An iPad-based perimetry application (app) designed to detect visual field defects does not have adequate diagnostic accuracy to be used as a screening tool for glaucoma, according to research published in Eye.
Researchers conducted a prospective cross-sectional study of patients undergoing their first Humphrey Field Analyzer (HFA) visual field test using 24-2 SITA standard HFA testing and iPad-based perimetry with the app at a glaucoma clinic in South India.
The researchers evaluated diagnostic accuracy by comparing the tablet-based app at various test thresholds using the area under receiver-operating characteristic curve (AUROC) with the consensus of 2 ophthalmologists.
A total of 203 eyes of 115 participants (58% men and 42% women) were included in the study. The researchers classified participant eyes as having no glaucoma (45%), mild glaucoma (15%), moderate glaucoma (16%), advanced glaucoma (12%), and severe glaucoma (12%).
The researchers found that the iPad-based perimetry had an AUROC of 0.64 (95% confidence interval [CI], 0.57-0.71) for detection of any visual field defect relative to HFA and 0.68 (95% CI, 0.59-0.76) for detection of moderate or worse glaucoma relative to ophthalmologist consensus.
When they set the specificity at 90%, indicating ≥19 missed points per hemifield, the sensitivity of the iPad-based perimetry for detection of moderate or worse glaucoma was 35% (95% CI, 22-48%).
“Better screening tests, further software improvements, and development of normative databases for perimetry tools are needed for glaucoma detection, particularly in resource-limited settings,” the researchers explain.
References:
Richardson QR, Kumar RS, Ramgopal B, et al. Diagnostic accuracy of an iPad application for detection of visual field defects. Eye (Lond). Published online September 5, 2022. doi:10.1038/s41433-022-02223-y