Validation of Testvision, an internet-based test for the detection of visual field loss

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Abstract

Purpose

The aim of the present study was to determine if the program Damato Testvision (DT), www.testvision.org, adequately detects visual field loss from glaucoma.

Methods

DT is available in three versions and was tested on 97 patients (188 eyes). The procedure was performed with a laptop connected to a computer monitor and a mouse placed on a height adjustable table. To determine sensitivity and specificity DT was compared to two gold standards: 1; Hodapp, Parrish and Anderson classification (Hodapp) of Humphrey 30:2 and 2; doctors' diagnoses.

Results

A total of 361 DT Standard tests were performed on 115 eyes. DT comparisons with Hodapp achieved sensitivity and specificity of 55% and 93% respectively when comparing no disease to early glaucomatous loss (AUC; 0,871). If early loss was merged with the no disease group, the sensitivity and specificity were 78% and 90% respectively (AUC; 0.931) Compared to the doctors' diagnosis DT achieved sensitivity and specificity of 52%; 96% respectively when borderline patients were classified in the glaucoma group (AUC; 0,867). If borderline patients were classified as controls: DT achieved sensitivity and specificity of 63%; 92% (AUC; 0,897).

Conclusion

Our study indicates that DT may be a promising tool to detect visual field defects in a pre-selected population. The test is successful without prior training of the test person but minimal computer knowledge is advisable. The authors believe that internet based visual field examination may play a role as an easy accessible and affordable test. With further development, DT could be a tool for glaucoma screening in the home setting. Future studies need to evaluate DTs performance in the general population without prior selection.

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