Abstract
Abstract: :
Purpose: 1.To calculate stage related the incidence of patients with bilateral Visual Field Loss (VFL) in different types of glaucoma. Are there any differences in visual field related disability to drive a car between the glaucomas? 2.To calculate for patients which all have VFL the relative frequency of moderate and severe VFL for the different types of glaucoma. Which type of glaucoma shows the more severe VFL ? 3.To calculated for POAG the relative frequency of patients with moderate to severe VFL within seven age groups. Methods: In 2170 consecutive glaucoma patients we staged the visual field findings in both eyes into 4 groups (1–4):1.No VFL,2.Beginning VFL (stage I and II, classification of Aulhorn),3.Moderate VFL (stage III and IV),4.severe VFL (Stage V). Patients with stage V, IV or III in both eyes were classified as unable to drive. Patients with no visual field loss in one eye and VFL I–V in the other eye were classified as able to drive. All other constellations e.g. stage I in one eye and stage II in the second eye were classified as questionable to drive a car. All patients were asked about their age at diagnosis. Visual field loss was used as the only criteria to judge the ability to drive. Results: 1.Unable to drive due to VFL only were in: POAG 11,5% (154 out of 1338), Normal Tension Glaucoma (NTG) 19,61% (30 of 153), Pigmentary Glaucoma (PG) 16% (8 of 50), Pseudoexfoliation glaucoma (PEX) 9,1% (6 of 66). A questionable ability to drive was found in: POAG 29,2%, NTG 43,1%, PG 22,0%, PEX 16,7%.2. In the eye with the more severe VFL a stage III to V was found in patients with VFL in: POAG in 36% (215 out of 597 patients), NTG 51,5% (51 of 99), PG 41,7% (10 of 24), PEX 58,8% (20 of 34).3. In patients with POAG in the eye with the more severe VFL a VFL Stage III to V was found within the age groups up to 30 years in 8,9%, 31–40 years 16,1%, 41–50 years 14,0%, 51–60 years 22,0%, 61–70 years 25,7%, 71–80 years 34,3%, 80 years and above 41,7%. Conclusions: There are differences in the VFL related disability to drive between glaucomas. The relative low incindence of severe VFL in POAG results from a large number of preperimetric glaucomas. In spite of the same average age there is more often a severe VFL in NTG compared to POAG. The higher the age at diagnosis the more severe the VFL. These results indicate that a disease specific, age related visual field control is absolutely essential for road safety.
Keywords: clinical (human) or epidemiologic studies: prevalence/incidence