Kim Ko Eun, Ahn Seong Joon
Department of Ophthalmology, Asan Medical Center, Ulsan University College of Medicine, Seoul 05505, Republic of Korea.
Department of Ophthalmology, Hanyang University Hospital, Hanyang University College of Medicine, Seoul 04763, Republic of Korea.
J Clin Med. 2025 Jul 25;14(15):5266. doi: 10.3390/jcm14155266.
Visual field (VF) testing remains a cornerstone in assessing retinal function by measuring how well different parts of the retina detect light. It is essential for early detection, monitoring, and management of many retinal diseases. By mapping retinal sensitivity, VF exams can reveal functional loss before structural changes become visible. This review summarizes how VF testing is applied across key conditions: hydroxychloroquine (HCQ) retinopathy, age-related macular degeneration (AMD), diabetic retinopathy (DR) and macular edema (DME), and inherited disorders including inherited dystrophies such as retinitis pigmentosa (RP). Traditional methods like the Goldmann kinetic perimetry and simple tools such as the Amsler grid help identify large or central VF defects. Automated perimetry (e.g., Humphrey Field Analyzer) provides detailed, quantitative data critical for detecting subtle paracentral scotomas in HCQ retinopathy and central vision loss in AMD. Frequency-doubling technology (FDT) reveals early neural deficits in DR before blood vessel changes appear. Microperimetry offers precise, localized sensitivity maps for macular diseases. Despite its value, VF testing faces challenges including patient fatigue, variability in responses, and interpretation of unreliable results. Recent advances in artificial intelligence, virtual reality perimetry, and home-based perimetry systems are improving test accuracy, accessibility, and patient engagement. Integrating VF exams with these emerging technologies promises more personalized care, earlier intervention, and better long-term outcomes for patients with retinal disease.
视野（VF）测试仍然是通过测量视网膜不同部位检测光线的能力来评估视网膜功能的基石。它对于许多视网膜疾病的早期检测、监测和管理至关重要。通过绘制视网膜敏感度图，视野检查可以在结构变化可见之前揭示功能丧失。本综述总结了视野测试在以下关键病症中的应用：羟氯喹（HCQ）视网膜病变、年龄相关性黄斑变性（AMD）、糖尿病性视网膜病变（DR）和黄斑水肿（DME），以及包括遗传性营养不良如视网膜色素变性（RP）在内的遗传性疾病。像戈德曼动态视野计这样的传统方法以及像阿姆斯勒方格表这样的简单工具有助于识别大的或中心性视野缺损。自动视野计（例如，汉弗莱视野分析仪）提供详细的定量数据，对于检测HCQ视网膜病变中的细微旁中心暗点和AMD中的中心视力丧失至关重要。倍频技术（FDT）在血管变化出现之前揭示DR中的早期神经缺陷。微视野计为黄斑疾病提供精确的局部敏感度图。尽管视野测试有其价值，但它面临着包括患者疲劳、反应变异性以及对不可靠结果的解释等挑战。人工智能、虚拟现实视野计和家庭式视野计系统的最新进展正在提高测试准确性、可及性和患者参与度。将视野检查与这些新兴技术相结合有望为视网膜疾病患者提供更个性化的护理、更早的干预和更好的长期结果。
