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In American journal of ophthalmology ; h5-index 67.0

PURPOSE : To assess accuracy and adherence of visual field (VF) home-monitoring in a pilot sample of glaucoma patients.

DESIGN : Prospective longitudinal feasibility and reliability study.

METHODS : Twenty adults (median 71 years) with an established diagnosis of glaucoma were issued a tablet-perimeter (Eyecatcher), and were asked to perform one VF home-assessment per eye, per month, for 6 months (12 tests total). Before and after home-monitoring, two VF assessments were performed in-clinic using Standard Automated Perimetry (SAP; 4 tests total, per eye).

RESULTS : All 20 participants could perform monthly home-monitoring, though one participant stopped after 4 months (Adherence: 98%). There was good concordance between VFs measured at home and in the clinic (r = 0.94, P < 0.001). In 21 of 236 tests (9%) Mean Deviation deviated by more than ±3 dB from the median. Many of these anomalous tests could be identified by applying machine learning techniques to recordings from the tablets' front-facing camera (Area Under the ROC Curve = 0.78). Adding home-monitoring data to 2 SAP tests made 6 months apart reduced measurement error (between-test measurement variability) in 97% of eyes, with mean absolute error more than halving in 90% of eyes. Median test duration was 4.5 mins (Quartiles: 3.9 - 5.2 mins). Substantial variations in ambient illumination had no observable effect on VF measurements (r = 0.07, P = 0.320).

CONCLUSIONS : Home-monitoring of VFs is viable for some patients, and may provide clinically useful data.

Jones Pete R, Campbell Peter, Callaghan Tamsin, Jones Lee, Asfaw Daniel S, Edgar David F, Crabb David P

2020-Aug-31

Glaucoma, Home Monitoring, Perimetry, Psychophysics, Visual Fields