Deepayan Kar, PhD, MS: A Virtual Reality Approach to Contrast Sensitivity in AMD

At ARVO 2024, Deepayan Kar, MD, PhD, describes the potential of measuring contrast sensitivity function using a novel gaze tracking-based VR headset in AMD.

Highlights

0:07 Significance of contrast sensitivity for AMD

1:14 What is the VR headset?

2:47 Results of the analysis

3:38 Clinical implications

4:31 Challenges in VR

6:05 Importance of innovation in ophthalmology

A recent analysis presented at the 2024 Association for Research in Vision and Ophthalmology (ARVO) Meeting focused on a novel approach to assess contrast sensitivity using a novel virtual reality (VR) headset in patients with age-related macular degeneration (AMD).

Contrast sensitivity, a key function affecting the quality of life metrics in AMD, measured with a gaze-tracking-based VR headrest revealed a trend to differentiate among groups with different disease stages of AMD.

In an interview with HCPLive, investigator Deepayan Kar, PhD, MS, an ophthalmology biomarker scientist in translational development at Apellis Pharmaceuticals, indicated the VR-based test remained objective and was efficiently administered across a wide age range and lens status during the study.

“We found that the test is feasible across a broad range of age groups and in our clinical study, the test had the ability to separate normal from disease eyes,” Kar told HCPLive. “Furthermore, we found a trend to differentiate between AMD disease severity groups. The test has a small footprint, so it’s really easy to scale it up for clinics or trials.”

The prospective cross-sectional observational study enrolled patients with wet or dry AMD between June and October 2023. Contrast sensitivity function (CSF) testing, based on a radial sweep test, was performed in each eye under mesopic conditions using the VR headset. In analysis, the area under the curve (AUC) of the log CSF and best-corrected distance visual acuity (BCVA) was tested monocularly in each eye.

Monocular CSF testing was completed in 66 eyes of 33 subjects with AMD (mean age, 78.9 years; 21 female). The AUC of log CST was identified as the worst in 9 eyes with GA (19.9 ± 12.7) followed by 25 eyes with wet AMD (32.5 ± 14.0) and 32 eyes with early or intermediate AMD (44.0 ± 12.4).

Furthermore, worse BCVA was moderately correlated with poor AUC (Pearson r = .42; P <.001) in the cohort. Among 25 eyes with BCVA 2020 (38% of the cohort), the AUC values ranged from 5 to 58 (42.6 ± 14.1).

Thus, investigators noted the range of variability of poor CSF was identified even in eyes with normal central visual acuity. Moreover, the AUC of log CSF showed no difference between phakic (n = 26) and pseudophakic (n = 40) eyes (39.3 ± 14.5 vs. 34.4 ± 15.8).

Kar noted the device, although still in the development stage, showed encouraging results in this analysis, and may lay the foundations for VR-based contrast sensitivity measures a potential functional outcome in AMD-based clinical trials.

“The device is still in the development stage and it is a cross-sectional study, so it gives a snapshot in time of AMD patients and individuals without AMD,” Kar told HCPLive. “The next goal is to look at it in a longitudinal manner, which means we’re going to see how the function changes across time and eventually establish it as a clinical trial outcome.”

Disclosures: Deepayan Kar is an employee of Apellis Pharmaceuticals.

References

_{Kar D, McKeown A, Michels S, Gruninger N, Wyder S, Pfister M, Scheibler L. Contrast sensitivity function using a prototype gaze tracking-based virtual reality headset in age-related macular degeneration (AMD). Paper presented at the Association for Research in Vision and Ophthalmology (ARVO) 2024 Meeting, May 5–9, 2024.}