TY - JOUR
T1 - Driving habits in older patients with central vision loss
AU - Sengupta, Sabyasachi
AU - Van Landingham, Suzanne W.
AU - Solomon, Sharon D.
AU - Do, Diana V.
AU - Friedman, David S.
AU - Ramulu, Pradeep Y.
N1 - Funding Information:
Supported in part by the Dennis W. Jahnigen Memorial Award (American Geriatrics Society, New York, New York); the National Institutes of Health , Bethesda, Maryland (grant no.: EY018595 ); Research to Prevent Blindness Robert and Helen Schaub Special Scholar Award, New York, New York; the Intramural Research Program of the National Institute on Aging, National Institutes of Health, Bethesda, Maryland; and the Doris Duke Charitable Research Foundation Clinical Research Fellowship, New York, New York. All funding organizations had no role in the design or conduct of this research.
PY - 2014/3
Y1 - 2014/3
N2 - Objective To determine if central visual loss is associated with driving cessation, driving restriction, or other-driver preference. Design Cross-sectional study. Participants Sixty-four subjects with bilateral visual loss (<20/32 in better eye) or severe unilateral visual loss (<20/200) from age-related macular degeneration (AMD) and 58 normally sighted controls between 60 and 80 years of age. Methods Participants self-reported driving habits. Other-driver preference was defined as preferring that another drive when there is more than 1 driver in the car. Subjects reporting 2 or more driving limitations were considered to have restricted their driving. Main Outcome Measures Self-reported driving cessation, other-driver preference, and driving restriction. Results Age-related macular degeneration subjects were older (74.7 vs. 69.7 years), had worse visual acuity (VA; mean better-eye VA, 0.43 vs. 0.08 logarithm of minimum angle of resolution [logMAR]) and contrast sensitivity (CS; 1.4 vs. 1.9 log units of CS [logCS]), and were more likely to be white when compared with controls (P < 0.001 for all). Drivers with AMD-related vision loss were more likely to avoid driving over longer distances, beyond 1 hour, at night, and in unfamiliar conditions (P < 0.05 for all). In multivariate models, driving cessation was associated with worse better-eye VA (odds ratio [OR], 1.5 per 1-line decrement in VA; P < 0.001) and worse binocular CS (OR, 1.36 per 0.1 logCS increment; P = 0.005); however, AMD group status was not associated with driving cessation (OR, 1.9; P = 0.35). Factors predicting driving restriction were AMD (OR, 9.0; P = 0.004), worse vision (OR, 2.5 per line of VA loss; P < 0.001), lower CS (OR, 2.2 per 0.1-logCS increment; P < 0.001), and female gender (OR, 27.9; P = 0.002). Other-driver preference was more common with worse vision (OR, 1.6 per 0.1-logMAR increment; P = 0.003), female gender (OR, 4.5; P = 0.02), and being married (OR, 3.8; P = 0.04). Conclusions Most patients with AMD-related central vision loss continue to drive, but demonstrate significant driving restrictions, especially with more severe VA and CS loss. Future work should determine which driving adaptations the visually impaired best balance safety and independence.
AB - Objective To determine if central visual loss is associated with driving cessation, driving restriction, or other-driver preference. Design Cross-sectional study. Participants Sixty-four subjects with bilateral visual loss (<20/32 in better eye) or severe unilateral visual loss (<20/200) from age-related macular degeneration (AMD) and 58 normally sighted controls between 60 and 80 years of age. Methods Participants self-reported driving habits. Other-driver preference was defined as preferring that another drive when there is more than 1 driver in the car. Subjects reporting 2 or more driving limitations were considered to have restricted their driving. Main Outcome Measures Self-reported driving cessation, other-driver preference, and driving restriction. Results Age-related macular degeneration subjects were older (74.7 vs. 69.7 years), had worse visual acuity (VA; mean better-eye VA, 0.43 vs. 0.08 logarithm of minimum angle of resolution [logMAR]) and contrast sensitivity (CS; 1.4 vs. 1.9 log units of CS [logCS]), and were more likely to be white when compared with controls (P < 0.001 for all). Drivers with AMD-related vision loss were more likely to avoid driving over longer distances, beyond 1 hour, at night, and in unfamiliar conditions (P < 0.05 for all). In multivariate models, driving cessation was associated with worse better-eye VA (odds ratio [OR], 1.5 per 1-line decrement in VA; P < 0.001) and worse binocular CS (OR, 1.36 per 0.1 logCS increment; P = 0.005); however, AMD group status was not associated with driving cessation (OR, 1.9; P = 0.35). Factors predicting driving restriction were AMD (OR, 9.0; P = 0.004), worse vision (OR, 2.5 per line of VA loss; P < 0.001), lower CS (OR, 2.2 per 0.1-logCS increment; P < 0.001), and female gender (OR, 27.9; P = 0.002). Other-driver preference was more common with worse vision (OR, 1.6 per 0.1-logMAR increment; P = 0.003), female gender (OR, 4.5; P = 0.02), and being married (OR, 3.8; P = 0.04). Conclusions Most patients with AMD-related central vision loss continue to drive, but demonstrate significant driving restrictions, especially with more severe VA and CS loss. Future work should determine which driving adaptations the visually impaired best balance safety and independence.
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U2 - 10.1016/j.ophtha.2013.09.042
DO - 10.1016/j.ophtha.2013.09.042
M3 - Article
C2 - 24290805
AN - SCOPUS:84896705607
SN - 0161-6420
VL - 121
SP - 727
EP - 732
JO - Ophthalmology
JF - Ophthalmology
IS - 3
ER -