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Prethy Rao, Beatriz Munoz, Kathleen Turano, Cynthia Munro, Sheila K. West; The Decline in Attentional Visual Fields over Time among Older Participants in the Salisbury Eye Evaluation Driving Study. Invest. Ophthalmol. Vis. Sci. 2013;54(3):1839-1844. doi: 10.1167/iovs.11-8874.
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© ARVO (1962-2015); The Authors (2016-present)
The loss of attentional visual field (AVF) has been linked to poor mobility and car crashes. We investigated the risk factors associated with a decrease in AVF over time among participants in the Salisbury Eye Evaluation Driving Study (SEEDS).
In a longitudinal cohort of 968 individuals ages 67 to 87, demographic, medical, visual, and cognitive factors were obtained at baseline (2005–2006) and follow-up (2007–2008) using structured medical questionnaires and onsite examinations. Using the standard deviation for the difference in AVF over 2 years of 4.3°, two subgroups were created: Those who lost 5° or more in two years and those who had no loss (i.e., loss of 5° or less, or no loss). Age-adjusted and multivariate odds ratios (OR) with 95% confidence intervals (95% CI) for each explanatory factor were determined using logistic regression.
The overall change in AVF was −0.34° (SD = 4.32), which was a significant decline from baseline. Of the population, 14% lost 5° or more of AVF. The following determinants were associated with a minimum loss of 5° over 2 years: female sex (OR = 1.59, P = 0.03), history of stroke (OR = 1.90, P = 0.03), depression (OR = 1.07, P = 0.02), a lower baseline Trails A and B scores (OR = 1.09, P = 0.003 and OR = 1.02, P = 0.02, respectively), and lower baseline visual acuity (OR = 1.21, P = 0.03). In addition, decline was related to a lower baseline measure of auditory attention (OR = 1.14, P = 0.007) and lower baseline visual fields in the central 20° (OR = 1.24, P = 0.01).
Loss in AVF over time is related independently to decrements in cognition and vision. The higher odds of loss in female subjects, independent of these factors, deserves further research.
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