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    Objective Assessment of Activity Limitation in Glaucoma with Smartphone Virtual Reality Goggles: A Pilot Study

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    Author
    Goh, RLZ; Kong, YXG; McAlinden, C; Liu, J; Crowston, JG; Skalicky, SE
    Date
    2018-01-01
    Source Title
    Translational Vision Science and Technology
    Publisher
    ASSOC RESEARCH VISION OPHTHALMOLOGY INC
    University of Melbourne Author/s
    Crowston, Jonathan; Kong, Yu; Skalicky, Simon
    Affiliation
    Ophthalmology (Eye & Ear Hospital)
    Metadata
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    Document Type
    Journal Article
    Citations
    Goh, R. L. Z., Kong, Y. X. G., McAlinden, C., Liu, J., Crowston, J. G. & Skalicky, S. E. (2018). Objective Assessment of Activity Limitation in Glaucoma with Smartphone Virtual Reality Goggles: A Pilot Study. TRANSLATIONAL VISION SCIENCE & TECHNOLOGY, 7 (1), https://doi.org/10.1167/tvst.7.1.10.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/255865
    DOI
    10.1167/tvst.7.1.10
    Abstract
    Purpose: To evaluate the use of smartphone-based virtual reality to objectively assess activity limitation in glaucoma. Methods: Cross-sectional study of 93 patients (54 mild, 22 moderate, 17 severe glaucoma). Sociodemographics, visual parameters, Glaucoma Activity Limitation-9 and Visual Function Questionnaire - Utility Index (VFQ-UI) were collected. Mean age was 67.4 ± 13.2 years; 52.7% were male; 65.6% were driving. A smartphone placed inside virtual reality goggles was used to administer the Virtual Reality Glaucoma Visual Function Test (VR-GVFT) to participants, consisting of three parts: stationary, moving ball, driving. Rasch analysis and classical validity tests were conducted to assess performance of VR-GVFT. Results: Twenty-four of 28 stationary test items showed acceptable fit to the Rasch model (person separation 3.02, targeting 0). Eleven of 12 moving ball test items showed acceptable fit (person separation 3.05, targeting 0). No driving test items showed acceptable fit. Stationary test person scores showed good criterion validity, differentiating between glaucoma severity groups (P = 0.014); modest convergence validity, with mild to moderate correlation with VFQ-UI, better eye (BE) mean deviation, BE pattern deviation, BE central scotoma, worse eye (WE) visual acuity, and contrast sensitivity (CS) in both eyes (R = 0.243-0.381); and suboptimal divergent validity. Multivariate analysis showed that lower WE CS (P = 0.044) and greater age (P = 0.009) were associated with worse stationary test person scores. Conclusions: Smartphone-based virtual reality may be a portable objective simulation test of activity limitation related to glaucomatous visual loss. Translational Relevance: The use of simulated virtual environments could help better understand the activity limitations that affect patients with glaucoma.

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