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Suzanne W. van Landingham, Chad Hochberg, Robert W. Massof, Emilie Chan, David S. Friedman, Pradeep Y. Ramulu; Driving Cessation, Driving Restriction, And Driver Preference In Older Adults With Glaucoma And Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4354.
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To determine if glaucoma and/or macular degeneration (AMD) is associated with driving limitation, driving cessation, or driver preference in older adults.
Fifty-eight control subjects with normal vision, 81 glaucoma patients with bilateral visual field (VF) loss, and 48 AMD subjects with bilateral or severe unilateral visual acuity (VA) loss reported their driving habits via questionnaires. All subjects were between the ages of 60 and 80. Main outcome measures were driving cessation, the number of driving limitations, and other driver preference (preferring another adult to drive when possible).
Driving cessation was noted in 22.5% glaucoma (p=0.01) and 28.3% AMD subjects (p=0.003) as compared to 6.9% of controls. More driving restrictions were present in glaucoma (mean=2.0, p=0.007) and AMD (mean=2.5, p<0.001) subjects than controls (mean=1.1). In multivariable models, driving cessation was more likely in glaucoma subjects as compared to controls (OR=4.0; 95% CI=1.1-14.7; P=0.03) and the odds of driving cessation doubled with each 5 decibel (dB) decrement in the better-eye VF (OR=2.0; 95% CI=1.4-2.9; p<0.001). Driving cessation was marginally more likely for AMD subjects (OR=3.6; 95% CI=0.94-14.2; p=0.06) and the odds of cessation increased with each one-line decrement in vision (OR=1.5; 95% CI=1.2-1.9; p<0.001). Glaucoma and AMD subjects were both more likely to report a greater number of driving restrictions than controls (OR=4.7; 95% CI=1.3-16.8; p=0.02 and OR=4.3; 95% CI 1.1-16.1; p=0.03), and the likelihood of reporting more restrictions increased with the severity of VF and VA loss (OR=1.6 / 5 dB decrement in the better-eye VF; 95% CI=1.1-2.4; p=0.02 and OR=2.0 / line of VA; 95% CI 1.4-3.0; p0.05 for both).
Glaucoma and AMD are associated with driving cessation and restriction of driving in the elderly, and driving becomes more limited with worsening VF and VA loss. These data indicate that glaucoma and AMD may have a substantial impact on independence and mobility in aging populations.
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