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Evaluating the Clinical Validity of Commercially Available Virtual Reality Headsets for Visual Field Testing: A

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Virtual reality (VR) perimetry shows promise for visual field testing, with some devices agreeing well with traditional methods like the Humphrey Field Analyzer (HFA). Further validation and standardization are needed for widespread clinical use.

Keywords:
Humphrey Field Analyzerdiagnostic validityglaucomahead-mounted displayophthalmologyoptometryperimetry

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Area of Science:

  • Ophthalmology
  • Medical Technology
  • Visual Science

Background:

  • Conventional perimetry, such as the Humphrey Field Analyzer (HFA), is the standard for visual field assessment.
  • Virtual reality (VR) perimetry offers a potential alternative, but its clinical validity requires thorough evaluation.
  • Variability in VR hardware, software, and protocols raises concerns about reliability.

Purpose of the Study:

  • To systematically review and evaluate the clinical validity of commercially available VR-based perimetry devices.
  • To compare the performance of VR perimetry systems against the established HFA standard.
  • To identify factors influencing VR perimetry accuracy and limitations.

Main Methods:

  • A systematic review following PRISMA guidelines was conducted.
  • Searches included MEDLINE, Embase, Scopus, and Web of Science databases.
  • Included studies compared VR devices to HFA, reporting visual field outcomes and categorizing devices by regulatory status.

Main Results:

  • Nineteen studies were included in the review.
  • Devices like Heru and Olleyes VisuALL demonstrated good agreement with HFA, particularly in moderate to advanced glaucoma.
  • Limitations included variable performance based on disease severity, device specifications, limited dynamic range, and lack of eye tracking in some devices. Pediatric and early-stage disease performance was often suboptimal.

Conclusions:

  • Several VR perimetry systems show clinically acceptable validity compared to HFA in specific patient groups.
  • Standardization of protocols, broader validation, and regulatory approval are crucial for clinical adoption.
  • VR perimetry holds potential for accessible visual field testing via telemedicine and decentralized care.