Okrent Smolar Avital Lily, Gagrani Meghal, Ghate Deepta
Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia.
Department of Ophthalmology, University of Pittsburgh School of Medicine Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Curr Opin Neurol. 2023 Feb 1;36(1):19-25. doi: 10.1097/WCO.0000000000001125. Epub 2022 Nov 21.
Peripheral visual field (VF) loss affects 13% of the population over 65. Its effect on activities of daily living and higher order visual processing is as important as it is inadequately understood. The purpose of this review is to summarize available literature on the impact of peripheral vision loss on driving, reading, face recognition, scene recognition and scene navigation.
In this review, glaucoma and retrochiasmal cortical damage are utilized as examples of peripheral field loss which typically spare central vision and have patterns respecting the horizontal and vertical meridians, respectively. In both glaucoma and retrochiasmal damage, peripheral field loss causes driving difficulty - especially with lane maintenance - leading to driving cessation, loss of independence, and depression. Likewise, peripheral field loss can lead to slower reading speeds and decreased enjoyment from reading, and anxiety. In glaucoma and retrochiasmal field loss, face processing is impaired which impacts social functioning. Finally, scene recognition and navigation are also adversely affected, impacting wayfinding and hazard detection leading to decreased independence as well as more frequent injury.
Peripheral VF loss is an under-recognized cause of patient distress and disability. All peripheral field loss is not the same, differential patterns of loss affect parameters of activities of daily living (ADL) and visual processing in particular ways. Future research should aim to further characterize patterns of deranged ADL and visual processing, their correlation with types of field loss, and associated mechanisms.
周边视野（VF）丧失影响着13%的65岁以上人群。其对日常生活活动和高级视觉处理的影响既重要又未得到充分理解。本综述的目的是总结关于周边视野丧失对驾驶、阅读、面部识别、场景识别和场景导航影响的现有文献。
在本综述中，青光眼和视交叉后皮质损伤被用作周边视野丧失的例子，前者通常保留中心视力，后者的视野缺损模式分别遵循水平和垂直子午线。在青光眼和视交叉后损伤中，周边视野丧失都会导致驾驶困难——尤其是在保持车道方面——进而导致停止驾驶、失去独立性和抑郁。同样，周边视野丧失会导致阅读速度变慢、阅读乐趣降低以及焦虑。在青光眼和视交叉后视野丧失中，面部处理能力受损，这会影响社交功能。最后，场景识别和导航也会受到不利影响，影响寻路和危险检测，导致独立性下降以及受伤频率增加。
周边视野丧失是患者痛苦和残疾的一个未被充分认识的原因。并非所有周边视野丧失都是相同的，不同的丧失模式会以特定方式影响日常生活活动（ADL）参数和视觉处理。未来的研究应旨在进一步描述ADL紊乱和视觉处理的模式、它们与视野丧失类型的相关性以及相关机制。
