Fields from home: device-independent online perimetry with Melbourne Rapid Fields.

AIMS

To assess the short-term reliability and agreement of home-based visual field (VF) testing using web-based Melbourne Rapid Fields (MRF-web) software compared to standard in-clinic Humphrey Field Analyzer (HFA) perimetry. To evaluate the feasibility and patient acceptance of home VF monitoring and whether increased testing frequency with home monitoring could detect progression earlier.

METHODS

Cross-sectional study with a repeated measures design of one eye of 100 adult participants from the Laser in Glaucoma and Ocular Hypertension trial with stable VFs with a questionnaire capturing participant feedback. Participants performed VF tests at home using MRF-web on their own computers. Each testing session included visual acuity, two 10-2 VFs and two 24-2 VFs. Analysis compared the MRF 24-2 with the two most recent HFA 24-2 from prior clinic visits. Bland-Altman plots and mixed linear models assessed test-retest variability and agreement, while simulations estimated the power to detect progression. Patient feedback was collected via online questionnaire.

RESULTS

MRF-web showed greater test-retest variability than HFA for point-wise values, with a significant learning effect. There was a significant proportional bias, with MRF underestimating damage compared to HFA. The SE for MTD progression was higher for MRF at a 6-month testing interval. Four-monthly MRF testing achieved similar progression detection power to 6-monthly

HFA

more frequent testing enabling earlier detection of progression. Most participants preferred home monitoring due to convenience.

CONCLUSIONS

Home-perimetry produced more variable results than in-clinic testing, but the increased testing frequency enabled the potential earlier detection of progression compared to standard in-clinic testing.