Glaucoma Home Monitoring Using Online Circular Contrast Perimetry Over 6 Months: Performance and Patient Attitudes in the Developing World Setting.

Abstract

Purpose: Online circular contrast perimetry (OCCP) provides perimetry on any computer or tablet without additional hardware. This study assessed the longitudinal performance and user feedback of home OCCP in an Asian population.

Methods: Twenty glaucoma and fifteen healthy participants underwent a comprehensive ocular examination and visual field tests in clinic, using OCCP and standard automated perimetry. Within a week, participants were asked to repeat OCCP at home. OCCP was then repeated after 3 months and 6 months at home, followed by a user-experience survey.

Results: No significant difference between clinic and home OCCP for test duration, false negative (FN) and fixation loss (FL) rates was found. False positive (FP) rate of home OCCP was slightly higher than that of clinic OCCP (p = 0.04). Bland-Altman plots indicated a small difference between Mean Deviation (MD) (1.26 dB, p = 0.0087) and good agreements between Pattern Standard Deviation (PSD) and Visual Index (VI) of clinic OCCP and home OCCP with insignificant difference of PSD and VI (p > 0.05). Intraclass correlation coefficient (ICC) analysis demonstrated good correlation of MD & VI and poor correlation of PSD between clinic OCCP and home OCCP. Over 6 months, home OCCP indicated moderate to excellent correlation of indices. Participants reported a positive attitude toward home OCCP; however, a high dropout rate was noted for the 3- and 6-month at-home testing.

Conclusion: Comparable results were observed between clinic and home OCCP at baseline. Acceptable consistency of home OCCP findings over 6 months was recognized. Patients may require additional support to achieve desired adherence to at-home monitoring protocols.