TY - JOUR
T1 - The role of specific visual subfields in collisions with oncoming cars during simulated driving in patients with advanced glaucoma
AU - Kunimatsu-Sanuki, Shiho
AU - Iwase, Aiko
AU - Araie, Makoto
AU - Aoki, Yuki
AU - Hara, Takeshi
AU - Fukuchi, Takeo
AU - Udagawa, Sachiko
AU - Ohkubo, Shinji
AU - Sugiyama, Kazuhisa
AU - Matsumoto, Chota
AU - Nakazawa, Toru
AU - Yamaguchi, Takuhiro
AU - Ono, Hiroshi
N1 - Funding Information:
Funding This work was supported by Japan Society for the Promotion of Science KAKENHI grant number 26462630.
Publisher Copyright:
© 2017 BMJ Publishing Group. All Rights Reserved.
PY - 2017/7/1
Y1 - 2017/7/1
N2 - Background/aims To assess the role of specific visual subfields in collisions with oncoming cars during simulated driving in patients with advanced glaucoma. Methods Normal subjects and patients with glaucoma with mean deviation <–12 dB in both eyes (Humphrey Field Analyzer 24-2 SITA-S program) used a driving simulator (DS; Honda Motor, Tokyo). Two scenarios in which oncoming cars turned right crossing the driver’s path were chosen. We compared the binocular integrated visual field (IVF) in the patients who were involved in collisions and those who were not. We performed a multivariate logistic regression analysis; the dependent parameter was collision involvement, and the independent parameters were age, visual acuity and mean sensitivity of the IVF subfields. Results The study included 43 normal subjects and 100 patients with advanced glaucoma. And, 5 of the 100 patients with advanced glaucoma experienced simulator sickness during the main test and were thus excluded. In total, 95 patients with advanced glaucoma and 43 normal subjects completed the main test of DS. Advanced glaucoma patients had significantly more collisions than normal patients in one or both DS scenarios (p<0.001). The patients with advanced glaucoma who were involved in collisions were older (p=0.050) and had worse visual acuity in the better eye (p<0.001) and had lower mean IVF sensitivity in the inferior hemifield, both 0°–12° and 13°–24° in comparison with who were not involved in collisions (p=0.012 and p=0.034). A logistic regression analysis revealed that collision involvement was significantly associated with decreased inferior IVF mean sensitivity from 13° to 24° (p=0.041), in addition to older age and lower visual acuity (p=0.018 and p<0.001). Conclusions Our data suggest that the inferior hemifield was associated with the incidence of motor vehicle collisions with oncoming cars in patients with advanced glaucoma.
AB - Background/aims To assess the role of specific visual subfields in collisions with oncoming cars during simulated driving in patients with advanced glaucoma. Methods Normal subjects and patients with glaucoma with mean deviation <–12 dB in both eyes (Humphrey Field Analyzer 24-2 SITA-S program) used a driving simulator (DS; Honda Motor, Tokyo). Two scenarios in which oncoming cars turned right crossing the driver’s path were chosen. We compared the binocular integrated visual field (IVF) in the patients who were involved in collisions and those who were not. We performed a multivariate logistic regression analysis; the dependent parameter was collision involvement, and the independent parameters were age, visual acuity and mean sensitivity of the IVF subfields. Results The study included 43 normal subjects and 100 patients with advanced glaucoma. And, 5 of the 100 patients with advanced glaucoma experienced simulator sickness during the main test and were thus excluded. In total, 95 patients with advanced glaucoma and 43 normal subjects completed the main test of DS. Advanced glaucoma patients had significantly more collisions than normal patients in one or both DS scenarios (p<0.001). The patients with advanced glaucoma who were involved in collisions were older (p=0.050) and had worse visual acuity in the better eye (p<0.001) and had lower mean IVF sensitivity in the inferior hemifield, both 0°–12° and 13°–24° in comparison with who were not involved in collisions (p=0.012 and p=0.034). A logistic regression analysis revealed that collision involvement was significantly associated with decreased inferior IVF mean sensitivity from 13° to 24° (p=0.041), in addition to older age and lower visual acuity (p=0.018 and p<0.001). Conclusions Our data suggest that the inferior hemifield was associated with the incidence of motor vehicle collisions with oncoming cars in patients with advanced glaucoma.
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U2 - 10.1136/bjophthalmol-2016-308754
DO - 10.1136/bjophthalmol-2016-308754
M3 - Article
C2 - 28400370
AN - SCOPUS:84992088973
SN - 0007-1161
VL - 101
SP - 896
EP - 901
JO - British Journal of Ophthalmology
JF - British Journal of Ophthalmology
IS - 7
ER -