1. Virtual Reality-based Infrared Pupillometry (VIP) for long COVID.
- Author
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Tang CH, Yang YF, Fung Poon KC, Man Wong HY, Hei Lai KK, Li CK, Yan Chan JW, Wing YK, Dou Q, Yung Tham CC, Pang CP, and Lung Chong KK
- Abstract
Objective: To evaluate the use of virtual reality-based infrared pupillometry (VIP) to detect individuals suffering long COVID., Design: Prospective, case-control cross-sectional study., Participants: Participants aged 20-60 were recruited from a community eye screening programme., Methods: Pupillary Light Responses (PLR) were recorded in response to 3 intensities of light stimuli (L6, L7 and L8) using a virtual reality head-mount display (VR-HMD). 9 PLR waveform features for each stimulus, were extracted by 2 masked observers and statistically analyzed. We also use various methods on the whole PLR waveform including trained, validated and tested (6:3:1) by machine learning models including Multi-layer Perceptron, Support Vector Machine, K-nearest Neighbors, Logistic Regression, Decision Tree, Random Forest and Long Short-Term Memory (LSTM) models for two and three-class classification into long-COVID (LCVD), post-COVID (PCVD) or control., Main Outcome Measures: Accuracies/AUC of individual or combination of PLR features and ML models using PLR features or whole pupillometric waveform., Results: PLR from a total of 185 subjects including 112 LCVD, 44 PCVD and 29 age/sex-matched controls were analysed. Models examined the independent effects of age and sex. Constriction Time(CT) after the brightest stimulus(L8) is significantly associated with LCVD status(two-way ANOVA, false discovery rate(FDR)<0.001; multinominal logistic regression, FDR<0.05). The overall accuracy/AUC of CT-L8 alone in differentiating LCVD from control or from PCVD were 0.7808/0.8711 and 0.8654/0.8140 respectively. Using cross-validated backward stepwise variable selection, CT-L8, CT-L6, Constriction Velocity(CV)-L6 were most useful to detect LCVD while CV-L8 for PCVD from other groups. The accuracy/AUC of selected features were 0.8000/0.9000 (control versus LCVD) and 0.9062/0.9710 (PCVD versus LCVD), better than when all 27 pupillometric features were combined. An LSTM model analyzing whole pupillometric waveform achieved the highest accuracy/AUC at 0.9375/1.000 in differentiating LCVD from PCVD and a slightly lower accuracy of 0.7838 for three-class classification (LCVD-PCVD-control)., Conclusions: We reported, for the first time, specific pupillometric signatures in differentiating LCVD from PCVD or control subjects using a VR-HMD. Combining statistical methods to identify specific pupillometric features and ML algorithms to analyse the performance further enhance the performance of VIP as a non-intrusive, low-cost, portable and objective method to detect and monitor long COVID., (Copyright © 2024. Published by Elsevier Inc.)
- Published
- 2024
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