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A. M. Stevens, E. Leloup, D. De Bacquer, P. G. Kestelyn, I. Stalmans, M. Tant, T. Zeyen; Glaucoma and Fitness to Drive. Invest. Ophthalmol. Vis. Sci. 2010;51(13):208.
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© ARVO (1962-2015); The Authors (2016-present)
to assess whether a number of perimetric strategies and the UFOV test, alone or in combination, are able to predict the outcome of an on the road driving test (apt, unapt, or apt with restrictions) in glaucoma patients.
50 glaucoma patients with binocular field damage, holder of a driving licence and active drivers, were asked to fill in a questionnaire about their medical history, driving habits and motor vehicle collisions. Subsequently, they underwent a comprehensive ophthalmic examination including a battery of perimetric tests: Goldmann, Octopus 30-2 and Esterman. Finally, they performed a UFOV test, a Mini Mental status and a practical driving test on the road under supervision of an expert of the Belgian Road Safety Institute. This practical test is considered the gold standard for evaluating the driving aptitude in Belgium.
Patients were 65 years on average (range 37-83 years); 32% of the drivers were female. The DVLA (Driver and Vehicle Licensing Agency)criteria, the current medical standards of fitness to drive in the United Kingdom, were met by 71% of patients. Overall, 20% of drivers failed the driving test while another 40% were found to be apt with restrictions. The agreement between the DVLA assessment and the driving test was weak (Kappa statistic 0.34). The patient 's age correlated strongly with the results of the integrated visual field (IVF) (Spearman rho 0.59) and the UFOV (Spearman rho 0.69) but not with the Esterman test results. ROC analysis revealed a superior predictive value of the UFOV test and the IVF with area-under-the-curve (AUC) values of 0.9 and 0.77 respectively. The predictive power associated with the Esterman score (AUC 0.71) seemed independent of age. The predictive power of UFOV, IVF and age combined was 0.96.
1)The combination of the patient's age, his performance on the UFOV test and his IVF is a reliable predictor of his ability to successfully perform a practical on the road driving test. 2)Younger patients with severe visual field damage are more likely to pass the practical driving test than older patients with similar field damage. 3) In our sample the DVLA criteria of the UK did not correlate well with the practical driving test in Belgium.
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