Shi Runjie B, Li-Han Leo Y, Kherani Irfan N, Trope Graham E, Buys Yvonne M, Wong Willy, Eizenman Moshe
Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada.
Ophthalmol Sci. 2024 Oct 29;5(2):100639. doi: 10.1016/j.xops.2024.100639. eCollection 2025 Mar-Apr.
To evaluate long-term retention, compliance, and performance of glaucoma patients using a virtual reality portable perimeter to monitor visual fields (VFs) at home.
Prospective, longitudinal, cohort study.
Twenty-five glaucoma patients with stable and reliable VFs (average age 67.4 years) were recruited at Toronto Western Hospital, Ontario, Canada.
Participants were instructed to perform bilateral home VF tests fortnightly for 2 years using the Toronto Portable Perimeter (TPP). Based on empirical home monitoring data, simulation analyses were conducted to evaluate the progression detection performance of high-frequency TPP testing.
Retention rates were calculated as the percentage of participants who performed ≥1 home VF test. Compliance rates measured the percentage of participants adhering to the recommended test frequency of every 2-month period. Visual field indices, test reliability, intertest variability, and the precision of estimating progression rate with TPP were compared to those with the Humphrey Field Analyzer (HFA). After 6 months, participants completed a questionnaire to evaluate their experiences and preferences. The years required to detect progression were also compared between HFA and TPP tests.
Eighteen of the 25 participants (72%) completed ≥1 unsupervised VF test at home, with an average test frequency of 1.6 tests/month. Compliance decreased as the monitoring duration progressed, dropping from 83% (initial 2 months) to 11% (final 2 months). Unfamiliarity with technology and time constraints were identified as the main barriers to regular testing. Visual field indices of TPP home tests were strongly correlated with clinical results ( > 0.900). Home testing significantly reduced intertest variability ( < 0.001) and improved the precision of progression rate estimates ( < 0.010). Participants overwhelmingly preferred home testing over clinic VF follow-ups ( < 0.001). Simulations showed that TPP tests can significantly shorten the time to detect progression for different progression rates compared with clinical VF follow-up, even with compromised compliance.
Despite the small sample size, our study demonstrated that glaucoma patients could reliably perform VF tests at home over a 2-year period. However, issues with retention rate and compliance with long-term VF monitoring were observed in some participants. Nevertheless, high-quality VF data from home tests can provide supplementary information to improve the timely detection of VF progression.
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
评估青光眼患者使用虚拟现实便携式视野计在家中监测视野（VF）的长期留存率、依从性和性能。
前瞻性、纵向队列研究。
在加拿大多伦多西部医院招募了25名视野稳定可靠的青光眼患者（平均年龄67.4岁）。
指导参与者使用多伦多便携式视野计（TPP）每两周进行一次双侧家庭视野测试，为期2年。基于实际家庭监测数据，进行模拟分析以评估高频TPP测试的进展检测性能。
留存率计算为进行≥1次家庭视野测试的参与者百分比。依从率衡量遵守每2个月推荐测试频率的参与者百分比。将视野指数、测试可靠性、测试间变异性以及使用TPP估计进展率的精度与使用汉弗莱视野分析仪（HFA）的情况进行比较。6个月后，参与者完成一份问卷以评估他们的体验和偏好。还比较了HFA和TPP测试检测进展所需的年限。
25名参与者中有18名（72%）在家中完成了≥1次无监督的视野测试，平均测试频率为每月1.6次。随着监测时间的推移，依从性下降，从最初2个月的83%降至最后2个月的11%。对技术不熟悉和时间限制被确定为定期测试的主要障碍。TPP家庭测试的视野指数与临床结果高度相关（>0.900）。家庭测试显著降低了测试间变异性（<0.001）并提高了进展率估计的精度（<0.010）。绝大多数参与者更喜欢家庭测试而非诊所视野随访（<0.001）。模拟显示，与临床视野随访相比，即使依从性受损，TPP测试也能显著缩短检测不同进展率进展的时间。
尽管样本量较小，但我们的研究表明青光眼患者在2年期间能够可靠地在家中进行视野测试。然而，在一些参与者中观察到了留存率和长期视野监测依从性的问题。尽管如此，来自家庭测试的高质量视野数据可以提供补充信息，以改善视野进展的及时检测。
作者对本文讨论的任何材料均无所有权或商业利益。
