Abstract
Precis: Online circular contrast perimetry was associated with a modest reduction in test-related anxiety compared with automated perimetry. Test durations were identical, and agreement between modalities was acceptable. However, Anxiety was unrelated to perimetric indices.
Purpose: Visual field assessment is often regarded as one of the least comfortable Ophthalmological tests. This perception can induce anxiety. In this study, we compared anxiety levels and test agreement between Standard Automated Perimetry (SAP), a clinical standard that is prone to anxiety, and Online Circular Contrast Perimetry (OCCP), a web-based alternative.
Methods: We conducted a prospective, comparative, within-subject study involving 100 patients, recruited from two eye centres in Ghana. Anxiety was assessed using the State-Trait Anxiety Inventory (STAI) tool. Anxiety scores, visual field test outcomes and reliability indices were analysed using the Wilcoxon Signed-Rank test, Spearman correlation, and Kruskal-Wallis test.
Results: Post-test anxiety was higher for SAP than OCCP (Median: 24.00 vs. 22.00, Z=-3.00, P=0.003, r=0.3, mean: 25.15 vs. 23.53). There was a statistically significant difference in pre-test anxiety, with lower anxiety scores reported before OCCP than before SAP despite identical median scores (20 for both; Z=-3.55, P<0.001, r=0.36) and only a small difference in mean scores (20.16 vs. 20.87). Trait anxiety was associated with post-test anxiety for SAP (ρ=0.42, P<0.001) and OCCP (ρ=0.29, P=0.004). Test durations were comparable (5.49 and 5.47 min, Z=-0.25, P=0.81) and agreement between modalities was acceptable.
Conclusions: OCCP is associated with slightly lower anxiety while demonstrating comparable test duration. These findings support its potential as a slightly more tolerable, accessible and cost-effective alternative for monitoring and screening for glaucoma.