A new study published in Journal of Glaucoma investigated the preferences of patients in regards to glaucoma testing types.
Give me some background first.
Glaucoma monitoring is typically done through visual field (VF) testing, which can lead to certain burdens for patients such as frequent visits and examinations.
With this in mind, researchers set out to explore how various alternatives and at-home monitoring could aid in this, including virtual reality (VR) and smart visual function analyzer (SVFA).
What devices were investigated?
- IMOvifa (CrewT Medical Systems, Inc.) SVFA VF
- Melbourne Rapid Fields (MRF, M&S Technologies) tablet VF
Now, talk about the study.
This observational prospective cohort study was conducted at Massachusetts Eye and Ear (MEE).
The goal: to investigate the SVFA perimeter and the tablet-based MRF VF test in comparison to the Humphrey 24-2 SITA Standard—which is often used in clinical practice.
And the participants?
During routine glaucoma appointments at MEE, survey data of 81 participants with previous glaucoma related diagnoses were recruited.
All had previous experience with clinic-based perimetry tests and passed various exclusion criteria.
Tell me more.
Participants attended two separate study visits 10-24 weeks apart; during the first visit, each completed a practice MRF VF test.
They were then randomized to take the SVFA VF and 24-2 SITA Standard HVF tests.
Go on…
In between the two study visits, participants were asked to perform weekly MRF VF tests on tablets given to them at home.
During their final study visit, they took the SVFA and HVF tests once again.
How was data collected?
After each study visit, participants were surveyed using Research Electronic Data Capture (REDCap) hosted at MEE. The questions covered:
- Test difficulty
- Time commitment
- Test understandability
- If reminders were used/helpful
- Device preference
- Willingness to test at home
- Why they missed a weekly MRF test (if applicable)
- Overall experience
Findings?
After completing tests on the new devices, participants preferred both to HVF (SVFA: 71.7%; MRF: 69.2%).
For SVFA, at the final visit, a significant increase was determined in participants preference compared to HVF (51.9%–69.1%, P=0.01; Table 3).
Regarding MRF, participants had a good overall experience, but after the final visit, favorable responses were lower than at the baseline.
Go on…
Participants showed a willingness to take SVFA at-home tests at least weekly. In comparison, they showed less willingness in terms of frequency for at-home MRF tests.
In the final study, it was determined that they had a decrease in willingness to test daily for MRF tests; however, an increase in willingness to test monthly was observed.
Limitations?
Both MRF and SVFA have strong correlations with HVF, but a few mixed results in the studies indicate the need for further research to fully ensure their accuracy and repeatability.
An unidentified number of MRF tests were administered in addition to SVFA, and the SVFA test was not performed at home. This is a possible influencer on the survey results and patient preference.
Other limitations included technical difficulties encountered on the devices and the study occurring during the COVID-19 pandemic.
Expert opinion?
Per the study authors, “As more studies evaluate these devices’ accuracy, reliability, and overall performance—we believe it is critical for user experience to be assessed.”
They continued: “Our findings show that patients would potentially be interested in performing frequent tests on the SVFA and MRF as part of their glaucoma care.”
Take home.
Patient preference of at-home monitoring offers the opportunity to implement more frequent testing in the future, leading to earlier detection earlier and decreased stress on both patients and the health care system.
However, further research is necessary to determine longitudinal test repeatability of the novel devices and address limitations.