September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
The longitudinal relationship between rates of progressive retinal nerve fiber layer (RNFL) loss and driving performance in glaucoma.
Author Affiliations & Notes
  • Andrew J Tatham
    Visual Performance Laboratory, Department of Ophthalmology, University of California San Diego, La Jolla, California, United States
    Princess Alexandra Eye Pavilion and Department of Ophthalmology, University of Edinburgh, Edinburgh, Scotland, United Kingdom
  • Alberto Diniz-Filho
    Visual Performance Laboratory, Department of Ophthalmology, University of California San Diego, La Jolla, California, United States
    Department of Ophthalmology and Otorhinolaryngology, Federal University of Minas Gerais, Belo Horizonte, Brazil
  • Erwin R Boer
    Visual Performance Laboratory, Department of Ophthalmology, University of California San Diego, La Jolla, California, United States
  • Felipe A Medeiros
    Visual Performance Laboratory, Department of Ophthalmology, University of California San Diego, La Jolla, California, United States
  • Footnotes
    Commercial Relationships   Andrew Tatham, Alcon (R), Heidelberg Engineering (F), Thea (R); Alberto Diniz-Filho, None; Erwin Boer, None; Felipe Medeiros, Alcon Laboratories Inc. (F), Alcon Laboratories Inc. (R), Allergan Inc. (F), Allergan Inc. (R), Allergan Inc. (C), Bausch & Lomb (F), Carl Zeiss Meditec Inc (F), Carl Zeiss Meditec Inc (R), Carl Zeiss Meditec Inc (C), Heidelberg Engineering Inc (F), Merck Inc. (F), National Eye Institute (F), Novartis (C), Reichert Inc (R), Reichert Inc (F), Sensimed (F), Topcon Inc (F)
  • Footnotes
    Support  Supported in part by National Institutes of Health/National Eye Institute grant R01 EY021818 (F.A.M.) and core grant P30EY022589.
Investigative Ophthalmology & Visual Science September 2016, Vol.57, No Pagination Specified. doi:
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Andrew J Tatham, Alberto Diniz-Filho, Erwin R Boer, Felipe A Medeiros; The longitudinal relationship between rates of progressive retinal nerve fiber layer (RNFL) loss and driving performance in glaucoma.. Invest. Ophthalmol. Vis. Sci. 201657(12):.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : Inability to drive is a major concern for patients with glaucoma. The purpose of this study was to examine the longitudinal relationship between rate of change in RNFL thickness and change in ability to divide attention during a simulated driving task.

Methods : 152 glaucoma patients were followed for an average of 3.7 years. At each visit investigations included visual acuity, contrast sensitivity, perimetry and optical coherence tomography (OCT). Ability to divide attention was assessed using a driving simulator to measure reaction times to stimuli presented simultaneously during two central tasks 1) curve negotiation and 2) car following. A joint longitudinal multivariate mixed model was used to investigate the association between rates of change in driving performance and RNFL thickness over time. Reaction time values were positively skewed therefore natural logarithms were calculated. The effect of potentially confounding variables including integrated binocular visual field (BVF), age, gender, race, and Montreal Cognitive Assessment score was also investigated.

Results : Average age at baseline was 64.8 ± 11.2 years. RNFL thickness in better and worst eyes was 84.8 ± 15.1 μm and 76.8 ± 16.7 μm respectively. The average rate of better eye RNFL loss was 0.4 ± 0.5 μm/year. Progressive RNFL loss was associated with increased reaction time to the curve negotiation divided attention task. Each 1μm/year faster loss was associated with a 0.02 ln unit/year increase in reaction time (R2 = 10.9%, P < 0.001) (Figure 1). In a multivariable model, accounting for change in BVF sensitivity over time, visual acuity, contrast sensitivity, age, gender and cognitive ability, each 1μm/year faster RNFL loss was associated with a 0.02 ln unit/year increase in reaction time (R2 = 40.1%, P < 0.001). Similar results were found for the car following divided attention task. Each 1μm/year faster loss was associated with a 0.09 ln unit/year increase in reaction time (R2 = 29.4%, P < 0.001).

Conclusions : Faster rates of glaucomatous RNFL loss were associated with worse simulated driving performance over time, with RNFL measurements providing additional information to BVF sensitivity. Inclusion of structural measurements may improve the ability to determine which patients with glaucoma are likely to develop impaired ability to perform tasks requiring divided attention.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×