Virtual Reality Enables Rapid and Multi-Faceted Retinal Function Screening

Abstract

Abstract Background: Given global population growth and aging, it is imperative to prioritize early eye disease detection and treatment. However, the current eye specialist workforce capacity is not bridging the growing gap, making it important to consider alternative solutions for increasing eye screening capabilities. This study compared virtual reality (VR) vision screening exams that help evaluate retinal health, such as 24-2 perimetry, Ishihara color blindness, and Amsler grid tests, against their in-clinic counterparts. Methods: 86 subjects were recruited from Mount Sinai’s ophthalmology clinic for a head-to-head comparison trial that was internally controlled across healthy controls and eyes with glaucoma and retinal disease. Results: Perimetry results from Humphrey Visual Field Analyzer (HVFA) and VR suprathreshold testing demonstrated a good sensitivity both overall (80% OD, 84% OS) and across control (86% OD, 89% OS), glaucoma (69% OD, 78% OS), and retinal disease (76% OD, 80% OS) groups. A Garway-Heath anatomical map showed an overall 70-80% agreement. Ishihara plate tests did not show a significant difference between the two testing modalities (p = 0.12; Mann-Whitney U test), which remained true across groups. Amsler grid testing differences were also non-significant (p = 0.81; Mann-Whitney U test), including each subgroup. Patient time required to complete VR exams was significantly improved (p<0.0001; Wilcoxon) compared to the gold standard tests. Conclusions: All VR tests showed high sensitivity and percent agreement compared to in-office standards, indicating a promising potential for VR technologies in visual function screening for early identification of prevalent diseases such as glaucoma and retinal conditions.