Assessment of Remote Training, At-Home Testing, and Test-Retest Variability of a Novel Test for Clustered Virtual Reality Perimetry

Zer Keen Chia, Alan W. Kong, Marcus L. Turner, Murtaza Saifee, Bertil E. Damato, Benjamin T. Backus, James J. Blaha, Joel S. Schuman, Michael S. Deiner, Yvonne Ou

Research output: Contribution to journalArticlepeer-review


Objective: To assess the feasibility of remotely training glaucoma patients to take a 10-session clustered virtual reality (VR) visual field (VF) test (Vivid Vision Perimetry [VVP-10]) at home, analyze results for test-retest variability, and assess correspondence with conventional perimetry. Design: Cross-sectional study. Subjects: Twenty-one subjects with glaucoma were enrolled and included in the feasibility assessment of remote training. Thirty-six eyes were used for test-retest analysis and determination of concordance with the Humphrey Field Analyzer (HFA). Methods: Subjects were provided with a mobile VR headset containing the VVP-10 test software and trained remotely via video conferencing. Subjects were instructed to complete 10 sessions over a 14-day period. Main Outcome Measures: Feasibility was determined by the number of subjects who were able to independently complete VVP-10 over the 14-day period after 1 remote training session. The intraclass correlation coefficient (ICC) for average fraction seen across 10 sessions and the standard error (SE) of the mean were primary outcome measures for assessing test-retest variability. Correlation with HFA mean sensitivity (MS) across eyes, was a secondary outcome measure. Results: Twenty subjects (95%) successfully completed the VVP-10 test series after 1 training session. The ICC for VVP-10 was 0.95 (95% confidence interval [CI], 0.92–0.97). The mean SE in units of fraction seen was 0.012. The Spearman correlations between VVP-10 average fraction seen and HFA MS were 0.87 (95% CI, 0.66–0.98) for moderate-to-advanced glaucoma eyes, and decreased to 0.67 (95% CI, 0.28–0.94) when all eyes were included. Conclusions: Remote training of patients at home is feasible, and subsequent remote clustered VF testing using VVP-10 by patients on their own, without any further interactions with caregivers or study staff, was possible. At-home VVP-10 results demonstrated low test-retest variability. Future studies must be conducted to determine if VVP-10, taken at home as convenient for the patient, may be a viable supplement to provide equivalent or complementary results to that of standard in-clinic assessment of visual function in glaucoma. Financial Disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

Original languageEnglish (US)
Pages (from-to)139-147
Number of pages9
JournalOphthalmology Glaucoma
Issue number2
StatePublished - Mar 1 2024


  • Clustered visual field testing
  • Feasibility
  • Glaucoma
  • Remote training
  • Virtual reality
  • Visual field testing

ASJC Scopus subject areas

  • Ophthalmology


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