Humphrey Visual Field Detection Analysis Principles (3rd Edition)

Author: Anders Heijl, Vincent Michael Patella
Publisher:
Publish Date: 2005-07-01
Features: Visual acuity (vision) and visual field are the two most important aspects of visual function, and the visual field can measure visual function outside the macular area. As early as the 5th century BC, Hippocrates first proposed the concepts of visual field and visual field defects in a case of hemianopia. However, it was not until the mid-19th century that Albrecht von Graefe introduced visual field examination into ophthalmology clinical practice, reporting pericentral visual field defects and peripheral visual field constriction in glaucoma, proposing that glaucoma visual field defects could occur before vision loss, and using the morphology of hemianopia for the localization diagnosis of central nervous system diseases. Since the mid-19th century, ophthalmologists have successively invented and developed various visual field testers, from simple visual field screens to arcuate visual field testers, Bjerrum visual field screens, and finally the projection-type hemispherical Goldmann visual field tester, leading to significant advancements in visual field examination. Since the 1970s, the introduction, development, and application of computerized automated visual field testers have significantly improved the sensitivity of visual field examination, ushering in a new era for clinical visual field testing.
In the field of ophthalmic visual field studies, the most researched and in-depth topic is glaucoma visual field changes. In the early stages of glaucoma, visual field changes are mild, varied, and unpredictable, and existing routine visual field examinations often fail to detect such early defects. On the other hand, theoretically, changes in the optic disc and retinal nerve fiber layer in glaucoma should be accompanied by corresponding visual field changes. However, both clinical and pathological physiological studies have shown that even when significant changes are present in the fundus or when retinal nerve fiber loss has reached a considerable extent, routine visual field tests may still yield normal results, suggesting that existing visual field testers and examination methods are not sufficiently sensitive.
Therefore, many clinical visual field experts have long been focused on how to detect early glaucoma visual field changes. They have continuously improved and refined existing visual field testers from the pathological mechanisms of glaucoma optic nerve damage and visual physiology, as well as from the sensitivity, specificity, and reliability of visual field examination. At the same time, new types of visual field testers have been developed and introduced. It can be said that the development of modern visual field testers is closely related to the progress of glaucoma visual field research. Currently, high-resolution visual field testing, pattern resolution visual field testing, blue-yellow visual field testing, peripheral displacement threshold testing, flicker and time-modulated visual field testing, and full-field psychophysical tests are under development and refinement.
This book will take the Humphrey computerized automated visual field analyzer as an example to provide you with some information on visual field testing, as well as many new testing strategies and analytical methods.