Phenotypic Analysis of Intentionally Created Monocular Visual Field Defects During Bilateral Randomized Visual Field...

Area of Science:

• Ophthalmology
• Neuroscience
• Visual Science

Background:

• The imo Vifa® is recognized for diagnosing functional visual field loss.
• Its efficacy in detecting malingering remains uncertain.
• Malingering can complicate accurate visual field defect diagnosis.

Purpose of the Study:

• To assess the feasibility of simulating monocular visual field defects using the imo Vifa®.
• To compare defect phenotypes resulting from simulated monocular defects under bilateral testing.
• To evaluate the imo Vifa®'s potential for malingering detection.

Main Methods:

• Twenty healthy participants underwent simulated monocular visual field defects (nasal hemianopia, temporal hemianopia, centripetal constriction, central scotoma).
• Bilateral randomized visual field testing was conducted using the AIZE-rapid mode with 24-2 and 24plus(1) programs.
• Participant roles included orthoptists, a physician, and administrative staff.

Main Results:

• Accurate simulation of intended monocular defects was difficult.
• Orthoptists and non-orthoptists produced varied patterns, often deviating from intended defects (e.g., homonymous hemianopia-like patterns).
• Participant expertise influenced the resulting visual field defect patterns.

Conclusions:

• Simulating specific monocular visual field abnormalities during bilateral testing is challenging.
• Participant comprehension of visual field testing significantly affects outcomes.
• Future studies should consider occlusion to improve monocular defect simulation for malingering detection.