Abstract
Importance: Independent validation of iPad visual field testing software Melbourne Rapid Fields (MRF). Background: To examine the functionality of MRF and compare its performance with Humphrey SITA 24-2 (HVF). Design: Prospective, cross-sectional validation study. Paricipants: Sixty glaucomas mean deviation (MD:-5.08±5.22); 17 pre-perimetric, 43 HVF field defects and 25 controls. Methods: The MRF was compared with HVF for scotoma detection, global indices, regional mean threshold values and sensitivity/specificity. Long-term test-retest variability was assessed after 6months. Main Outcome Measures: Linear regression and Bland Altman analyses of global indices sensitivity/specificity using ROC curves, intraclass correlations. Results: Using a cluster definition of three points at <1% or two at 0.5% to define a scotoma on HVF, MRF detected 39/54 abnormal hemifields with a similar threshold-based criteria. Global indices were highly correlated between MRF and HVF: MD r2 = 0.80, PSD r2 = 0.77, VFI r2 = 0.85 (all P<0.0001). For manifest glaucoma patients, correlations of regional mean thresholds ranged from r2 = 0.45-0.78, despite differing array of tested points between devices. ROC analysis of global indices showed reasonable sensitivity/specificity with AUC values of MD:0.89, PSD:0.85 and VFI:0.88. MRF retest variability was low with ICC values at 0.95 (MD and VFI), 0.94 (PSD). However, individual test point variability for mid-range thresholds was higher. Conclusions and Relevance: MRF perimetry, despite using a completely different test paradigm, shows good performance characteristics compared to HVF for detection of defects, correlation of global indices and regional mean threshold values. Reproducibility for individual points may limit application for monitoring change over time, and fixation monitoring needs improvement.
| Language | English |
|---|---|
| Pages | 346-355 |
| Number of pages | 10 |
| Journal | Clinical and Experimental Ophthalmology |
| Volume | 46 |
| Issue number | 4 |
| Early online date | 2017 |
| DOIs | |
| Publication status | Published - Jun 2018 |
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Keywords
- iPad perimetry
- Perimetry
- Visual field
Cite this
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Performance of iPad-based threshold perimetry in glaucoma and controls. / Schulz, Angela M.; Graham, Elizabeth C.; You, Yuyi; Klistorner, Alexander; Graham, Stuart L.
In: Clinical and Experimental Ophthalmology, Vol. 46, No. 4, 06.2018, p. 346-355.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Performance of iPad-based threshold perimetry in glaucoma and controls
AU - Schulz, Angela M.
AU - Graham, Elizabeth C.
AU - You, Yuyi
AU - Klistorner, Alexander
AU - Graham, Stuart L.
PY - 2018/6
Y1 - 2018/6
N2 - Importance: Independent validation of iPad visual field testing software Melbourne Rapid Fields (MRF). Background: To examine the functionality of MRF and compare its performance with Humphrey SITA 24-2 (HVF). Design: Prospective, cross-sectional validation study. Paricipants: Sixty glaucomas mean deviation (MD:-5.08±5.22); 17 pre-perimetric, 43 HVF field defects and 25 controls. Methods: The MRF was compared with HVF for scotoma detection, global indices, regional mean threshold values and sensitivity/specificity. Long-term test-retest variability was assessed after 6months. Main Outcome Measures: Linear regression and Bland Altman analyses of global indices sensitivity/specificity using ROC curves, intraclass correlations. Results: Using a cluster definition of three points at <1% or two at 0.5% to define a scotoma on HVF, MRF detected 39/54 abnormal hemifields with a similar threshold-based criteria. Global indices were highly correlated between MRF and HVF: MD r2 = 0.80, PSD r2 = 0.77, VFI r2 = 0.85 (all P<0.0001). For manifest glaucoma patients, correlations of regional mean thresholds ranged from r2 = 0.45-0.78, despite differing array of tested points between devices. ROC analysis of global indices showed reasonable sensitivity/specificity with AUC values of MD:0.89, PSD:0.85 and VFI:0.88. MRF retest variability was low with ICC values at 0.95 (MD and VFI), 0.94 (PSD). However, individual test point variability for mid-range thresholds was higher. Conclusions and Relevance: MRF perimetry, despite using a completely different test paradigm, shows good performance characteristics compared to HVF for detection of defects, correlation of global indices and regional mean threshold values. Reproducibility for individual points may limit application for monitoring change over time, and fixation monitoring needs improvement.
AB - Importance: Independent validation of iPad visual field testing software Melbourne Rapid Fields (MRF). Background: To examine the functionality of MRF and compare its performance with Humphrey SITA 24-2 (HVF). Design: Prospective, cross-sectional validation study. Paricipants: Sixty glaucomas mean deviation (MD:-5.08±5.22); 17 pre-perimetric, 43 HVF field defects and 25 controls. Methods: The MRF was compared with HVF for scotoma detection, global indices, regional mean threshold values and sensitivity/specificity. Long-term test-retest variability was assessed after 6months. Main Outcome Measures: Linear regression and Bland Altman analyses of global indices sensitivity/specificity using ROC curves, intraclass correlations. Results: Using a cluster definition of three points at <1% or two at 0.5% to define a scotoma on HVF, MRF detected 39/54 abnormal hemifields with a similar threshold-based criteria. Global indices were highly correlated between MRF and HVF: MD r2 = 0.80, PSD r2 = 0.77, VFI r2 = 0.85 (all P<0.0001). For manifest glaucoma patients, correlations of regional mean thresholds ranged from r2 = 0.45-0.78, despite differing array of tested points between devices. ROC analysis of global indices showed reasonable sensitivity/specificity with AUC values of MD:0.89, PSD:0.85 and VFI:0.88. MRF retest variability was low with ICC values at 0.95 (MD and VFI), 0.94 (PSD). However, individual test point variability for mid-range thresholds was higher. Conclusions and Relevance: MRF perimetry, despite using a completely different test paradigm, shows good performance characteristics compared to HVF for detection of defects, correlation of global indices and regional mean threshold values. Reproducibility for individual points may limit application for monitoring change over time, and fixation monitoring needs improvement.
KW - iPad perimetry
KW - Perimetry
KW - Visual field
UR - http://www.scopus.com/inward/record.url?scp=85034031932&partnerID=8YFLogxK
U2 - 10.1111/ceo.13082
DO - 10.1111/ceo.13082
M3 - Article
VL - 46
SP - 346
EP - 355
JO - Australian Journal of Opthalmology
T2 - Australian Journal of Opthalmology
JF - Australian Journal of Opthalmology
SN - 1442-6404
IS - 4
ER -