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Online Circular Contrast Perimetry: Validity and Repeatability of Home Performance
Yang X Chen1, James Corbett2,3, Jesse Gale3,4
1The Alfred Hospital, Alfred Health. Melbourne, Victoria, Australia.
Precis:
Online Circular Contrast Perimetry (OCCP) offers clinically validated threshold perimetry to patients via a web application from their own devices. This study evaluates the feasibility, repeatability, and reliability of OCCP when performed in unsupervised home environments.
Purpose:
To evaluate the feasibility, repeatability, and reliability of online circular contrast perimetry (OCCP) when performed in unsupervised home environments on personal devices.
Patients And Methods:
A total of 55 participants (20 control and 35 open angle glaucoma patients) were recruited. Participants underwent baseline visual field testing using OCCP in a clinical setting, followed by weekly unsupervised home tests over 6 weeks on their personal computers. An online survey was completed afterwards. Global perimetric indices and reliability indices were compared between clinic-based and home-based tests and analyzed to assess the repeatability and reliability of OCCP at home. Rasch analysis assessed the psychometric properties of the survey and intergroup variability.
Results:
No statistically significant differences were found in mean deviation (MD), pattern standard deviation (PSD), or visual index values between home and clinic tests ( P >0.05), and these values did not significantly alter over the 6 weekly at-home tests. OCCP false positive and fixation loss responses were statistically higher at home compared with baseline ( P =0.002 and P =0.001). Test-retest intraclass correlation coefficients for OCCP home use compared with in-clinic for MD ranged from 0.90 to 0.93, and for PSD ranged from 0.81 to 0.85. Bland-Altman analysis for MD revealed zero test-retest bias with limits of agreement ranging from ±5.28 to ±5.83 dB across the 6 weeks. The survey indicated high user satisfaction; however, Rasch analysis revealed suboptimal precision and targeting.
Conclusions:
OCCP retains a similar diagnostic accuracy and repeatability in home environments on personal devices compared with clinic-based environments and has the potential to be utilized as a remote tool for glaucoma screening and surveillance.
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