Driving performance and behavior adaptation of glaucoma patients

Abstract

Purpose : The aim of this study was to assess the driving performance and the adaptation of patients with glaucoma in comparison to healthy subjects during a simulated driving test.

Methods : Driving performance and driving behavior of 13 glaucoma patients (GL) and 9 healthy control subjects (CO), matched for age and sex, were compared in a fixed base driving simulator. All subjects performed 4 scenarios including nine hazardous situations in urban roads. During the driving scenarios, several driving measures were collected including reaction time to hazardous situations as well as longitudinal regulation (speed, time headway) and lateral control (lateral position, duration of lateral excursion), on curved and straight roads.

Results : Mean binocular visual acuity (BCVA) was significantly different (p=.012) between GL (-0.13±0.14 LogMAR) and CO (-0.26±0.05 LogMAR). Compared to control subjects, glaucoma patients showed significantly longer reaction time (sec) when reacting to hazardous situations with pedestrians crossing from the left (GL: 1.59 ±0.50; CO: 0.90 ±0.26, p<.05), from the right (GL: 1.59 ±0.42; CO: 1.24 ±0.16, p<.01), and cars crossing from the left (GL: 3.14±0.53; CO: 2.72±0.23, p<.05). Analyses of driving behavioral adaptations in curved roads showed that glaucoma patients have a more inwardly lateral position (meters) in large left curves (GL: 0.22±0.27; CO: -0.14±0.26, p<.01), in small left curves (GL: 0.63±0.17; CO: 0.45±0.14, p<.05), and in small right curves (GL: -0.43±0.28; CO: -0.17±0.20, p<.05). They also had a longer mean duration of lateral excursion (sec) (GL: 3.89±8.52; CO: 0.00±0.00, p<.05) and higher number of lane crossings (GL: 1.08±2.02; CO: 0.00±0.00, p<.05). longer standard deviation of time headway (GL: 1.29±0.94; CO: 0.44±0.10, p<.05) with preceding cars compared to control subjects.

Conclusions : Our study suggests that glaucoma patients had unsafe driving attitudes in a virtual driving environment. The most problematic situations for glaucoma patients were those with small targets located in the peripheral visual field. They also showed unsafe lateral behavioral adaptation in curves and showed poor longitudinal regulation.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.