Dataset Information

Development of a Pediatric Visual Field Test.

ABSTRACT:

Purpose

We describe a pediatric visual field (VF) test based on a computer game where software and hardware combine to provide an enjoyable test experience.

Methods

The test software consists of a platform-based computer game presented to the central VF. A storyline was created around the game as was a structure surrounding the computer monitor to enhance patients' experience. The patient is asked to help the central character collect magic coins (stimuli). To collect these coins a series of obstacles need to be overcome. The test was presented on a Sony PVM-2541A monitor calibrated from a central midpoint with a Minolta CS-100 photometer placed at 50 cm. Measurements were performed at 15 locations on the screen and the contrast calculated. Retinal sensitivity was determined by modulating stimulus in size. To test the feasibility of the novel approach 20 patients (4-16 years old) with no history of VF defects were recruited.

Results

For the 14 subjects completing the study, 31 ± 15 data points were collected on 1 eye of each patient. Mean background luminance and stimulus contrast were 9.9 ± 0.3 cd/m² and 27.9 ± 0.1 dB, respectively. Sensitivity values obtained were similar to an adult population but variability was considerably higher - 8.3 ± 9.0 dB.

Conclusions

Preliminary data show the feasibility of a game-based VF test for pediatric use. Although the test was well accepted by the target population, test variability remained very high.

Translational relevance

Traditional VF tests are not well tolerated by children. This study describes a child-friendly approach to test visual fields in the targeted population.

SUBMITTER: Miranda MA

PROVIDER: S-EPMC5156444 | biostudies-literature | 2016 Dec

REPOSITORIES: biostudies-literature

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Publications

Development of a Pediatric Visual Field Test.

Miranda Marco A MA Henson David B DB Fenerty Cecilia C Biswas Susmito S Aslam Tariq T

Translational vision science & technology 20161214 6

<h4>Purpose</h4>We describe a pediatric visual field (VF) test based on a computer game where software and hardware combine to provide an enjoyable test experience.<h4>Methods</h4>The test software consists of a platform-based computer game presented to the central VF. A storyline was created around the game as was a structure surrounding the computer monitor to enhance patients' experience. The patient is asked to help the central character collect magic coins (stimuli). To collect these coins ...[more]

PMID: 27980876

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Project description:PURPOSE:To develop a visual field (VF) feature model to predict the reversal of glaucoma hemifield test (GHT) results to within normal limits (WNL) after 2 consecutive outside normal limits (ONL) results. DESIGN:Retrospective cohort study. PARTICIPANTS:Visual fields of 44?503 eyes from 26?130 participants. METHODS:Eyes with 3 or more consecutive reliable VFs measured with the Humphrey Field Analyzer (Swedish interactive threshold algorithm standard 24-2) were included. Eyes with ONL GHT results for the 2 baseline VFs were selected. We extracted 3 categories of VF features from the baseline tests: (1) VF global indices (mean deviation [MD] and pattern standard deviation), (2) mismatch between baseline VFs, and (3) VF loss patterns (archetypes). Logistic regression was applied to predict the GHT results reversal. Cross-validation was applied to evaluate the model on testing data by the area under the receiver operating characteristic curve (AUC). We ascertained clinical glaucoma status on a patient subset (n = 97) to determine the usefulness of our model. MAIN OUTCOME MEASURES:Predictive models for GHT results reversal using VF features. RESULTS:For the 16?604 eyes with 2 initial ONL results, the prevalence of a subsequent WNL result increased from 0.1% for MD < -12 dB to 13.8% for MD ?-3 dB. Compared with models with VF global indices, the AUC of predictive models increased from 0.669 (MD ?-3 dB) and 0.697 (-6 dB ? MD < -3 dB) to 0.770 and 0.820, respectively, by adding VF mismatch features and computationally derived VF archetypes (P < 0.001 for both). The GHT results reversal was associated with a large mismatch between baseline VFs. Moreover, the GHT results reversal was associated more with VF archetypes of nonglaucomatous loss, severe widespread loss, and lens rim artifacts. For a subset of 97 eyes, using our model to predict absence of glaucoma based on clinical evidence after 2 ONL results yielded significantly better prediction accuracy (87.7%; P < 0.001) than predicting GHT results reversal (68.8%) with a prescribed specificity 67.7%. CONCLUSIONS:Using VF features may predict the GHT results reversal to WNL after 2 consecutive ONL results.

Dataset Information

Development of a Pediatric Visual Field Test.

Purpose

Methods

Results

Conclusions

Translational relevance

Publications

Development of a Pediatric Visual Field Test.

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