Abstract
PURPOSE: To assess the reliability and acceptability of home-based visual field monitoring in glaucoma patients using a self-developed online perimeter (Perimouse). PATIENTS AND METHODS: In this prospective study, patients with stable open-angle glaucoma conducted monthly remote visual field tests using the Perimouse threshold program in an unsupervised home setting over six months, with Humphrey Field Analyzer (HFA) tests performed before and after the trial. The study evaluated patient compliance with Perimouse and compared its stability and variability to HFA. Additionally, a questionnaire assessed patient acceptability of Perimouse. RESULTS: Sixty glaucoma patients (97 eyes) participated in this study. The follow-up completion rate of home tests remained 67.01% in the sixth month despite a gradual decline over time. A pointwise analysis demonstrated overall consistency, although variability increased as sensitivity decreased. Bland-Altman analysis of Perimouse mean deviation (MD) showed that the mean differences between Month 1 and Months 2-6 were close to zero. The mean absolute error for Perimouse MD ranged from 0.71 to 1.04, compared to 0.55 for HFA. Perimouse test duration decreased over six months, from 10.04 ± 2.74 minutes to 8.31 ± 2.77 minutes. The questionnaire indicated that Perimouse scoring higher than HFA in stress relief, visual comfort, and cost-effectiveness (P<0.05). CONCLUSION: This study showed that participants could perform Perimouse remotely in an unsupervised setting with video and written instructions. Perimouse may support home-based visual field monitoring and enhance self-management for glaucoma patients.