Tablet-based perimetry does not serve as a substitute for general glaucoma screening.

Tablet-based perimetry does not serve as a substitute for general glaucoma screening. Photo: VisualFields app.

Recent research assessing the diagnostic accuracy of tablet-based perimetry found that this tool has inadequate diagnostic accuracy, suggesting it is an ineffective approach for general glaucoma screening.

The prospective, cross-sectional study included 203 eyes from 115 patients undergoing their first Humphrey Field Analyzer (HFA) visual field test. Of these, 82 eyes were classified as moderate or worse glaucoma. All study participants underwent 24-2 SITA Standard HFA testing and iPad-based perimetry via the VisualFields Easy application.

The data showed that tablet-based perimetry had an area under the receiver operating characteristic (AUROC) curve of 0.64 for detection of any visual field defect relative to HFA and an AUROC of 0.68 for detection of moderate or worse glaucoma relative to eyecare provider examination, according to the study authors. At a set specificity of 90%, they reported that the sensitivity of tablet-based perimetry for detection of moderate or worse glaucoma was 35%.

Based on these findings, the study authors concluded that, in this patient population of naïve visual field test takers, the diagnostic accuracy of VisualFields Easy is insufficient for use as a general glaucoma screening tool.

“Diagnostic accuracy was greater when used as a test for more advanced forms of glaucoma, which has potential implications for monitoring patients with known glaucoma in places without sophisticated visual field equipment; however, longitudinal studies are needed to determine repeatability for this function,” they noted in their recent paper. “Better screening tests, further software improvements and development of normative databases for perimetry tools are needed for glaucoma detection, particularly in resource-limited settings.”

Richardson QR, Kumar RS, Ramgopal B, et al. Diagnostic accuracy of an iPad application for detection of visual field defects. Eye (Lond). September 5, 2022. [Epub ahead of print].