研究目的
To study Damato Multifixation Campimetry Online (DMCO), an inexpensive online visual field test, used for screening at optician shops in Denmark.
研究成果
Screening with DMCO demonstrated high specificity (97-99%) but unsatisfactory sensitivity (14-69%). Future studies with larger sample sizes are needed to accurately determine sensitivity and to improve the DMCO algorithm and test design for better performance in community screening settings.
研究不足
The study was not powered to estimate sensitivity accurately. Participating opticians may not represent the average, and there was potential self-selection bias among participants. Diagnosis of glaucoma was made by only one blinded ophthalmologist, which could introduce variability. Participants with poor visual acuity or high myopia were excluded, limiting generalizability. The time delay between DMCO testing and eye examination (median 31 days for positives, 138 days for negatives) might affect results.
1：Experimental Design and Method Selection:
This was an evaluation of a diagnostic test using the DMCO STANDARD 4,5 algorithm for screening visual field defects. The methodology involved performing DMCO tests on participants and comparing results with reference standards including Humphrey Visual Field Analyzer tests and clinical diagnoses by ophthalmologists.
2：Sample Selection and Data Sources:
Participants were included if they were at least 50 years old, had a visual acuity of minimum 0.5, and had less myopia than 6 D. They were recruited from 13 optician shops in Denmark through formal invitations, advertisements, or opportunistically.
3：5, and had less myopia than 6 D. They were recruited from 13 optician shops in Denmark through formal invitations, advertisements, or opportunistically.
List of Experimental Equipment and Materials:
3. List of Experimental Equipment and Materials: Standard equipment included a computer (ThinkCentre M72e), a 22-inch monitor with a matt screen, a wireless mouse (all from Lenovo), a height-adjustable table and chair (recommended but not mandatory), and normal room lighting. The DMCO test was accessed via www.testvision.org using Firefox or Explorer browsers. Additional equipment for eye examinations included a Snellen Chart for BCVA measurement, Goldmann tonometer, Humphrey Field Analyzer 30–2 SITA Fast, slit-lamp, gonioscopy equipment, and equipment for optic disc photography.
4：Experimental Procedures and Operational Workflow:
Participants learned to perform DMCO by reading instructions, watching a demo movie, and doing a rehearsal. The test involved presenting stimuli on the screen, and participants signaled awareness by moving an arrow with a mouse. Each eye was tested separately with occlusion. DMCO was performed once or twice based on missed stimuli. Results were emailed to the first author. Participants with positive DMCO results underwent a full eye examination by an ophthalmologist, including HFA testing, slit-lamp examination, gonioscopy, and optic disc evaluation. A subset with negative DMCO results was invited as controls for the same examination.
5：Data Analysis Methods:
Descriptive statistics (mean, SD, percentages) were used. Specificity and sensitivity were estimated using 2x2 tables with 95% confidence intervals. Groups were compared using t-tests and chi-square tests. Power calculations indicated a need for at least 550 participants to estimate specificity.
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