Correlation between Melbourne Rapid Field (MRF) using a portable

device and Humphrey Visual Field in glaucoma patients at a

primary attention health service in Santiago de Chile

Jaime Tapia MD1,2,3, Diego Paredes MD1, Pablo Musa MD 1,2, Carolina Ibanez MD, PhD1
1.-Ophthalmology Department, Pontificia Universidad Católica de Chile
2.- Ophthalmology Department, Hospital Sotero del Rio, Puente Alto, Santiago de Chile
3.- San Lázaro, Primary Attention Health Service, Puente Alto, Santiago de Chile

Purpose Results
High quality campimetry tests are not usually available in primary care
settings. Thus, confirming glaucoma diagnosis in those with glaucoma a. Correlation b. Agreement
suspicion may be delayed. Portable campimetry tests have been
proposed as an alternative in low-resource settings.
The aims of this study were:
• To estimate the correlation between a portable test (Melbourne

[MRF MD] - [HVF MD], dB

Rapid Field; MRF) and the Humphrey Visual Field (HVF).
• To calculate the MRF accuracy to identify patients with glaucoma

MRF MD, dB
defined as a mean deviation (DM) ≤ -6 dB in the HVF

Methods
Participants: all adults (>18 years) seen in an ophthalmic primary care
center with a diagnosis or suspicion of glaucoma between June and Pearson correlation
August 2018. Exclusion criteria are shown in table 1. coefficient: 0.92
Procedures: all participants performed both tests (MRF and HVF) HVF MD, dB HVF MD, dB
First, the MRF was performed in the clinic using iPad 3 (Figure 1).
-30 dB 0 dB -30 dB 0 dB

Figure 2
a. Correlation between HVF and MRF
b. Agreement HVF vs MRF. Stressed that visual fields with MD closer to 0, tend to
Figure 1. have less dispersion than those with more severe defects
Participant conducting MRF
in Ipad, 33 cm distance
is checked during the test Accuracy

Figure 3
MRF MD, dB
Later, the HVF was conducted following the standard pathway of care, i.e.
in a tertiary eye hospital. The technician at the hospital conducting HVF
was blind to the result of the MRF. By using a 2 dB cut-off points for
Exclusion criteria the MRF, can screen almost all
• Best Corrected Visual acuity worse than 0.5 in Snellen patients who had an HVF worse
than 6 dB, that is, worse than
Baseline
• HVF no reliable (>25% FP >30%FN on HVF)
mild defects
• High ametropia (EE >-6.00 sph or > +4.00 sph)
• Other ocular disease causing changes in visual fields (i.e.
macular edema or central retinal vein occlusion )
HVF MD, dB

Analysis:
Correlaction was evaluated using Pearson correlation coefficient. Conclusions
Sensitivity and specificity of the MRF was calculated using two cut-offs:
• DM in MRF ≤ -2 dB. Implementing MRF in primary care facilities was easy, and had a low
• DM in MRF ≤ -1 dB. cost.
Bland Altman plots were used to evaluated agreement between the tests.
All of the MRF VF was included
Exist a high correlation and agreement between MRF and HVF.
Results MRF was sensitive to detect moderate glaucoma and it could be used
Eyes evaluated for the prioritization of patients requiring HVF.
Characteristics
(n=62; 33 patients)
Age in years, average ± sd 68 ± 10 MRF may improve visual health in low-resource settings.
Sex, No. women (%) 33 (53)
Visual Acuity average± sd 0.82 ± 0.2 References
Intraocular Presume (mmHg) median
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[IQR] Portable Tablet Perimeter With the Huphrey Field Analyzer. Am J Ophthalmol. 2018 Jun;190:9-16
Media Deviation (HVF), median [IQR] -3.5 [-8.9; -1.4]
2. Vingrys AJ, Healey JK, Validation of a Tablet as a Tangent Perimeter. Transl Vis Sci Technol. 2016 Jul 14;5(4):3
Patern standard deviation (HVF), median
2.8 [1.8; 7.9] 3.- Schulz AM, Graham EC, You Y, Klistorner A, Graham SL. Performance of iPad-based threshold perimetry in glaucoma and
[IQR] controls. Clin Exp Ophthalmol. 2018 May;46(4):346-355
No reliable MRF No. (%) 11 (18)