MELBOURNE RAPID FIELDS (MRF) TEST

 

The Melbourne Rapid Fields (MRF) Visual Field Test is a computer or tablet-based software. It was developed by researchers in Australia and allows testing on Apple iPads (generation 3/4 or later) and computers/laptops via Cloud technology. The software enables in-office or remote visual field testing due to its low cost and easy portability.

https://www.appviewmrf.com/what-is-mrf-visual-field-test/

The software is robust despite variations in ambient light, blur, and viewing distance. The instrument is cheaper, easier to handle, avoids the claustrophobia of bowl perimeters, and is easier to understand by patients, compared to the Humphrey Visual Field Analyzer (HFA).

A few studies have shown that the MRF software gives visual field (VF) results comparable to the HFA.

A study by Kumar and Thulasidas has shown the perimetric outcomes of MRF were comparable to those from the HFA 24-2 SITA standard. The study involved 28 eyes of 28 glaucoma patients. Mean (standard deviation) test times were 342.07 (56.70) seconds for MRF and 375.11 (88.95) for HFA 24-2 SITA standard (P = 0.046). Mean MD was significantly lower for MRF (Δ = 3.09, P < 0.001), and mean PSD was significantly higher for MRF (Δ = 1.40, P < 0.005) compared with HFA. The mean foveal threshold for the MRF was significantly lower than the mean HFA foveal threshold ((Δ = 9.25, P < 0.001). Other perimetric outcomes showed no significant differences between both methods.

Kang et al, have performed a study involving 79 participants (133 eyes) comparing MRF and HFA. Their study reported the global indices of MD and PSD did not significantly vary between HFA and the MRF techniques. However, the sensitivities significantly differed from those of the HFA at 36 and 39 locations, respectively, out of 52 locations. Relative to HFA, the tablet overestimated light sensitivity in the nasal field while underestimating the temporal field.

Kumar’s study found MRF showed a significantly lesser number of points depressed at P < 5% on PSD probability plot than HFA, pointing towards the possibility of underestimating glaucomatous defects and missing early cases of glaucoma. There is also a lack of standardized background illumination involving the tablets, compared to the standard methodology for HFA universally.

The development of an effective tracking system for monitoring head and eye positions in real-time using the iPad camera may allow fixation monitoring during peripheral field testing as well as for the central test. The poor availability of the internet and speed limitations may hamper the use of this portable method in rural and underdeveloped areas. Therefore, an internet-independent mechanism can be developed for this software.

REFERENCES:

Kumar H, Thulasidas M. Comparison of Perimetric Outcomes from Melbourne Rapid Fields Tablet Perimeter Software and Humphrey Field Analyzer in Glaucoma Patients. J Ophthalmol. 2020 Aug 22;2020:8384509. doi: 10.1155/2020/8384509. PMID: 32908686; PMCID: PMC7463344.

Kang J, De Arrigunaga S, Freeman SE, Zhao Y, Lin M, Liebman DL, Roldan AM, Kim JA, Chang DS, Friedman DS, Elze T. Comparison of Perimetric Outcomes from a Tablet Perimeter, Smart Visual Function Analyzer, and Humphrey Field Analyzer. Ophthalmol Glaucoma. 2023 Sep-Oct;6(5):509-520.