Virtual Reality Visual Field Testing in Glaucoma: Benefits and Drawbacks.

Abstract

Importance: Virtual reality-assisted visual field testing (VRVFT) is a novel modality for evaluating glaucoma progression, offering potential advantages over standard automated perimetry (SAP). To date, no narrative literature review has comprehensively discussed the benefits and drawbacks of VRVFT for glaucoma patients.

Observations: A narrative literature review was conducted using PubMed and MEDLINE via EBSCOhost, covering articles published from 2014 to October 2023. The search terms used were "virtual reality visual field" AND "glaucoma". Filters applied included "Free full text", "Full text", and "Peer Reviewed." Inclusion criteria encompassed studies evaluating VRVFT in relation to glaucoma. Exclusion criteria included duplicates, meta-analyses, literature not discussing glaucoma or VRVFT, and other literature reviews. Sixteen studies met the inclusion criteria, comprising various study designs. VRVFT showed comparable reliability and efficacy to SAP in detecting glaucomatous visual field defects. Benefits of VRVFT included improved accessibility, patient comfort, and resource optimization. Drawbacks included technical limitations such as restricted luminance range, lack of sophisticated eye-tracking in some devices, and implementation challenges like patient technology familiarity and access to equipment.

Conclusion: VRVFT presents several benefits, making it a promising alternative or complement to conventional glaucomatous visual field testing in outpatient clinics and remote settings. Addressing technical limitations and standardizing protocols are essential for broader clinical adoption.