Relationship Between Humphrey Automated Perimetry and Virtual Reality-Based Perimetry: A Constant dB Offset and Normative Data

Background: Automated visual field testing is fundamental in ophthalmology, but differences in stimulus scaling and luminance between devices hinder direct comparison of sensitivity values. Virtual reality (VR)-based perimetry has emerged as a portable alternative, yet its relationship with conventional perimetry requires clarification. Methods: This prospective cross-sectional study included 60 healthy participants stratified into younger (<50 years) and older (≥50 years) groups. Differential light sensitivity was assessed in the right eye using Humphrey Automated Perimetry (HFA) with the 30-2 test pattern and a VR-based perimeter (Dicopt-Pro) in randomized order. Pointwise sensitivity values were analyzed using linear regression and Bland–Altman analysis, and sensitivity profiles were examined as a function of visual field eccentricity. Results: A strong linear relationship was observed between HFA and Dicopt-Pro sensitivity values in both age groups (R ≥ 0.96). A systematic and approximately constant inter-device offset was identified, with mean differences of 15.7 ± 0.4 dB in younger subjects and 13.7 ± 0.5 dB in older subjects. Bland–Altman analysis showed consistent bias without proportional error. Dicopt-Pro sensitivity profiles demonstrated an eccentricity-dependent decline comparable to HFA while preserving age-related differences. Conclusions: VR-based perimetry using Dicopt-Pro shows sensitivity patterns closely aligned with conventional Humphrey perimetry when a systematic, age-specific inter-device offset is considered, enabling clinically meaningful interpretation of Dicopt-Pro results within an HFA-referenced framework.