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G. McGwin, A. Xie, A. Mays, W. Joiner, D. DeCarlo, T. Hall, C. Owsley; Visual Field Defects and the Risk of Motor Vehicle Collisions Among Patients With Glaucoma . Invest. Ophthalmol. Vis. Sci. 2005;46(13):3523.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To evaluate the association between visual field defects in the central 24° field and the risk of motor vehicle collisions (MVC) among patients with glaucoma. Methods: A case–control study was conducted on glaucoma patients aged 55 and older being treated at three university–affiliated eye care practices. Cases were patients who sustained a police–reported motor vehicle collision (MVC); controls were those who did not experience an MVC. For each patient, an Advanced Glaucoma Intervention Study (AGIS) score was calculated on automated visual fields collected with the 24–2 or 30–2 programs. Analyses were conducted for the better and worse eye (defined based upon AGIS score) separately. Additionally, demographic, behavioral, driving and clinical characteristics were obtained via chart abstractions and patient telephone survey. Results: With respect to the better eye AGIS score, compared to patients with no visual field defect, those with severe defects (scores 12–20) had an increased risk of MVC (odds ratio [OR] 3.2, 95% confidence interval [CI] 0.9–10.4), although this association was not statistically significant (p=0.0576). Moderate (6–11) or minor field defects (1–5) in the better eye were not associated with the risk of crash involvement. For the worse eye, patients with moderate and severe field defects were at significantly increased risk of a MVC (OR 3.6, 95% CI 1.4–9.4 and OR 4.4, 95% CI 1.6–12.4 respectively) compared to those with no defects. Minor field defects in the worse eye did not increase MVC risk (OR 1.3, 95% CI 0.5–3.4). These associations were adjusted for demographic, behavioral, driving and clinical characteristics. Conclusions: Glaucoma patients with moderate or severe visual field impairment in the central 24° radius field in the worse functioning eye are at increased risk of involvement in a vehicle crash.
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