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The value of visual field testing in the era of advanced imaging: clinical and psychophysical perspectives
Authors:Jack Phu MPH BOptom BSc FAAO  Sieu K Khuu PhD BSc  Michael Yapp MOptom PGCertOcTher FAAO  Nagi Assaad MBBS MBiomedE FRANZCO  Michael P Hennessy MBBS MBiomedE FRANZCO  Michael Kalloniatis PhD MScOptom FAAO
Affiliation:1. Centre for Eye Health, The University of New South Wales, Kensington, New South Wales, Australia;2. School of Optometry and Vision Science, The University of New South Wales, Kensington, New South Wales, Australia;3. Department of Ophthalmology, Prince of Wales Hospital, Randwick, New South Wales, Australia
Abstract:White‐on‐white standard automated perimetry (SAP) is widely used in clinical and research settings for assessment of contrast sensitivity using incremental light stimuli across the visual field. It is one of the main functional measures of the effect of disease upon the visual system. SAP has evolved over the last 40 years to become an indispensable tool for comprehensive assessment of visual function. In modern clinical practice, a range of objective measurements of ocular structure, such as optical coherence tomography, have also become invaluable additions to the arsenal of the ophthalmic examination. Although structure‐function correlation is a highly desirable determinant of an unambiguous clinical picture for a patient, in practice, clinicians are often faced with discordance of structural and functional results, which presents them with a challenge. The construction principles behind the development of SAP are used to discuss the interpretation of visual fields, as well as the problem of structure‐function discordance. Through illustrative clinical examples, we provide useful insights to assist clinicians in combining a range of clinical results obtained from SAP and from advanced imaging techniques into a coherent picture that can help direct clinical management.
Keywords:Bloch's law  glaucoma  optical coherence tomography  perimetry  psychophysics  Ricco's law  spatial summation  structure‐function  temporal summation  tilted disc syndrome
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