Six-month Longitudinal Comparison of a Portable Tablet Perimeter With the Humphrey Field Analyzer

• Published in: American journal of ophthalmology 2018-06, Vol.190, p.9-16
• Main Authors: Prea, Selwyn Marc, Kong, Yu Xiang George, Mehta, Aditi, He, Mingguang, Crowston, Jonathan G., Gupta, Vinay, Martin, Keith R., Vingrys, Algis J.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Bias; Clinical trials; Computers, Handheld; Female; Field study; Follow-Up Studies; Glaucoma; Glaucoma, Open-Angle - diagnosis; Glaucoma, Open-Angle - physiopathology; Humans; Intraocular Pressure - physiology; Male; Middle Aged; Ocular Hypertension - diagnosis; Ocular Hypertension - physiopathology; Ophthalmology; Optic nerve; Optics; Patients; Reproducibility of Results; Sensitivity and Specificity; Time Factors; Vision Disorders - diagnosis; Vision Disorders - physiopathology; Visual Field Tests - instrumentation; Visual Fields - physiology; Young Adult
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2018.03.009

To establish the medium-term repeatability of the iPad perimetry app Melbourne Rapid Fields (MRF) compared to Humphrey Field Analyzer (HFA) 24-2 SITA-standard and SITA-fast programs. Multicenter longitudinal observational clinical study. Sixty patients (stable glaucoma/ocular hypertension/glaucoma suspects) were recruited into a 6-month longitudinal clinical study with visits planned at baseline and at 2, 4, and 6 months. At each visit patients undertook visual field assessment using the MRF perimetry application and either HFA SITA-fast (n = 21) or SITA-standard (n = 39). The primary outcome measure was the association and repeatability of mean deviation (MD) for the MRF and HFA tests. Secondary measures were the point-wise threshold and repeatability for each test, as well as test time. MRF was similar to SITA-fast in speed and significantly faster than SITA-standard (MRF 4.6 ± 0.1 minutes vs SITA-fast 4.3 ± 0.2 minutes vs SITA-standard 6.2 ± 0.1 minutes, P < .001). Intraclass correlation coefficients (ICC) between MRF and SITA-fast for MD at the 4 visits ranged from 0.71 to 0.88. ICC values between MRF and SITA-standard for MD ranged from 0.81 to 0.90. Repeatability of MRF MD outcomes was excellent, with ICC for baseline and the 6-month visit being 0.98 (95% confidence interval: 0.96-0.99). In comparison, ICC at 6-month retest for SITA-fast was 0.95 and SITA-standard 0.93. Fewer points changed with the MRF, although for those that did, the MRF gave greater point-wise variability than did the SITA tests. MRF correlated strongly with HFA across 4 visits over a 6-month period, and has good test-retest reliability. MRF is suitable for monitoring visual fields in settings where conventional perimetry is not readily accessible.