Enhanced diplopia detection and binocular single vision assessment through virtual reality: A comprehensive study

Area of Science:

• Ophthalmology
• Virtual Reality Technology
• Medical Diagnostics

Background:

• Diplopia, or double vision, significantly impacts quality of life and requires accurate assessment.
• Current methods for assessing binocular single vision (BSV) function and diplopia can be limited in scope and portability.
• Virtual reality (VR) offers a novel platform for immersive and quantitative visual assessments.

Purpose of the Study:

• To develop and validate a novel VR-based system (VR-BSVT) for quantitative assessment of diplopia.
• To evaluate the diagnostic accuracy and stability of the VR-BSVT system in clinical settings.
• To explore the potential of VR-BSVT for future home healthcare and telemedicine applications.

Main Methods:

• Development of a VR-BSVT system using Oculus Quest 2 and Unity software, measuring VR-BSVF, VR-BSVD, and VR-BAR.
• Clinical control study involving 31 healthy subjects and 35 patients with diplopia, with two VR-BSVT assessments per participant.
• Statistical analysis including ROC curves, Spearman's correlation, Bland-Altman plots, and ICC to assess diagnostic accuracy and stability.

Main Results:

• The VR-BSVT system demonstrated good diagnostic stability, with no significant differences in VR-BAR measurements between groups (P=0.988).
• VR-BSVF and VR-BSVD metrics were significantly lower in the diplopia group (P<0.01), indicating reduced BSV function.
• ROC analysis confirmed the system's ability to accurately discriminate patients with diplopia, with a 95% agreement range of -17.70 to 22.86.

Conclusions:

• The developed VR-BSVT system provides rapid, accurate, and stable detection and assessment of clinical diplopia.
• VR-BSVT utilizes VR technology to assess diplopia over a larger visual space compared to traditional methods.
• The system's compactness and portability position it as a valuable tool for future remote vision healthcare.