Glaucoma Screening Using an iPad-Based Visual Field Test in a West African Population

Area of Science:

• Ophthalmology
• Medical Technology
• Public Health

Background:

• Visual field testing is crucial for diagnosing and monitoring glaucoma.
• Low-resource settings often face challenges with access to advanced diagnostic equipment.
• The Melbourne Rapid Fields (MRF) offers a potentially more accessible alternative for visual field assessment.

Purpose of the Study:

• To evaluate the performance of the Melbourne Rapid Fields (MRF) for clinic-based visual field testing.
• To assess the MRF's utility in a low-resource setting, comparing it with the Humphrey Field Analyzer (HFA).

Main Methods:

• A prospective cross-sectional study was conducted with 103 participants (66 glaucoma patients, 37 controls).
• Participants underwent both MRF and HFA testing.
• Key outcome measures included Mean Deviation (MD), Pattern Standard Deviation (PSD), sensitivity, and specificity.

Main Results:

• MRF showed less negative MD and more positive PSD compared to HFA (P < 0.001).
• Agreement analysis revealed significant biases, indicating weak agreement between MRF and HFA.
• For moderate to advanced glaucoma detection, MRF sensitivity was 60.9% versus HFA's 78.3% (P=0.10).

Conclusions:

• The MRF underestimates MD and overestimates PSD values compared to the HFA, with significant agreement biases.
• Despite discrepancies, the MRF demonstrates potential as a screening tool in low-resource environments, especially for moderate to advanced glaucoma.