3D Virtual Reality may Enhance Adherence in Glaucoma Patients UsingMonotherapy: A Randomized Clinical Trial

Aim of the study: To determine the impact of 3D Virtual Reality on the adherence of patients to three months of treatment for glaucoma. Materials and methods: Randomized, single-blind clinical trial. Seventy patients were randomized to receive information about glaucoma via 3D Virtual Reality (3D group, 35 patients) or via printed material (control group, 35 patients). The mean measurement of both eyes from all patients was used to evaluate outcomes. The randomization was stratified to balance the number of patients using monotherapy or polytherapy between the groups. At the first appointment, patients in the 3D Virtual Reality group watched a 3D video about glaucoma; patients in the control group received information via printed material. The primary outcome measures were Intraocular Pressure (IOP), Corneal Pachymetry, and Visual Field, performed at first and the three-month appointments. Results: Neither the Corneal Pachymetry nor Visual Field changed after the three months of treatment; however, the overall IOP decreased (p=0.0001). IOP variation did not differ between monotherapy and polytherapy patients (p=0.15). Women had a trend toward better control of IOP than men, but the effect did not reach statistical significance (p=0.055). Even though overall IOP variation did not differ between the 3D and Control groups (p=0.25), the IOP decrease was higher in the 3D group than the control group, in monotherapy strata (p=0.006). Conclusion: Our data showed that 3D virtual stimulation did not improve the three-month treatment adherence of glaucoma. However, it may improve adherence in patients at early stages or less affected by the disease, such as those in monotherapy. For those patients, we recommend further studies with larger sample sizes.