Is virtual reality perimetry as reliable as static perimetry in detecting neurological visual field loss?
Reviewed by Claire Howard

This study compares agreement between virtual reality perimetry (VRP) and static automated perimetry (SAP) in a variety of neuro-ophthalmological conditions. For this work the Order of Magnitude (OM) VR-based visual field assessment system was used which has been developed by the institute carrying out this research. Data were included from 160 eyes (148 patients). A retrospective / post-hoc analysis was undertaken for patients who underwent visual field testing using both tests as part of an already completed research study. Two fellowship-trained neuro-ophthalmologists compared the visual field defects observed on both devices. Percent agreement was used to compare the interpretation of the two examiners on both techniques. The most common aetiologies were optic atrophy due to various causes, optic neuritis, ischaemic optic neuropathy, and compressive optic neuropathy. Good agreement between VRP and SAP was found for bitemporal (93.8%), hemianopic (90.8%), altitudinal (79.4%), and generalised visual field defects (86.4%). The agreement was acceptable for central / centrocaecal scotomas and not acceptable for enlarged blind spots. Between the two examiners there was good agreement for bitemporal (92.3%), hemianopic (82%), altitudinal (83%), and generalised field defects (76.4%). Results suggest that VRP gives reasonable agreement with SAP in various neuro-ophthalmological conditions, especially those likely to produce hemianopic, altitudinal, and generalised visual field defects. This has potential benefits in assessing patients with physical limitations, those in hospital beds and those who are unable to cooperate with SAP testing, as VRP testing is more portable. These potential benefits and their accuracy need to be explored further in future prospective larger sample studies. A further limitation of this study is that the work was carried out by the institute that developed the VR based test, introducing a potential bias to the work.

Agreement between virtual reality perimetry and static automated perimetry in various neuro-ophthalmological conditions: a pilot study.
Badakere A, Ali MA, Negi R, et al.
NEURO-OPHTHALMOLOGY
2023;47(5–6):255–61.