Feasibility, Accuracy, and Reproducibility of Virtual Reality Visual Field Testing in Patients With Glaucoma

The proposed study aims to evaluate the global and pointwise accuracy and reproducibility of a virtual reality (VR) based visual field testing system on a Pico VR platform in direct comparison to the current standard Zeiss Humphrey Field Analyzer (HFA) in glaucoma patients with various levels of decreased visual field sensitivities. Specifically, we aim to evaluate (1) if both devices produce similar global and pointwise threshold values; (2) the reproducibility of threshold values across the entire tested visual field; (3) whether the stage of glaucoma impacts the accuracy and reproducibility between the two devices; (4) whether scotomas exhibit similar threshold sensitives and reproducibility between the two devices; and (5) differences in reported reliability indices between the two devices.

Each participant will perform visual field testing for both eyes using both the VR visual field system and HFA (order randomized). Five separate sessions (both tests for each patient; both eyes) will be conducted, at least 24 hours apart. Patients will also be asked to fill out a questionnaire to qualitatively evaluate their perception of each visual field test.

Inclusion criteria

• >18 years of age
• diagnosis of primary open-angle glaucoma
• ability to perform visual field testing
• capacity to provide informed consent to research protocol

Exclusion criteria

• diagnosis of secondary glaucoma or non-glaucomatous optic neuropathy
• previous intraocular surgery (excluding cataract surgery and minimally invasive glaucoma surgery)
• significant media opacity
• pregnancy
• seizure disorder
• cardiac pacemaker/other implantable device
• severe vertigo/balance disorder