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Clinical validation of a novel web-application for remote assessment of distance visual acuity.
Thirunavukarasu, Arun James; Mullinger, Deborah; Rufus-Toye, Remi Mohan; Farrell, Sarah; Allen, Louise E.
  • Thirunavukarasu AJ; Department of Ophthalmology, Cambridge University Hospitals NHS Trust, Cambridge, UK. ajt205@cantab.ac.uk.
  • Mullinger D; School of Clinical Medicine, University of Cambridge, Cambridge, UK. ajt205@cantab.ac.uk.
  • Rufus-Toye RM; Department of Ophthalmology, Cambridge University Hospitals NHS Trust, Cambridge, UK.
  • Farrell S; Department of Ophthalmology, Cambridge University Hospitals NHS Trust, Cambridge, UK.
  • Allen LE; School of Clinical Medicine, University of Cambridge, Cambridge, UK.
Eye (Lond) ; 36(10): 2057-2061, 2022 10.
Article in English | MEDLINE | ID: covidwho-2050363
ABSTRACT
BACKGROUND/

OBJECTIVES:

Ophthalmic disorders cause 8% of hospital clinic attendances, the highest of any specialty. The fundamental need for a distance visual acuity (VA) measurement constrains remote consultation. A web-application, DigiVis, facilitates self-assessment of VA using two internet-connected devices. This prospective validation study aimed to establish its accuracy, reliability, usability and acceptability. SUBJECTS/

METHODS:

In total, 120 patients aged 5-87 years (median = 27) self-tested their vision twice using DigiVis in addition to their standard clinical assessment. Eyes with VA worse than +0.80 logMAR were excluded. Accuracy and test-retest (TRT) variability were compared using Bland-Altman analysis and intraclass correlation coefficients (ICC). Patient feedback was analysed.

RESULTS:

Bias between VA tests was insignificant at -0.001 (95% CI -0.017 to 0.015) logMAR. The upper limit of agreement (LOA) was 0.173 (95% CI 0.146 to 0.201) and the lower LOA -0.175 (95% CI -0.202 to -0.147) logMAR. The ICC was 0.818 (95% CI 0.748 to 0.869). DigiVis TRT mean bias was similarly insignificant, at 0.001 (95% CI -0.011 to 0.013) logMAR, the upper LOA was 0.124 (95% CI 0.103 to 0.144) and the lower LOA -0.121 (95% CI -0.142 to -0.101) logMAR. The ICC was 0.922 (95% CI 0.887 to 0.946). 95% of subjects were willing to use DigiVis to monitor vision at home.

CONCLUSIONS:

Self-tested distance VA using DigiVis is accurate, reliable and well accepted by patients. The app has potential to facilitate home monitoring, triage and remote consultation but widescale implementation will require integration with NHS databases and secure patient data storage.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Vision Tests / Software Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Eye (Lond) Journal subject: Ophthalmology Year: 2022 Document Type: Article Affiliation country: S41433-021-01760-2

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Vision Tests / Software Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Eye (Lond) Journal subject: Ophthalmology Year: 2022 Document Type: Article Affiliation country: S41433-021-01760-2