Phenotypic Analysis of Intentionally Created Monocular Visual Field Defects During Bilateral Randomized Visual Field Testing Using the Imo Vifa®

Sep 30, 2026

The imo Vifa® perimeter is used for diagnosing functional visual field loss, but its value for detecting malingering has remained unclear. This study intentionally simulated monocular visual field defects under bilateral randomized visual field testing in healthy participants and compared resulting defect phenotypes. Twenty participants without ocular disease produced four defect types (nasal hemianopia, temporal hemianopia, centripetal constriction, central scotoma). Simulation accuracy was difficult, with patterns varying by participants’ understanding of visual field testing.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

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Abstract

1. Introduction

Background/Objectives

Methods

Results

Conclusions

Article Phenotypic Analysis of Intentionally Created Monocular Visual Field Defects During Bilateral Randomized Visual Field Testing Using the Imo Vifa® Yuiko Kawaguchi 1,*, Yuki Takagi 1,2, Takashi Kojima 1,3, Akeno Tamaoki 1 and Tatsushi Kaga 1 Academic Editor: Brent Siesky and Makoto Inoue Received: 13 November 2025 Revised: 9 December 2025 Accepted: 17 December 2025 Published: 19 December 2025 Copyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. 1 Department of Ophthalmology, Japan Community Healthcare Organization Chukyo Hospital, 1-1-10 Sanjo, Minami-ku, Nagoya 457-8510, Aichi, Japan; [ytakagi@sanjogroup.jp](ytakagi@sanjogroup.jp) (Y.T.); [kojima@sanjogroup.jp](kojima@sanjogroup.jp) (T.K.); [tamaoki@chukyogroup.jp](tamaoki@chukyogroup.jp) (A.T.); [kaga@sanjogroup.jp](kaga@sanjogroup.jp) (T.K.) 2 Department of Ophthalmology, Japan Community Healthcare Organization Kanitono Hospital, 1221-5 Dota, Kani 509-0206, Gifu, Japan 3 Nagoya Eye Clinic, Kanayama, COLLECT-MARK, 24-14, Namiyose-cho, Atsuta-ku, Nagoya 456-0003, Aichi, Japan * Correspondence: [kawaguchi_yuiko@chukyogroup.jp](kawaguchi_yuiko@chukyogroup.jp); Tel.: +81-52-691-7151 Abstract Background/Objectives: The imo Vifa® is reportedly useful for diagnosing functional visual field loss; however, its potential for detecting malingering is unclear. Here, we intentionally simulated monocular visual field defects under bilateral randomized visual field testing conditions using the imo Vifa® in healthy participants and compared their resulting defect phenotypes. Methods: Twenty participants (mean age, 37.3 ± 12.4 years; 12 orthoptists, 1 physician, and 7 administrative staff members) without ocular disease were enrolled. Four types of monocular visual field defects were simulated: right eye nasal hemianopia, left eye temporal hemianopia, right eye centripetal visual field constriction, and left eye central scotoma. Bilateral randomized visual field testing was performed using the AIZErapid mode with the 24-2 and 24plus(1) programs. Results: Accurate simulation of the intended defects was challenging. Orthoptists produced left homonymous hemianopia for right nasal hemianopia and left temporal hemianopia. Regarding right nasal hemianopia, many office workers generated patterns resembling right homonymous hemianopia-like, whereas for left temporal hemianopia, noncertified orthoptists produced patterns similar to those of left homonymous hemianopia-like. Considering the right centripetal constriction, all orthoptists produced the intended centripetal constriction, whereas non-orthoptists generated right homonymous hemianopia-like or patchy patterns. Orthoptists produced central scotomas or patchy patterns for the left central scotoma, whereas non-orthoptists generated left homonymous hemianopia-like patterns. Conclusions: Creating targeted monocular abnormalities during bilateral randomized visual field testing was challenging. Differences in the participants’ understanding of visual field testing influenced the resulting patterns. In future research, having participants create monocular visual field defects under occlusion conditions would be necessary. Keywords: visual field test; imo Vifa® ; bilateral randomized visual field testing; simulated visual field defect 1. Introduction Functional visual loss refers to visual impairment, including decreased visual acuity or visual field defects in the absence of any organic ocular pathology [1] . This impairment is most frequently observed in girls aged 9–11 years [2] . Meanwhile, malingering is the deliberate feigning of visual loss, often for secondary gains such as economic or legal benefits [3] . However, visual evoked potentials can be objectively measured and are considered useful for diagnosing psychogenic visual field defects [4–6] . Ruling

FAQs

What was the goal of the study using the imo Vifa® perimeter?

To intentionally simulate monocular visual field defects during bilateral randomized testing and compare the resulting defect phenotypes, clarifying whether the approach can reflect functional loss patterns.

Which monocular visual field defects were simulated?

Right eye nasal hemianopia, left eye temporal hemianopia, right eye centripetal constriction, and left eye central scotoma.

Why were the intended defect simulations challenging?

Accurate simulation was difficult, and the resulting patterns were influenced by participants’ understanding of visual field testing.

Sep 30, 2026

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