TY - JOUR
T1 - On-road Driving Performance of Patients with Bilateral Moderate and Advanced Glaucoma
AU - Bhorade, Anjali M.
AU - Yom, Victoria H.
AU - Barco, Peggy
AU - Wilson, Bradley
AU - Gordon, Mae
AU - Carr, David
N1 - Funding Information:
Funding/Support: This work was supported by awards from the Missouri Department of Transportation Traffic and Highway Safety Division, Jefferson City, Missouri; National Eye Institute, Bethesda, Maryland (1K23EY017616-01); American Glaucoma Society, San Francisco, California; Grace Nelson Lacey Grant, St Louis, Missouri; donations from the Schnuck and Wolff foundations, St. Louis, Missouri; unrestricted grants from Research to Prevent Blindness, New York, New York; National Institutes of Health Vision Core Grant P30 EY02687, Bethesda, Maryland; and the Washington University Institute of Clinical and Translational Sciences grants UL1 TR000448 and TL1 TR000449 from the National Center for Advancing Translational Sciences, Bethesda, Maryland. The funding organizations had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. Financial disclosures: Peggy Barco reports funding from the Missouri Department of Transportation during the conduct of the study. David Carr reports funding from the National Institute of Health, Missouri Department of Transportation, Traffic Injury Research Foundation, Medscape, American Automotive Association Foundation Traffic Safety, and State Farm Insurance. The following authors have no financial disclosures: Anjali M. Bhorade, Victoria H. Yom, Bradley Wilson, and Mae Gordon. All authors attest that they meet the current ICMJE criteria for authorship.
Publisher Copyright:
© 2016 Elsevier Inc. All rights reserved.
PY - 2016/6/1
Y1 - 2016/6/1
N2 - Purpose To compare on-road driving performance of patients with moderate or advanced glaucoma to controls and evaluate factors associated with unsafe driving. Design Case-control pilot study. Methods A consecutive sample of 21 patients with bilateral moderate or advanced glaucoma from Washington University, St Louis, Missouri and 38 community-dwelling controls were enrolled. Participants, aged 55-90 years, underwent a comprehensive clinical evaluation by a trained occupational therapist and an on-road driving evaluation by a masked driver rehabilitation specialist. Overall driving performance of pass vs marginal/fail and number of wheel and/or brake interventions were recorded. Results Fifty-two percent of glaucoma participants scored a marginal/fail compared to 21% of controls (odds ratio [OR], 4.1; 95% CI, 1.30-13.14; P =.02). Glaucoma participants had a higher risk of wheel interventions than controls (OR, 4.67; 95% CI, 1.03-21.17; P =.046). There were no differences detected between glaucoma participants who scored a pass vs marginal/fail for visual field mean deviation of the better (P =.62) or worse (P =.88) eye, binocular distance (P =.15) or near (P =.23) visual acuity, contrast sensitivity (P =.28), or glare (P =.88). However, glaucoma participants with a marginal/fail score performed worse on Trail Making Tests A (P =.03) and B (P =.05), right-sided Jamar grip strength (P =.02), Rapid Pace Walk (P =.03), Braking Response Time (P =.03), and identifying traffic signs (P =.05). Conclusions Patients with bilateral moderate or advanced glaucoma are at risk for unsafe driving - particularly those with impairments on psychometric and mobility tests. A comprehensive clinical assessment and on-road driving evaluation is recommended to effectively evaluate driving safety of these patients.
AB - Purpose To compare on-road driving performance of patients with moderate or advanced glaucoma to controls and evaluate factors associated with unsafe driving. Design Case-control pilot study. Methods A consecutive sample of 21 patients with bilateral moderate or advanced glaucoma from Washington University, St Louis, Missouri and 38 community-dwelling controls were enrolled. Participants, aged 55-90 years, underwent a comprehensive clinical evaluation by a trained occupational therapist and an on-road driving evaluation by a masked driver rehabilitation specialist. Overall driving performance of pass vs marginal/fail and number of wheel and/or brake interventions were recorded. Results Fifty-two percent of glaucoma participants scored a marginal/fail compared to 21% of controls (odds ratio [OR], 4.1; 95% CI, 1.30-13.14; P =.02). Glaucoma participants had a higher risk of wheel interventions than controls (OR, 4.67; 95% CI, 1.03-21.17; P =.046). There were no differences detected between glaucoma participants who scored a pass vs marginal/fail for visual field mean deviation of the better (P =.62) or worse (P =.88) eye, binocular distance (P =.15) or near (P =.23) visual acuity, contrast sensitivity (P =.28), or glare (P =.88). However, glaucoma participants with a marginal/fail score performed worse on Trail Making Tests A (P =.03) and B (P =.05), right-sided Jamar grip strength (P =.02), Rapid Pace Walk (P =.03), Braking Response Time (P =.03), and identifying traffic signs (P =.05). Conclusions Patients with bilateral moderate or advanced glaucoma are at risk for unsafe driving - particularly those with impairments on psychometric and mobility tests. A comprehensive clinical assessment and on-road driving evaluation is recommended to effectively evaluate driving safety of these patients.
UR - http://www.scopus.com/inward/record.url?scp=84964344687&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2016.02.031
DO - 10.1016/j.ajo.2016.02.031
M3 - Article
C2 - 26949136
AN - SCOPUS:84964344687
VL - 166
SP - 43
EP - 51
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
SN - 0002-9394
ER -