Hekmatjah Natan, Chibututu Chimelie, Han Ying, Keenan Jeremy D, Oatts Julius T
School of Medicine, University of California, San Francisco, San Francisco, California, United States of America.
University of Michigan Medical School, Ann Arbor, Michigan, United States of America.
PLoS One. 2025 Jan 24;20(1):e0318074. doi: 10.1371/journal.pone.0318074. eCollection 2025.
The purpose of this systematic review was to consolidate and summarize available data comparing virtual reality perimetry (VRP) with standard automated perimetry (SAP) in adults with glaucoma. Understanding the utility and diagnostic performance of emerging VRP technology may expand access to visual field testing but requires evidence-based validation.
A systematic literature search was conducted in 3 databases (PubMed Central, Embase, and Cochrane Central Register of Controlled Trials) from the date of inception to 10/09/2024. Eligibility criteria included randomized controlled trials or prospective or retrospective cohort studies that compared different modalities of VRP to SAP in adults >18 years of age with glaucoma. Studies were excluded if they were review articles, letters, case reports, abstract-only papers, unavailable full text, or non-English language. Identified studies were formally evaluated for risk of bias using the Newcastle-Ottawa tool. The study protocol was prospectively registered with PROSPERO in May 2023 (registration number: CRD42023429071).
The literature search yielded 1657 results. After deduplication, abstract and title screening, 14 studies met inclusion criteria and were included in the final systematic review. Compared to Humphrey Field Analyzer or Octopus 900, 10 different VRP devices were included in our study: Oculus Quest, Smartphone-based Campimetry, Toronto Portable Perimeter, VirtualEye, Advance Vision Analyzer, VisuALL, Vivid Vision Perimeter, C3 fields visual field analyzer, Radius, and Virtual Field. Overall, published studies of VRP are promising; however, more work is required to better evaluate these devices, namely test-retest repeatability.
VRP holds strong potential to evaluate visual fields in adults with glaucoma, though further data is needed to validate emerging technologies and testing protocols. Eye providers may consider using these devices to monitor certain adults with glaucoma.
本系统评价的目的是整合和总结在青光眼成人患者中比较虚拟现实视野检查（VRP）与标准自动视野检查（SAP）的现有数据。了解新兴VRP技术的效用和诊断性能可能会扩大视野检查的可及性，但需要基于证据的验证。
从各数据库创建之日至2024年9月10日，在3个数据库（PubMed Central、Embase和Cochrane对照试验中央注册库）中进行了系统的文献检索。纳入标准包括随机对照试验或前瞻性或回顾性队列研究，这些研究比较了18岁以上青光眼成人中不同模式的VRP与SAP。如果研究是综述文章、信件、病例报告、仅摘要的论文、无法获取全文或非英语语言的，则排除这些研究。使用纽卡斯尔-渥太华工具对纳入的研究进行偏倚风险的正式评估。该研究方案于2023年5月在PROSPERO上进行了前瞻性注册（注册号：CRD42023429071）。
文献检索产生了1657条结果。在进行去重、摘要和标题筛选后，14项研究符合纳入标准并被纳入最终的系统评价。与Humphrey视野分析仪或Octopus 900相比，我们的研究纳入了10种不同的VRP设备：Oculus Quest、基于智能手机的平面视野计、多伦多便携式视野计、VirtualEye、Advance Vision Analyzer、VisuALL、Vivid Vision视野计、C3 fields视野分析仪、Radius和Virtual Field。总体而言，已发表的VRP研究很有前景；然而，需要更多工作来更好地评估这些设备，即重测重复性。
VRP在评估青光眼成人患者视野方面具有很大潜力，不过需要更多数据来验证新兴技术和测试方案。眼科医疗服务提供者可考虑使用这些设备来监测某些青光眼成人患者。
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