Tablet-based multi-stimulus perimetry for glaucoma screening

PURPOSE: To evaluate the Multi-Stimulus Vision Tester for a single eye (MVT-s), a tablet-based perimetry tool for detecting glaucomatous visual field (VF) defects. PARTICIPANTS: Forty-two eyes of 42 patients with glaucoma were classified into three stages on the basis of the mean deviation (MD) measured by the imo perimeter: early (12 eyes), moderate (19 eyes), and advanced (11 eyes), with an overall median MD of MD of - 8.5 dB (IQR, - 13.2 to - 5.2). Additionally, 39 eyes of 39 visually normal individuals were included as controls. METHODS: All participants underwent testing with the MVT-s and standard automated perimetry using the imo perimeter. The MVT-s used a multipoint stimulation paradigm with flickering stimuli, presenting up to three test points simultaneously. Participants recorded their responses by directly touching the stimulus locations on the screen. The MVT-s test was performed three times on the same day for each participant. We evaluated the relationship between the number of abnormal points detected by the MVT-s and MD obtained with the imo, diagnostic accuracy using sensitivity, specificity, and receiver operating characteristic curve analysis, short-term test-retest reproducibility using the intraclass correlation coefficient (ICC), and examination time. RESULTS: Abnormal points increased with disease severity (median 7.5, 17.0, and 22.0 in early, moderate, and advanced glaucoma; p < 0.001) and correlated with MD (ρ = - 0.84). Discrimination was high (AUC 0.93). Using cutoffs of ≥ 3/ ≥ 4/ ≥ 5 abnormal points, sensitivities were 92.9/92.9/90.5% and specificities were 79.5/82.1/84.6%. Test-retest reproducibility was good, with ICCs of 0.95 overall, 0.82 in normal eyes, and 0.93 in glaucomatous eyes. CONCLUSION: The MVT-s demonstrated high diagnostic accuracy and reproducibility for detecting glaucomatous VF defects, with a relatively short examination time, suggesting its potential as a practical screening and complementary assessment tool in glaucoma care.