Validation of a Head-mounted Virtual Reality Visual Field Screening Device.

Area of Science:

• Ophthalmology
• Medical Technology
• Glaucoma Research

Background:

• Visual field testing is crucial for glaucoma diagnosis and management.
• The Humphrey Visual Field Analyzer (HFA) is the current standard but is large, costly, and can be uncomfortable.
• The C3 Fields Analyzer (CFA) is a novel virtual reality head-mounted device for visual field testing.

Purpose of the Study:

• To investigate the efficacy of the CFA as a subjective visual field test for glaucoma screening and monitoring.
• To compare the performance of the CFA with the established HFA.

Main Methods:

• The CFA presented stimuli in 54 positions, mirroring the HFA 24-2 SITA Standard test.
• A suprathreshold algorithm approximating an 18 dB deficit was used.
• 157 patients (controls and glaucoma patients) were tested with both the CFA and HFA.

Main Results:

• Missed stimuli on the CFA correlated with HFA mean deviation (r=0.62) and pattern standard deviation (r=0.36).
• The area under the ROC curve was 0.77 for mild glaucoma and 0.86 for moderate-advanced glaucoma.
• 38% of patients with an 18 dB or worse deficit on HFA missed the CFA stimulus at the same location.

Conclusions:

• The CFA demonstrated moderate effectiveness in identifying glaucoma subjects.
• The device did not reliably replicate point-by-point deficits identified by the HFA.
• Further device refinements are necessary to enhance testing and screening performance.