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Development and Validation of an Internet-Based Remote Perimeter (Perimouse).

Zidong Chen^1,2, Xiaoyuan Shen^1,3, Yuning Zhang^1,4

¹Sun Yat-Sen University, Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Guangzhou, PR China.

Translational Vision Science & Technology

|March 20, 2024

Summary

Perimouse, a novel web-based visual field test, demonstrates strong correlation with the Humphrey Field Analyzer. This accessible tool shows promise for widespread glaucoma screening and monitoring.

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Area of Science:

Ophthalmology
Medical Technology
Visual Science

Background:

Visual field testing is crucial for diagnosing and monitoring glaucoma.
Current methods like the Humphrey Field Analyzer (HFA) can be resource-intensive.
There is a need for accessible, reliable remote visual field assessment tools.

Purpose of the Study:

To validate the feasibility and reliability of Perimouse, an internet-based remote perimeter.
To assess Perimouse's performance in healthy individuals and patients with primary open-angle glaucoma.
To compare Perimouse results with a standard visual field test, the HFA.

Main Methods:

A cross-sectional study involving 45 healthy participants and 27 glaucoma patients.
Perimouse utilized a mouse cursor and saccade vectors for visual field evaluation on a laptop.
Two programs were used: a fixed-brightness screening program and a variable-brightness threshold program.
Outcomes were compared against the Humphrey Field Analyzer (HFA) 24-2 Swedish Interactive Testing Algorithm.

Main Results:

Perimouse showed moderate to high concordance with HFA in the screening program (Intraclass coefficient: 0.58–0.86).
In the threshold program, Perimouse accurately reflected visual sensitivity changes, with a strong correlation to HFA (R = 0.950).
Test-retest variability was low (0.09 dB), and spectacle correction/lighting had minimal impact.

Conclusions:

Perimouse is a reliable visual field test with strong correlation to HFA.
The web-based nature and use of a mouse cursor enhance accessibility.
Perimouse holds significant potential for population-based screening and monitoring of visual field defects.