Subjective visual vertical in virtual reality (Curator SVV): validation and normative data

摘要

Subjective visual vertical (SVV) assesses the ability to perceive verticality, which is a measure of vestibular otolithic function. Vestibular lesions influence this perception of verticality. We developed a method using virtual reality (VR) display and an Android software application named 'Curator SVV'. The virtual reality SVV (Curator SVV) consisted of ten readily identifiable artworks projected by a Samsung phone S6 which is inserted into a virtual reality headset. In the first study, 20 patients had there SVV assessed with two devices: (1) a commercially available SVV measurement device (VestiTest(A (R))) and (2) a virtual reality SVV using the Curator SVV application. In a second study, 32 healthy subjects had their SVV assessed by the Curator SVV application whilst sitting in a chair. In the first study, there was no significant difference (p = 0.44, paired t test and p = 0.01, test of equivalence) between results obtained by Curator SVV and the commercially available device. In the second study, the average angle measured for healthy subjects was 0.00A degrees A +/- 0.85A degrees. The normal range (mean +/- 2 SD) was +/- 2A degrees in standard upright position. We were able to demonstrate that the Curator SVV can be readily employed as an objective, non-invasive and affordable means of assessing otolith function in the clinical context. We validated this novel methodology by finding strong quantitative parity between a standard commercial SVV unit and the VR Curator SVV method. Our very lightweight and mobile device can be employed in clinical contexts including at the bedside and in different head and body positions.