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A ‘web app’ for diagnosing hemianopia
  1. Nato Koiava1,
  2. Yean-Hoon Ong2,
  3. Maurice M Brown2,
  4. James Acheson1,
  5. G T Plant3,4,
  6. Alexander P Leff1,3,4
  1. 1Institute of Neurology, University College London, London, UK
  2. 2Multimedia Department, University College London, London, UK
  3. 3Institute of Cognitive Neuroscience, University College London, London, UK
  4. 4National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
  1. Correspondence to Dr A P Leff, Institute of Cognitive Neuroscience, University College London, 17 Queen Square, London WC1N 3AR, UK; a.leff{at}ucl.ac.uk

Abstract

Background Hemianopia commonly complicates stroke and, less frequently, head injury and brain tumours. Patients' activities of daily living are often affected although these can be ameliorated by appropriate behavioural therapy. Identifying a field defect is the first step in the rehabilitation process. An online visual field test (an ‘app’) was developed as part of a free to use web based therapy site for patients with hemianopic alexia, called Read-Right (http://www.readright.ucl.ac.uk). This study is an attempt to validate this test by comparing with a clinical ‘gold standard’—the Humphrey automated visual field analyser.

Methods 22 patients had their visual fields assessed with both techniques on the same day. The criterion validity of the Read-Right was examined by comparing it with Humphrey 10-2 and 24-2 perimetry using the following measures: (1) sensitivity and specificity; (2) κ statistics; and (3) intraclass correlation.

Results Read-Right demonstrated high sensitivity and specificity, particularly for the undamaged field. In the damaged field, κ values were highly significant, especially for points along the horizontal meridian. The intraclass correlation score for the damaged field indicated excellent correlation between the two tests. Read-Right perimetry performed well on all measures. It had a tendency to under call damaged points offset from the horizontal meridian, and this and other aspects of the test will be revamped.

Conclusion Read-Right is not designed to replace standardised visual perimetry; it does, however, offer a quick and easy assessment that can be used to screen patients. The test is available as part of two free to use web based therapy applications.

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Footnotes

  • Funding This work was supported by the NIHR CBRC at University College Hospitals and funded by the Stroke Association (grant No TSA 2007/11).

  • Competing interests None.

  • Ethics approval This study was approved by the University College London ethics committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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