Longitudinal Simulated Driving Performance and Rates of Progressive Visual Field Loss in Glaucoma.
Malek Davina A, Diniz-Filho Alberto, Boer Erwin R, Medeiros Felipe A
AI Summary
Glaucoma patients with faster visual field loss showed worsening divided attention during driving simulation, indicating increased risk for driving performance decline.
Abstract
Purpose
The purpose of this study was to evaluate the association between longitudinal changes in driving performance, assessed through driving simulation, and rates of progressive visual field (VF) loss in patients with glaucoma.
Methods
Ninety-five patients with glaucoma underwent Standard Automated Perimetry (SAP) and driving simulations every 6 months. Rates of VF loss were estimated by changes in mean sensitivity (MS) of the integrated binocular VF over time. Driving performance was assessed using a simulator by maintaining lane position on a winding road while responding to peripheral visual stimuli to assess divided attention. Reaction time (RT) recorded the duration between the presentation of the stimuli and the participant's response. Linear mixed models evaluated longitudinal changes in SAP MS and mean RT. Multivariable linear regression models were used to predict driving performance, adjusting for age, cognitive impairment, and driving exposure.
Results
Progressive VF loss was associated with a longitudinal increase in mean RT to the divided attention task. In the multivariable model, each 1 decibel (dB)/year faster loss of integrated binocular MS was associated with a 0.024 logarithms (ln) s/year increase in mean RT (95% confidence interval [CI] = 0.007 to 0.042, P = 0.008). Baseline MS also significantly influenced driving performance, with each 10 dB worse baseline binocular MS associated with a 0.031 ln s/year increase in mean RT (95% CI = 0.016 to 0.045, P < 0.001).
Conclusions
Faster VF progression in patients with glaucoma was associated with worsening performance on a divided attention task during driving simulation.
Translational relevance: Patients with glaucoma who exhibit faster VF progression may be at greater risk for a decline in driving performance.
MeSH Terms
Shields Classification
Key Concepts4
In patients with glaucoma, faster visual field (VF) progression was associated with worsening performance on a divided attention task during driving simulation.
In patients with glaucoma, each 1 decibel (dB)/year faster loss of integrated binocular mean sensitivity (MS) was associated with a 0.024 logarithms (ln) s/year increase in mean reaction time (RT) to a divided attention task during driving simulation (95% confidence interval [CI] = 0.007 to 0.042, P = 0.008).
In patients with glaucoma, each 10 dB worse baseline binocular mean sensitivity (MS) was associated with a 0.031 logarithms (ln) s/year increase in mean reaction time (RT) to a divided attention task during driving simulation (95% CI = 0.016 to 0.045, P < 0.001).
A prospective cohort study of 95 patients with glaucoma evaluated the association between longitudinal changes in driving performance, assessed through driving simulation, and rates of progressive visual field (VF) loss.
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