Home Monitoring of Visual Functions in Neuro-Ophthalmic Diseases Using an AI-Assisted Virtual Reality Platform

BACKGROUND: This study evaluates the feasibility and acceptability of a virtual reality platform (VRP) for home monitoring of visual function in patients with neuro-ophthalmic conditions. METHODS: Fifteen patients with nonarteritic anterior ischemic optic neuropathy (NAAION), optic neuritis, or papilledema were enrolled and monitored remotely over 12 weeks. Visual acuity, color vision, and visual field testing were collected 3 times per week using the VRP. Compliance and satisfaction levels were analyzed. RESULTS: A total of 21 eyes were included (38.1% NAAION, 42.9% optic neuritis, 19% papilledema). Most participants (71.4%) found weekly VRP use easy, and all felt confident using it at home. While 86% reported no technical issues, 21%-28% experienced transient symptoms such as blurred vision or dizziness. Compliance was highest in the NAAION group, with 75% completing the full 12-week period. In the optic neuritis group, 55.6% remained after Week 1 and 44.4% continued through Week 8. The papilledema group discontinued by Week 4. Main reasons for discontinuation included time constraints, scheduling conflicts, and stable vision after improvement. In general, visual acuity and visual field indices (mean deviation and pattern SD [PSD]) showed no significant changes over time, confirming good VRP'S reproducibility for home monitoring. This VRP also detected cases of visual function worsening, enabling earlier rescheduling of clinical appointments. CONCLUSION: The VRP is a feasible and well-accepted tool for home-based visual monitoring in neuro-ophthalmic patients as an alternative to in-person eye examinations. This approach enables early detection of changes and can improve long-term management.