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Review
. 2025 Jul 25;14(15):5266.
doi: 10.3390/jcm14155266.

Visual Field Examinations for Retinal Diseases: A Narrative Review

Ko Eun Kim  1 , Seong Joon Ahn  2
Affiliations
Review

Visual Field Examinations for Retinal Diseases: A Narrative Review

Ko Eun Kim et al. J Clin Med. .

Abstract

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.

Keywords: progression; retinal disease; screening; visual fields.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Test grid patterns for commonly used Humphrey visual field protocols: 10-2, 24-2, 24-2C, and 30-2.
Figure 2
Figure 2
Representative fundus autofluorescence images and corresponding visual field defects in (A) parafoveal and (B) pericentral patterns of retinopathy.
See this image and copyright information in PMC

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