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Glaucoma home-monitoring using a tablet-based visual field test (Eyecatcher): An assessment of accuracy and adherence over six months

Jones, P. R. ORCID: 0000-0001-7672-8397, Campbell, P. ORCID: 0000-0002-6019-1596, Callaghan, T. ORCID: 0000-0002-9258-8504, Jones, L., Asfaw, D. S, Edgar, D. F ORCID: 0000-0001-9004-264X and Crabb, D. P. ORCID: 0000-0001-8754-3902 (2020). Glaucoma home-monitoring using a tablet-based visual field test (Eyecatcher): An assessment of accuracy and adherence over six months. American Journal of Ophthalmology, doi: 10.1016/j.ajo.2020.08.039

Abstract

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.

Publication Type: Article
Additional Information: © 2020. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Publisher Keywords: Visual Fields, Perimetry, Home Monitoring, Glaucoma, Psychophysics
Subjects: R Medicine > RE Ophthalmology
Departments: School of Health Sciences > Optometry & Visual Science
Date Deposited: 03 Sep 2020 12:11
URI: https://openaccess.city.ac.uk/id/eprint/24869
[img] Text - Accepted Version
This document is not freely accessible until 31 August 2021 due to copyright restrictions.
Available under License Creative Commons Attribution Non-commercial No Derivatives.

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