July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
Binocular visual fields, simulated driving performance and self-reported driving in glaucoma.
Author Affiliations & Notes
  • John Paul Bader
    College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, United States
  • David Anderson
    Neurological Sciences, University of Nebraska Medical Center, Omaha, Nebraska, United States
  • Madeleine Sharp
    Neurological Sciences, University of Nebraska Medical Center, Omaha, Nebraska, United States
  • Matthew Rizzo
    Neurological Sciences, University of Nebraska Medical Center, Omaha, Nebraska, United States
  • Deepta A Ghate
    Ophthalmology and Visual Sciences, University of Nebraska Medical Center, Omaha, Nebraska, United States
  • Footnotes
    Commercial Relationships   John Bader, None; David Anderson, None; Madeleine Sharp, None; Matthew Rizzo, None; Deepta Ghate, None
  • Footnotes
    Support  NIGMS 1U54GM115458-02, NIA R01 AG017177
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 1392. doi:https://doi.org/
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    • Get Citation

      John Paul Bader, David Anderson, Madeleine Sharp, Matthew Rizzo, Deepta A Ghate; Binocular visual fields, simulated driving performance and self-reported driving in glaucoma.. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1392. doi: https://doi.org/.

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

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Abstract

Purpose : Drivers with glaucoma show increased driving safety risk. We tested the hypothesis that binocular visual field loss affects driving performance and self-reported driving in glaucoma.

Methods : We studied 17 drivers: 7 with glaucomatous field defects (Visual field index (VFI) range: 21-97%) and 10 glaucoma suspects with full fields. Binocular VFI (VFI-OU) was calculated using integrated monocular fields from the Humphrey Visual Field (HVF) Analyzer. Subjects were tested in an immersive driving simulator (full car, interactive controls, 290° forward field of view) in driving scenarios on an empty highway with a concurrent in-simulator visual field task (Anderson 2017, https://doi.org/10.17077/drivingassessment.1607). Driving metrics were acceleration (lateral, longitudinal), steering wheel position, accelerator pedal position, and velocity. The National Eye Institute 25-Item Visual Function Questionnaire (NEI-VFQ) indexed driver self-reported visual quality of life (global and driving subscale scores). Group comparison used independent-sample t-tests. Pearson correlations evaluated the relationship between VFI-OU, driving metrics and NEI-VFQ scores across all subjects.

Results : While glaucoma subjects were older (74 v 57 years, p<0.05), age was not significantly correlated (p>0.10) with VFI-OU, NEI-VFQ global or driving scores. Glaucoma group had significantly (p<0.05) lower NEI-VFQ driving scores (74 v 90) and global scores (83 v 92) and higher lateral acceleration variability (0.008 v 0.003) compared to the comparison group. Other driving metrics did not differ significantly between groups.

Decreased VFI-OU was associated (p<0.05) with increased steering wheel position variability (r= -0.54), lateral acceleration variability (r= -0.62) and decreased NEI-VFQ global score (r= 0.52). Increased global NEI-VFQ score was associated (p<0.05) with increasing maximum velocity (r=0.48). Decreased NEI-VFQ driving score was associated (p<0.05) with increased steering wheel position variability (r= -0.64) and lateral acceleration variability (r= -0.54).

Conclusions : Binocular field deficits and self-reported driving performance correlated with poorer vehicle control measures even in the absence of on-road hazards. These results suggest a categorical glaucoma diagnosis (with a wide range of disease severity) may not be as sensitive to driving performance as VFI-OU.

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

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