Virtual Reality Hemifield Measurements for Corrective Surgery Eligibility in Ptosis Patients: A Pilot Clinical Trial.

Autor:	Labkovich M; Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Warburton AJ; Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Ying S; Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Valliani AA; Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Kissel N; Department of Statistics & Data Science, Carnegie Mellon, Pittsburgh, PA, USA., Serafini RA; Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA.; Nash Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Mathew R; Department of Medical Education, SUNY Downstate, Brooklyn, NY, USA., Paul M; Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Hovstadius SM; Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Navarro VN; Department of Uro Onc Research, Weill Cornell Medicine, New York, NY, USA., Patel A; Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Reddy H; Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Chelnis JG; Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Jazyk:	angličtina
Zdroj:	Translational vision science & technology [Transl Vis Sci Technol] 2022 Oct 03; Vol. 11 (10), pp. 35.
DOI:	10.1167/tvst.11.10.35
Abstrakt:	Purpose: We developed an accelerated virtual reality (VR) suprathreshold hemifield perimetry algorithm, the median cut hemifield test (MCHT). This study examines the ability of the MCHT to determine ptosis severity and its reversibility with an artificial improvement by eyelid taping on an HTC Vive Pro Eye VR headset and the Humphrey visual field analyzer (HVFA) to assess the capabilities of emerging technologies in evaluating ptosis. Methods: In a single visit, the MCHT was administered along with the HVFA 30-2 on ptotic untaped and taped eyelids in a randomized order. The primary end points were a superior field visibility comparison with severity of VF loss and VF improvement after taping for MCHT and HVFA. Secondary end points included evaluating patients' Likert-scaled survey responses on the comfort, speed, and overall experience with both testing modalities. Results: VR's MCHT superior field degrees visible correlated well for severe category margin to reflex distance (r = 0.78) compared with HVFA's (r = -0.21). The MCHT also demonstrated noninferiority (83.3% agreement; P = 1) against HVFA for detection of 30% or more superior visual field improvement after taping, warranting a corrective surgical intervention. In comparing hemi-VF in untaped eyes, both tests demonstrated relative obstruction to the field when comparing normal controls to severe ptosis (HVFA P < 0.05; MCHT P < 0.001), which proved sufficient to demonstrate percent improvement with taping. The secondary end point of patient satisfaction favored VR vision testing presentation mode in terms of comfort (P < 0.01), speed (P < 0.001), and overall experience (P < 0.01). Conclusions: This pilot trial supports the use of MCHT for the quantitative measurement of visual field loss owing to ptosis and the reversibility of ptosis that is tested when conducting a presurgical evaluation. We believe the adoption of MCHT testing in oculoplastic clinics could decrease patient burden and accelerate time to corrective treatment. Translational Relevance: In this study, we look at vision field outputs in patients with ptosis to evaluate its severity and improvement with eyelid taping on a low-profile VR-based technology and compare it with HVFA. Our results demonstrate that alternative, portable technologies such as VR can be used to grade the degree of ptosis and determine whether ptosis surgery could provide a significant superior visual field improvement of 30% or more, all while ensuring a more comfortable experience and faster testing time.
Databáze:	MEDLINE
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