Usefulness of a simplified self-checking tool (Quattro Checker®) for visual field defects in glaucoma patients

To develop and evaluate iPad Quattro Checker® (iPad QC®), a tablet-based screening tool for detecting glaucomatous visual field (VF) abnormalities.

We evaluated three screening methods-the iPad QC®, paper-based Quattro Checker® (paper QC®), and CLOCK CHART®-in glaucoma patients across disease stages (n = 64) and in normal participants (n = 38). VF abnormalities were defined in relation to corresponding quadrants of the Humphrey Field Analyzer (HFA). Sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC) were calculated.

Among all patients, the AUCs of the iPad QC®, paper QC®, and CLOCK CHART® were 0.97, 0.94, and 0.96, respectively. The iPad QC® retained 80.2% sensitivity in early glaucoma, with an AUC of 0.90 (95% CI: 0.81-0.98). More than half of previously unaware patients recognized their VF deficits using the iPad QC®. Testing required only a few minutes, could be self-administered on a widely available tablet, and was performed under ordinary room lighting.

The iPad QC® demonstrated high sensitivity for detecting visual field abnormalities even in the early stages of glaucoma. Its capability for self-testing using widely available tablet devices, along with its ability to raise patients' awareness of VF defects, further enhances its usefulness as a practical screening tool.