Comparison of 30-2 Visual Field Using Melbourne Rapid Fields Online Perimetry and Humphrey Field Analyzer

Area of Science:

• Ophthalmology
• Medical Technology
• Visual Science

Background:

• Glaucoma visual field testing is crucial for diagnosis and management.
• The Humphrey Field Analyzer (HFA) is a standard but less portable device.
• Melbourne Rapid Fields (MRF) is a newer, web-based perimetry software.

Purpose of the Study:

• To evaluate the 30-2 visual field (VF) protocol of MRF compared to the HFA 30-2 SITA fast protocol.
• To assess MRF's performance in Japanese glaucoma patients across all severity stages.

Main Methods:

• A prospective, cross-sectional study involving 87 Japanese glaucoma patients (87 eyes).
• MRF software with computer vision gaze monitoring and Bayes logic thresholding was used.
• MRF 30-2 VF results were compared against HFA 30-2 SITA-Fast, analyzing mean deviation (MD) and pattern deviation (PD).
• Test-retest reliability of MRF was assessed over two sessions.

Main Results:

• MRF showed high agreement with HFA for MD (ICC: 0.97) and PD (ICC: 0.91).
• Bland-Altman analysis indicated minimal bias for MD (-0.76 dB) and PD (0.79 dB) between MRF and HFA.
• MRF test-retest reliability was good, with low bias for MD (0.25 dB) and PD (-0.21 dB).
• MRF demonstrated 80% sensitivity and 72% specificity for detecting defects in mild glaucoma cases.

Conclusions:

• MRF serves as a portable and accessible alternative to HFA for 30-2 visual field testing.
• The software demonstrates good agreement with HFA, particularly for moderate to advanced glaucoma.
• Consideration of MRF's slightly higher false negatives, longer test times, and output differences is recommended for clinical interpretation.