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Identification of functional visual field loss by automated static perimetry
1Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Acta Ophthalmologica
|April 5, 2014
Summary
New criteria using automated static perimetry can identify functional visual field loss. Key indicators include irregular field defects, threshold spikes, and poor test-retest correlations, aiding diagnosis in visual field testing.
Area of Science:
- Ophthalmology
- Neuroscience
- Medical Imaging
Background:
- Diagnosing functional visual field loss, lacking objective evidence, traditionally relied on kinetic perimetry.
- Automated static perimetry is now dominant, necessitating updated diagnostic criteria for functional visual field loss.
Purpose of the Study:
- To establish new diagnostic criteria for functional visual field loss using automated static perimetry.
- To differentiate functional visual field loss from true organic lesions.
Main Methods:
- Retrospective analysis of automated perimetry data from 36 subjects with functional visual field loss.
- Comparison with control groups including normal eyes and eyes with known organic lesions (e.g., glaucoma, optic nerve compression).
Main Results:
- Standard automated perimetry statistics were insufficient for reliable discrimination.
- Functional fields often showed severe, irregular contractions/depressions and isolated "threshold spikes" that shifted location.
- Visual evaluation of maps and intertest correlations (median 0.47 for functional vs. 0.81 for organic) improved discrimination.
Conclusions:
- Automated static perimetry can identify functional visual loss.
- Diagnostic criteria include irregular field defects, threshold spikes, and low intertest correlations.
