficient for MD (r=0.97; P<0.0001), PSD (r=0.837; P<0.0001), and MS (r=0.97; P<0.001). Bland-Altman analysis revealed a bias of -1.06 dB, with 95% limits of agreement between -2 and -4.2, when comparing MS between RVF100 to HFA. Pointwise analysis of sensitivity differences at each tested point location revealed variation between –1.51 and 4.22 dB. In the usability questionnaire, patients rated VR perimetry more comfortable (Likert score: 3.51/4) and more engaging (3.6/4) compared to the HFA. They also reported better focus and posture with the RVF100 (3.4/4). Conclusions: Preliminary results demonstrate a robust correlation between the RVF100 VR headset and the HFA in MS, MD, and PSD among participants with and without glaucoma. These encouraging findings highlight the potential of VR perimetry as a cost-effective and user-friendly alternative to HFA. Future studies will further validate RVF100’s clinical validity and sensitivity to detect various pathological patterns and severities of visual field defects.