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Guidi S, Kosovicheva A, Wolfe B. Seeing the truck, but missing the cyclist: effects of blur on duration thresholds for road hazard detection. Cogn Res Princ Implic 2024; 9:32. [PMID: 38767722 PMCID: PMC11106223 DOI: 10.1186/s41235-024-00557-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 05/04/2024] [Indexed: 05/22/2024] Open
Abstract
Drivers must respond promptly to a wide range of possible road hazards, from trucks veering into their lane to pedestrians stepping onto the road. While drivers' vision is tested at the point of licensure, visual function can degrade, and drivers may not notice how these changes impact their ability to notice and respond to events in the world in a timely fashion. To safely examine the potential consequences of visual degradation on hazard detection, we performed two experiments examining the impact of simulated optical blur on participants' viewing duration thresholds in a hazard detection task, as a proxy for eyes-on-road duration behind the wheel. Examining this question with older and younger participants, across two experiments, we found an overall increase in viewing duration thresholds under blurred conditions, such that younger and older adults were similarly impacted by blur. Critically, in both groups, we found that the increment in thresholds produced by blur was larger for non-vehicular road hazards (pedestrians, cyclists and animals) compared to vehicular road hazards (cars, trucks and buses). This work suggests that blur poses a particular problem for drivers detecting non-vehicular road users, a population considerably more vulnerable in a collision than vehicular road users. These results also highlight the importance of taking into account the type of hazard when considering the impacts of blur on road hazard detection.
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Affiliation(s)
- Silvia Guidi
- Department of Psychology, University of Toronto Mississauga, 3359 Mississauga Road, Mississauga, ON, L5L 1C6, Canada.
| | - Anna Kosovicheva
- Department of Psychology, University of Toronto Mississauga, 3359 Mississauga Road, Mississauga, ON, L5L 1C6, Canada
| | - Benjamin Wolfe
- Department of Psychology, University of Toronto Mississauga, 3359 Mississauga Road, Mississauga, ON, L5L 1C6, Canada
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Sharma Y, Patel P, Kurmi BD. A Mini-review on New Developments in Nanocarriers and Polymers for Ophthalmic Drug Delivery Strategies. Curr Drug Deliv 2024; 21:488-508. [PMID: 37143264 DOI: 10.2174/1567201820666230504115446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 02/20/2023] [Accepted: 03/13/2023] [Indexed: 05/06/2023]
Abstract
The eye is an important and vital organ of the human body consisting of two segments - anterior and posterior segments and these segments are associated with many diseases. This review elaborates upon the various eye-related diseases with their medications and carriers used to deliver them. Delivery strategies include drugs encapsulated into liposomes, polymeric micelles of drugs, solid lipid nanoparticles, nanostructured lipid carriers, nano emulsions, and Nanosuspension used to improve penetrating properties, bioavailability, and residence time of the drugs as examples available in the literature. With regard to this, different forms of ocular drug delivery are classified and elaborated. Additionally, the possibility of addressing the physical and chemical complexities of ocular diseases and how they could be overcome with environmentally stable nanoformulations are briefly discussed. Enhanced drug delivery efficiency with various novel pharmaceuticals along with enhanced uptake by different routes/modes of drug administration. Current advancements in drug carrier systems, i.e., nanocarriers, have shown promise for improving the retention time, drug permeation and prolonging the duration of release of the drug in the ocular site. Bio-degradable polymers investigated for the preparation of nanocarriers for the entrapment of drugs and to enhance the efficacy through improved adherence of tissue in the eye, sustained release measures, enhanced bioavailability, lower toxicity, and targeted delivery is applicable. This review covers the introduction of various nanocarriers and polymers for ocular drug delivery with the purpose of enhancing the absorption, retention and bioavailability of medications in the eye.
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Affiliation(s)
- Yash Sharma
- Department of Pharmaceutical Quality Assurance, ISF College Pharmacy, GT Road, Moga-142001, Punjab, India
| | - Preeti Patel
- Department of Pharmaceutical Chemistry, ISF College Pharmacy, GT Road, Moga-142001, Punjab, India
| | - Balak Das Kurmi
- Department of Pharmaceutics, ISF College Pharmacy, GT Road, Moga-142001, Punjab, India
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Nguyen H, Di Tanna GL, Coxon K, Brown J, Ren K, Ramke J, Burton MJ, Gordon I, Zhang JH, Furtado J, Mdala S, Kitema GF, Keay L. Associations between vision impairment and vision-related interventions on crash risk and driving cessation: systematic review and meta-analysis. BMJ Open 2023; 13:e065210. [PMID: 37567751 PMCID: PMC10423787 DOI: 10.1136/bmjopen-2022-065210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
OBJECTIVES To systematically investigate the associations between vision impairment and risk of motor vehicle crash (MVC) involvement, and evaluate vision-related interventions to reduce MVCs. DESIGN Medline (Ovid), EMBASE and Global Health electronic databases were systematically searched from inception to March 2022 for observational and interventional English-language studies. Screening, data extraction and appraisals using the Joanna Briggs Institute appraisal tools were completed by two reviewers independently. Where appropriate, measures of association were converted into risk ratios (RRs) or ORs for meta-analysis. PARTICIPANTS Drivers of four-wheeled vehicles of all ages with no cognitive declines. PRIMARY AND SECONDARY OUTCOMES MVC involvement (primary) and driving cessation (secondary). RESULTS 101 studies (n=778 052) were included after full-text review. 57 studies only involved older drivers (≥65 years) and 85 were in high-income settings. Heterogeneity in the data meant that most meta-analyses were underpowered as only 25 studies, further split into different groups of eye diseases and measures of vision, could be meta-analysed. The limited evidence from the meta-analyses suggests that visual field defects (four studies; RR 1.51 (95% CI 1.23, 1.85); p<0.001; I2=46.79%), and contrast sensitivity (two studies; RR 1.40 (95% CI 1.08, 1.80); p=0.01, I2=0.11%) and visual acuity loss (five studies; RR 1.21 (95% CI 1.02, 1.43); p=0.03, I2=28.49%) may increase crash risk. The results are more inconclusive for available evidence for associations of glaucoma (five studies, RR 1.27 (95% CI 0.67, 2.42); p=0.47; I2=93.48%) and cataract (two studies RR 1.15 (95% CI 0.97, 1.36); p=0.11; I2=3.96%) with crashes. Driving cessation may also be linked with glaucoma (two studies; RR 1.62 (95% CI 1.20, 2.19); p<0.001, I2=22.45%), age-related macular degeneration (AMD) (three studies; RR 2.21 (95% CI 1.47, 3.31); p<0.001, I2=75.11%) and reduced contrast sensitivity (three studies; RR 1.30 (95% CI 1.05, 1.61); p=0.02; I2=63.19%). Cataract surgery halved MVC risk (three studies; RR 0.55 (95% CI 0.34, 0.92); p=0.02; I2=97.10). Ranibizumab injections (four randomised controlled trials) prolonged driving in persons with AMD. CONCLUSION Impaired vision identified through a variety of measures is associated with both increased MVC involvement and cessation. Cataract surgery can reduce MVC risk. Despite literature being highly heterogeneous, this review shows that detection of vision problems and appropriate treatment are critical to road safety. PROSPERO REGISTRATION NUMBER CRD42020172153.
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Affiliation(s)
- Helen Nguyen
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Gian Luca Di Tanna
- George Institute for Global Health, The University of New South Wales, Sydney, New South Wales, Australia
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Kristy Coxon
- School of Health Sciences, and the Translational Health Research Institute, Western Sydney University-Campbelltown Campus, Campbelltown, New South Wales, Australia
| | - Julie Brown
- George Institute for Global Health, The University of New South Wales, Sydney, New South Wales, Australia
| | - Kerrie Ren
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Matthew J Burton
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
- National Institute for Health Research Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Iris Gordon
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Justine H Zhang
- International Centre for Eye Health, London School of Hygiene and Tropical Medicine, London, UK
| | - João Furtado
- Division of Ophthalmology, Universidade de São Paulo Faculdade de Medicina de Ribeirão Preto, Ribeirao Preto, São Paulo, Brazil
| | - Shaffi Mdala
- Ophthalmology Department, Queen Elizabeth Central Hospital, Blantyre, Southern Region, Malawi
| | - Gatera Fiston Kitema
- Ophthalmology Department, University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda
| | - Lisa Keay
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
- George Institute for Global Health, The University of New South Wales, Sydney, New South Wales, Australia
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Rosenfeld M, Goverover Y, Weiss P. Self-awareness predicts fitness to drive among adults referred to occupational therapy evaluation. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:1005025. [DOI: 10.3389/fresc.2022.1005025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 10/26/2022] [Indexed: 11/17/2022]
Abstract
BackgroundDriving is associated with independence, well-being, quality of life, and an active lifestyle. Driving requires cognitive, motor, and visual skills, including self-awareness and processing speed. This study examines whether driver self-awareness, motor processing speed, and cognitive processing speed can predict fitness to drive among individuals referred to occupational therapy evaluation due to concerns about their driving ability.MethodIn this cross-sectional study, 39 participants were referred to off- and on-road driving evaluation to determine their fitness to drive due to changes in health status, advanced age, license renewal requirement, or prior automobile accidents. A registered occupational therapist (OT) classified 23 of the participants as fit to drive and 16 as unfit to drive. Motor and cognitive processing speed were assessed by the Stationary Perception-Reaction Timer and the Color Trails Test, respectively. Driving self-awareness was assessed by comparing the DI and OT evaluations to the participants' estimation of their own on-road driving performance.ResultsThe fit-to-drive participants had a better motor and cognitive processing speed than those unfit-to-drive. The unfit-to-drive group overestimated their driving ability, whereas the fit-to-drive group accurately or almost accurately estimated their driving ability. Driving self-awareness was a significant predictor of participants' fitness to drive.ConclusionsThis study demonstrates the importance of self-awareness for predicting fitness to drive among people at risk for compromised driving skills. Thus, driving self-awareness should be addressed as part of fitness-to-drive evaluations and interventions.
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Comparison of the effects of alcohol and cannabis on visual function and driving performance. Does the visual impairment affect driving? Drug Alcohol Depend 2022; 237:109538. [PMID: 35717788 DOI: 10.1016/j.drugalcdep.2022.109538] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/23/2022] [Accepted: 06/09/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Alcohol and cannabis are the most widely consumed psychoactive substances worldwide. This study compared the effects of alcohol and cannabis on visual function and driving performance, as well as self-perceived effects. Also, the relationship between visual effects under the influence and driving performance was studied. METHODS Sixty-four young drivers, with a history of alcohol and/or cannabis use were included. Of these, 33 were allocated to the alcohol group and 31 to the cannabis group. All participants were evaluated in a baseline session. The alcohol group underwent two sessions: after drinking 300 ml and 450 ml of red wine (A1 and A2). The cannabis group attended one session after smoking cannabis (C). Visual function was evaluated at the contrast sensitivity, stereoacuity, and intraocular straylight level. Participants drove a driving simulator. A general score (overall visual score, OVS; overall driving performance score, ODPS) was obtained for both visual functioning and driving performance. RESULTS The evaluation of visual function demonstrated a significant impairment in OVS for all conditions studied (A1, p = 0.005; A2, p < 0.001; C, p < 0.001) with respect to the baseline session. General driving performance (ODPS) demonstrated a significant worsening for the A2 condition (p = 0.003). Finally, a significant relationship between driving performance and visual function was found (rho=0.163, p = 0.039 and χ2 = 4.801, p = 0.028). CONCLUSIONS Cannabis and alcohol use negatively impact visual function. However, driving performance was only significantly affected by the higher alcohol dose. This impairment in visual function was significantly associated with worse driving performance.
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Andersson J, Bro T, Lajunen T. Self-Perception and the Relation to Actual Driving Abilities for Individuals With Visual Field Loss. Front Hum Neurosci 2022; 16:852794. [PMID: 35370585 PMCID: PMC8972404 DOI: 10.3389/fnhum.2022.852794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/24/2022] [Indexed: 11/29/2022] Open
Abstract
Background In Sweden, individuals with visual field loss (VFL) have their driving license withdrawn. The literature clearly indicates that individuals with VFL are unsafe drivers on a group level. However, many drivers with VFL can be safe on an individual level. The literature also suggests that self-perception, beliefs, and insights of one’s own capabilities are related to driving performance. This study had three aims: (1) To investigate self-perceived driving capability ratings for individuals with VFL; (2) to compare these ratings between groups with different medical conditions associated with VFL (stroke, glaucoma, and diabetes); and (3) to relate the self-perception ratings to actual driving performance in an advanced driving simulator. Methods Participants comprised 723 individuals whose driver’s license had been withdrawn because of VFL and 92 normally sighted elderly individuals. All participants completed a background survey, rated difficulties with different traffic situations, rated their strengths and weaknesses as drivers, and rated aspects that were important for causing traffic accidents. Of the VFL group participants, 264 also completed a simulator-based driving test that they knew could lead to renewal of their driving license. VFL participants and normally sighted was at the same age when they completed the simulator driving test. Results Overall, individuals with VFL rated their capabilities as high on all instruments and scales used, even higher than the elderly normally sighted control group. The only VFL etiology group that rated lower than other groups was the diabetes group. Safety orientation and internal control orientation values were best at discriminating between VFL participants in terms of self-perception of driving performance. Participants categorized as “high” in terms of safety skills and internal control were more modest in their ratings. Finally, participants who passed the simulated driving test did not differ from those who failed, in any of the self-perception measures. Conclusion Self-perception ratings among individuals with VFL were higher than those of normally sighted elderly individuals. Self-assessed skills did not predict driving performance. Groups with different VFL etiologies rated similarly. Self-ratings of driving abilities cannot be used to assess actual driving performance. Actual driving tests (on road or in the simulator) are necessary to discriminate between safe and unsafe drivers with VFL.
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Affiliation(s)
- Jan Andersson
- Swedish National Road and Transport Research Institute (VTI), Linköping, Sweden
- *Correspondence: Jan Andersson,
| | - Tomas Bro
- The Eye Unit, Höglandssjukhuset, Eksjö, Sweden
| | - Timo Lajunen
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
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Kim M, Ladomersky E, Mozny A, Kocherginsky M, O'Shea K, Reinstein ZZ, Zhai L, Bell A, Lauing KL, Bollu L, Rabin E, Dixit K, Kumthekar P, Platanias LC, Hou L, Zheng Y, Wu J, Zhang B, Hrachova M, Merrill SA, Mrugala MM, Prabhu VC, Horbinski C, James CD, Yamini B, Ostrom QT, Johnson MO, Reardon DA, Lukas RV, Wainwright DA. Glioblastoma as an age-related neurological disorder in adults. Neurooncol Adv 2021; 3:vdab125. [PMID: 34647022 PMCID: PMC8500689 DOI: 10.1093/noajnl/vdab125] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background Advanced age is a major risk factor for the development of many diseases including those affecting the central nervous system. Wild-type isocitrate dehydrogenase glioblastoma (IDHwt GBM) is the most common primary malignant brain cancer and accounts for ≥90% of all adult GBM diagnoses. Patients with IDHwt GBM have a median age of diagnosis at 68–70 years of age, and increasing age is associated with an increasingly worse prognosis for patients with this type of GBM. Methods The Surveillance, Epidemiology, and End Results, The Cancer Genome Atlas, and the Chinese Glioma Genome Atlas databases were analyzed for mortality indices. Meta-analysis of 80 clinical trials was evaluated for log hazard ratio for aging to tumor survivorship. Results Despite significant advances in the understanding of intratumoral genetic alterations, molecular characteristics of tumor microenvironments, and relationships between tumor molecular characteristics and the use of targeted therapeutics, life expectancy for older adults with GBM has yet to improve. Conclusions Based upon the results of our analysis, we propose that age-dependent factors that are yet to be fully elucidated, contribute to IDHwt GBM patient outcomes.
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Affiliation(s)
- Miri Kim
- Department of Neurological Surgery, Loyola University Medical Center, Maywood, Illinois, USA.,Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Erik Ladomersky
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Andreas Mozny
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Masha Kocherginsky
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kaitlyn O'Shea
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Zachary Z Reinstein
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Lijie Zhai
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - April Bell
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kristen L Lauing
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Lakshmi Bollu
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Erik Rabin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Karan Dixit
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Priya Kumthekar
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Leonidas C Platanias
- Department of Medicine, Division of Hematology-Oncology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Lifang Hou
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Yinan Zheng
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jennifer Wu
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Bin Zhang
- Department of Medicine, Division of Hematology-Oncology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Maya Hrachova
- Division of Neuro-Oncology, Department of Neurology, Mayo Clinic, Phoenix, Arizona, USA
| | - Sarah A Merrill
- Division of Neuro-Oncology, Department of Neurology, Mayo Clinic, Phoenix, Arizona, USA
| | - Maciej M Mrugala
- Division of Neuro-Oncology, Department of Neurology, Mayo Clinic, Phoenix, Arizona, USA
| | - Vikram C Prabhu
- Department of Neurological Surgery, Loyola University Medical Center, Maywood, Illinois, USA
| | - Craig Horbinski
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Charles David James
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Bakhtiar Yamini
- Department of Neurological Surgery, University of Chicago Medical Center & Biological Sciences, Chicago, Illinois, USA
| | - Quinn T Ostrom
- Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Margaret O Johnson
- Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - David A Reardon
- Dana-Farber/Harvard Cancer Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Rimas V Lukas
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Derek A Wainwright
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Department of Medicine, Division of Hematology-Oncology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Department of Microbiology and Immunology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Aggressive Driving Behaviours in Cannabis Users. The Influence of Consumer Characteristics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083911. [PMID: 33917856 PMCID: PMC8068208 DOI: 10.3390/ijerph18083911] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/05/2021] [Accepted: 04/07/2021] [Indexed: 11/30/2022]
Abstract
This study analysed dangerous driving behaviours in twenty young occasional cannabis users through objective and self-reported data, studying the relationship between the two aspects. Visual function was assessed in a baseline session and after smoking cannabis, as well as speed-related behaviour in a driving simulator. The participants responded to questionnaires on sociodemographic factors, their consumption profile, and the incidence of dangerous behaviours (Dula Dangerous Driving Index; DDDI). After cannabis use, the results revealed a significant deterioration in visual function. In terms of speed management, they showed significantly greater acceleration force in the two different sections of the route, and they drove significantly faster. Our correlations indicate that males and heavier users display more risky speed management. Likewise, the heavier cannabis users admitted to increased dangerous driving behaviour, and an accident in the preceding year was associated with a trend towards aggressive driving behaviour according to the DDDI questionnaire. The findings of this study suggest that cannabis users adopt dangerous behaviours when driving, despite the effect this drug has on certain important functions, such as vision. The results suggest a need for awareness-raising and information campaigns.
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Next-generation contact lenses: Towards bioresponsive drug delivery and smart technologies in ocular therapeutics. Eur J Pharm Biopharm 2021; 161:80-99. [DOI: 10.1016/j.ejpb.2021.02.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 12/25/2020] [Accepted: 02/09/2021] [Indexed: 12/11/2022]
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Wood JM, Black AA, Anstey KJ, Horswill MS. Hazard Perception in Older Drivers With Eye Disease. Transl Vis Sci Technol 2021; 10:31. [PMID: 33520426 PMCID: PMC7838553 DOI: 10.1167/tvst.10.1.31] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 12/16/2020] [Indexed: 12/05/2022] Open
Abstract
Purpose Timely detection of hazards is a key driving skill; however, the hazard perception of drivers with eye disease and related visual changes and the visual predictors of hazard perception are poorly understood. Methods Participants included drivers aged 65 years and older with a range of eye diseases, including cataract, age-related maculopathy (AMD), and glaucoma (n = 99; mean age, 75.4 ± 6.4 years) and controls (n = 118; mean age, 72.2 ± 5.5 years). Visual performance was assessed using clinical measures (visual acuity, contrast sensitivity, visual fields) and non-clinical measures (useful field of view, motion sensitivity). Participants completed a computer-based hazard perception test (HPT) that has been related to driving performance and crash risk. Results Participants with eye disease exhibited a 0.73-second delay in HPT response times compared to controls (6.61 ± 1.62 seconds vs. 5.88 ± 1.38 seconds; age-adjusted P = 0.012). Participants with glaucoma exhibited significantly delayed responses compared to those with AMD (P = 0.038) and controls (P = 0.004). Poorer motion sensitivity (standardized β = 0.27; P < 0.001), visual acuity (β = 0.21; P = 0.002), and better-eye mean defect (β = –0.17; P = 0.009) were most strongly associated with delayed HPT responses. Motion sensitivity remained significantly associated with HPT responses, adjusted for visual acuity and visual fields. Conclusions HPT responses of older drivers with eye disease were delayed compared to controls and translate to an estimated 16-meter longer stopping distance when traveling at 80 km/hr. Decreased motion sensitivity was most strongly associated with delayed HPT responses. Translational Relevance HPT tests can provide insight into difficulties regarding road hazard detection of older drivers with eye disease and provide a potential avenue for interventions to improve road safety.
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Affiliation(s)
- Joanne M Wood
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - Alex A Black
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - Kaarin J Anstey
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Mark S Horswill
- School of Psychology, The University of Queensland, Brisbane, Australia
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Molina R, Redondo B, Di Stasi LL, Anera RG, Vera J, Jiménez R. The short-term effects of artificially-impaired binocular vision on driving performance. ERGONOMICS 2021; 64:212-224. [PMID: 32841064 DOI: 10.1080/00140139.2020.1814427] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 08/19/2020] [Indexed: 05/24/2023]
Abstract
Appropriate visual function is paramount to ensuring adequate driving performance and road safety. Here, we examined the influence of sudden artificially-impaired binocular vision on driving performance using a car simulator. Twenty-four young drivers (mean age 22.42 ± 3.19 years) drove under three different visual conditions (natural driving, monocular blur, and monocular occlusion) through three different traffic environments with low, medium, and high levels of complexity (highway, rural, and city, respectively). We assessed their driving performance, perceived level of task complexity, and subjectively-experienced road safety. Furthermore, as a manipulation check, we also evaluated the drivers' cardiac vagal responses, as a well-known index of task complexity. The sudden deterioration of binocular vision caused unsafe driving behaviours (distance out of the road and maximum breaking intensity) in the most complex traffic environments. Specific self-regulatory strategies (i.e. increased cardiac vagal responses) and subjective responses corroborated these results. Practitioner summary: This study provides evidence that the sudden deterioration of binocular vision has a detrimental effect on simulated driving performance. Our analysis of cardiovascular functioning shows that drivers adopt self-regulatory strategies when their binocular vision functioning is compromised. Abbreviations: VA: visual acuity; BV: binocular vision; HRV: heart rate variability; NASA: TLX: NASA-Task Load Index; SSS: Stanford Sleepiness scale; RMSSD: root mean square of successive difference; HF: high-frequency.
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Affiliation(s)
- Rubén Molina
- Department of Optics, Faculty of Science, Campus de Fuentenueva, University of Granada, Granada, Spain
| | - Beatríz Redondo
- Department of Optics, Faculty of Science, Campus de Fuentenueva, University of Granada, Granada, Spain
| | | | - Rosario G Anera
- Department of Optics, Faculty of Science, Campus de Fuentenueva, University of Granada, Granada, Spain
| | - Jesús Vera
- Department of Optics, Faculty of Science, Campus de Fuentenueva, University of Granada, Granada, Spain
| | - Raimundo Jiménez
- Department of Optics, Faculty of Science, Campus de Fuentenueva, University of Granada, Granada, Spain
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Abstract
PURPOSE Choroideremia is an incurable, X-linked, recessive retinal dystrophy caused by loss of function mutations in the CHM gene. It is estimated to affect approximately 1 in 50,000 male patients. It is characterized by progressive degeneration of the retinal pigment epithelium, choroid, and photoreceptors, resulting in visual impairment and blindness. There is an unmet need in choroideremia, because currently, there are no approved treatments available for patients with the disease. METHODS We review the patient journey, societal impact, and emerging treatments for patients with choroideremia. RESULTS Its relative rarity and similarities with other retinal diseases in early years mean that diagnosis of choroideremia can often be delayed. Furthermore, its impact on affected individuals, and wider society, is also likely underestimated. AAV2-mediated gene therapy is an investigational treatment that aims to replace the faulty CHM gene. Early-phase studies reported potentially important visual acuity gains and maintenance of vision in some patients, and a large Phase 3 program is now underway. CONCLUSION Choroideremia is a disease with a significant unmet need. Interventions that can treat progression of the disease and improve visual and functional outcomes have the potential to reduce health care costs and enhance patient quality of life.
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Nguyen H, Di Tanna GL, Coxon K, Brown J, Ren K, Ramke J, Burton MJ, Gordon I, Zhang JH, Furtado JM, Mdala S, Kitema GF, Keay L. Associations between vision impairment and driving and the effectiveness of vision-related interventions: protocol for a systematic review and meta-analysis. BMJ Open 2020; 10:e040881. [PMID: 33154062 PMCID: PMC7646345 DOI: 10.1136/bmjopen-2020-040881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 09/28/2020] [Accepted: 10/18/2020] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Driving is one of the main modes of transport with safe driving requiring a combination of visual, cognitive and physical skills. With population ageing, the number of people living with vision impairment is set to increase in the decades ahead. Vision impairment may negatively impact an individual's ability to safely drive. The association between vision impairment and motor vehicle crash involvement or driving participation has yet to be systematically investigated. Further, the evidence for the effectiveness of vision-related interventions aimed at decreasing crashes and driving errors has not been synthesised. METHODS AND ANALYSIS A search will be conducted for relevant studies on Medline (Ovid), EMBASE and Global Health from their inception to March 2020 without date or geographical restrictions. Two investigators will independently screen abstracts and full texts using Covidence software with conflicts resolved by a third investigator. Data extraction will be conducted on all included studies, and their quality assessed to determine the risk of bias using the Joanna Briggs Institute Critical Appraisal Tools. Outcome measures include crash risk, driving cessation and surrogate measures of driving safety (eg, driving errors and performance). The results of this review will be reported using the Preferred Reporting Items for Systematic Review and Meta-Analysis guideline. Meta-analysis will be undertaken for outcomes with sufficient data and reported following the Meta-analyses of Observational Studies in Epidemiology guideline. Where statistical pooling is not feasible or appropriate, narrative summaries will be presented following the Synthesis Without Meta-analysis in systematic reviews guideline. ETHICS AND DISSEMINATION This review will only report on published data thus no ethics approval is required. Results will be included in the Lancet Global Health Commission on Global Eye Health, published in a peer-reviewed journal and presented at relevant conferences. PROSPERO REGISTRATION NUMBER CRD42020172153.
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Affiliation(s)
- Helen Nguyen
- School of Optometry and Vision Science, Faculty of Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Gian Luca Di Tanna
- The George Institute for Global Health, Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, Australia
| | - Kristy Coxon
- School of Health Sciences, and the Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Julie Brown
- The George Institute for Global Health, Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, Australia
| | - Kerrie Ren
- School of Optometry and Vision Science, Faculty of Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Jacqueline Ramke
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
| | - Matthew J Burton
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Moorfields Eye Hospital, London, United Kingdom
| | - Iris Gordon
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Justine H Zhang
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Manchester Royal Eye Hospital, Manchester, United Kingdom
| | - João M Furtado
- Division of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Shaffi Mdala
- Opthalmology Department, Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - Gatera Fiston Kitema
- Ophthalmology Department, School of Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Lisa Keay
- School of Optometry and Vision Science, Faculty of Science, University of New South Wales, Sydney, New South Wales, Australia
- The George Institute for Global Health, Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, Australia
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14
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Falkenstein M, Karthaus M, Brüne-Cohrs U. Age-Related Diseases and Driving Safety. Geriatrics (Basel) 2020; 5:E80. [PMID: 33086572 PMCID: PMC7709672 DOI: 10.3390/geriatrics5040080] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 10/13/2020] [Accepted: 10/16/2020] [Indexed: 11/16/2022] Open
Abstract
Due to demographic changes, the number of older drivers is steadily increasing. Mobility is highly relevant for leading an independent life in the elderly. It largely depends on car driving, which is a complex task requiring a multitude of cognitive and motor skills vulnerable to age- related functional deterioration. The almost inevitable effects of senescence may be potentiated by age-related diseases, such as stroke or diabetes mellitus. Respective pharmacological treatment may cause side effects, additionally affecting driving safety. The present article reviews the impact of age-related diseases and drug treatment of these conditions on driving fitness in elderly drivers. In essence, we focus on diseases of the visual and auditory systems, diseases of the central nervous system (i.e., stroke, depression, dementia and mild cognitive disorder, and Parkinson's disease), sleep disorders, as well as cardiovascular diseases, diabetes mellitus, musculoskeletal disorders, and frailty. We will outline the role of functional tests and the assessment of driving behavior (by a driving simulator or in real traffic), as well as the clinical interview including questions about frequency of (near) accidents, etc. in the evaluation of driving fitness of the elderly. We also address the impact of polypharmacy on driving fitness and end up with recommendations for physicians caring for older patients.
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Affiliation(s)
- Michael Falkenstein
- Institute for Work Learning and Aging (ALA), Hiltroper Landwehr 136, 44805 Bochum, Germany
| | - Melanie Karthaus
- Leibniz Institute for Working Environment and Human Factors (IfADo), 44139 Dortmund, Germany;
| | - Ute Brüne-Cohrs
- LWL University Hospital, Clinic for Psychiatry, Psychotherapy and Preventive Medicine, 44791 Bochum, Germany;
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Chen YT, Mazer B, Myers A, Vrkljan B, Koppel S, Charlton JL, Marshall SC, Gélinas I. Changes in older drivers' self-awareness of driving ability over one year. ACCIDENT; ANALYSIS AND PREVENTION 2020; 144:105552. [PMID: 32526499 DOI: 10.1016/j.aap.2020.105552] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 03/25/2020] [Accepted: 04/12/2020] [Indexed: 06/11/2023]
Abstract
Older drivers' self-awareness of driving ability can prompt self-regulatory behaviors and modifications of their everyday driving performance. To date, studies have yet to examine how older drivers' self-awareness of changes in driving ability over time or identify the characteristics of those who can accurately monitor such changes. 64 older drivers (Age: Mean = 80.0 years, SD = 5.4; male: 70 %) were recruited and categorized into four groups based on the correspondence of changes in their perceived and actual driving ability over one year: 40 % of the participants were accurate in their stable or better driving ability over time, 30 % did not detect their driving performance had worsened and over-estimated their driving ability, and the remainder either accurately detected their performance had worsened or under-estimated their driving performance. No demographic or clinical factors were associated with older drivers' self-awareness of changes in driving ability over time, except the mental processing and executive functioning measured using the Trail Making Tests Part B, showed a marginal effect. Implications for clinical importance are discussed.
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Affiliation(s)
- Yu-Ting Chen
- School of Physical and Occupational Therapy, McGill University, 3654 prom Sir-William-Osler, Montréal, QC, H3G 1Y5, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 3205 Place Alton-Goldbloom, Laval, QC, H7V 1R2, Canada
| | - Barbara Mazer
- School of Physical and Occupational Therapy, McGill University, 3654 prom Sir-William-Osler, Montréal, QC, H3G 1Y5, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 3205 Place Alton-Goldbloom, Laval, QC, H7V 1R2, Canada
| | - Anita Myers
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Brenda Vrkljan
- School of Rehabilitation Science, McMaster University, Room 403, 1400 Main St. W. Hamilton, ON, L8S 1C7, Canada
| | - Sjaan Koppel
- Monash University Accident Research Centre, Monash University, 21 Alliance Ln, Clayton VIC 3800, Australia
| | - Judith L Charlton
- Monash University Accident Research Centre, Monash University, 21 Alliance Ln, Clayton VIC 3800, Australia
| | - Shawn C Marshall
- Ottawa Hospital Research Institute, 501 Smyth Box 511, Ottawa, ON, K1H 8L6, Canada
| | - Isabelle Gélinas
- School of Physical and Occupational Therapy, McGill University, 3654 prom Sir-William-Osler, Montréal, QC, H3G 1Y5, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), 3205 Place Alton-Goldbloom, Laval, QC, H7V 1R2, Canada.
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16
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Derhy D, Lithfous S, Speeg C, Gaucher D, Despres O, Dufour A, Bourcier T, Sauer A. Driving Skills Tested on Simulator After Strabismus Surgery: A Prospective Study. Transl Vis Sci Technol 2020; 9:36. [PMID: 32855882 PMCID: PMC7422777 DOI: 10.1167/tvst.9.8.36] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 03/10/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose The sense of vision is responsible for 90% of the information obtained by the motorist. Improvement in binocular visual acuity (VA) and visual field (VF) achieved after strabismus surgery could have beneficial effects on driving. Our study sought to identify functional improvements (VA and VF) and improvements in driving ability following strabismus surgery. Methods In a prospective cohort study, the following parameters are analyzed before and 3 months after strabismus surgery: simulated driving performance (including eye movements and actions on vehicle control), binocular VA, binocular VF, and self-confidence during driving. Results Twenty patients participated in the study. The mean preoperative logMAR binocular VA and stereopsis do not significantly differ from the postoperative. The mean Esterman VF score increases from 91.3 (±17.2) preoperatively to 96.9 (±13.9) postoperatively (P = 0.045). The mean self-confidence directed at driving scores decreases from 20.5 (±10.3) points before surgery to 11.0 (±6.0) points after surgery (P < 0.001). The distance at which the road signs are identified is significantly higher after surgery. The average speed of the vehicle and the speed near the targets (30 m) increase significantly after strabismus surgery. A significant decrease in ocular movements near targets is also observed. The number of brake pedal depressions and the rate of brake pedal depressions slightly decrease after surgery. Conclusions This study demonstrates the potential beneficial effects of strabismus surgery on driving ability, with significant improvements in self-confidence during driving, VF, and driving on a simulator. Translational Relevance This was the first study to use a driving simulator in strabismus.
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Affiliation(s)
- Dan Derhy
- Department of Ophtalmologie, Centre Hospitalier Universitaire (CHU) - Université de Strasbourg, Nouvel Hôpital Civil, Strasbourg, France
| | - Ségolène Lithfous
- CI2N, Centre d'Investigations Neurocognitives & Neurophysiologiques UMS 3489 CNRS / UdS . Strasbourg, France
| | - Claude Speeg
- Department of Ophtalmologie, Centre Hospitalier Universitaire (CHU) - Université de Strasbourg, Nouvel Hôpital Civil, Strasbourg, France
| | - David Gaucher
- Department of Ophtalmologie, Centre Hospitalier Universitaire (CHU) - Université de Strasbourg, Nouvel Hôpital Civil, Strasbourg, France
| | - Olivier Despres
- CI2N, Centre d'Investigations Neurocognitives & Neurophysiologiques UMS 3489 CNRS / UdS . Strasbourg, France
| | - André Dufour
- CI2N, Centre d'Investigations Neurocognitives & Neurophysiologiques UMS 3489 CNRS / UdS . Strasbourg, France
| | - Tristan Bourcier
- Department of Ophtalmologie, Centre Hospitalier Universitaire (CHU) - Université de Strasbourg, Nouvel Hôpital Civil, Strasbourg, France
| | - Arnaud Sauer
- Department of Ophtalmologie, Centre Hospitalier Universitaire (CHU) - Université de Strasbourg, Nouvel Hôpital Civil, Strasbourg, France
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Casares-López M, Castro-Torres JJ, Martino F, Ortiz-Peregrina S, Ortiz C, Anera RG. Contrast sensitivity and retinal straylight after alcohol consumption: effects on driving performance. Sci Rep 2020; 10:13599. [PMID: 32788613 PMCID: PMC7423611 DOI: 10.1038/s41598-020-70645-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Accepted: 07/30/2020] [Indexed: 01/11/2023] Open
Abstract
In this study, we aimed to investigate the effects of alcohol intake on visual function and driving performance, as well as on the relationship between these. A total of 40 healthy participants took part in three experimental sessions: one baseline session and two further sessions after consuming two different quantities of alcohol (300 ml and 450 ml of red wine). The breath alcohol content (BrAC) was measured using a breath analyzer. The contrast sensitivity and retinal straylight due to the forward intraocular scattering were measured to characterize visual function, and driving performance was assessed in three different scenarios using a driving simulator. The results showed a deterioration in contrast sensitivity and retinal straylight after drinking alcohol, in addition to an impaired ability to drive, especially for the highest alcohol intake. We also observed that the deteriorated driving performance was a function of the contrast sensitivity and retinal straylight under the effects of alcohol, indicating that these visual variables can partially predict driving performance in these conditions.
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Affiliation(s)
- Miriam Casares-López
- Laboratory of Vision Sciences and Applications, Department of Optics, Facultad de Ciencias (Edificio Mecenas), University of Granada, Avenida Fuentenueva s/n, 18071, Granada, Spain
| | - José J Castro-Torres
- Laboratory of Vision Sciences and Applications, Department of Optics, Facultad de Ciencias (Edificio Mecenas), University of Granada, Avenida Fuentenueva s/n, 18071, Granada, Spain.
| | - Francesco Martino
- Laboratory of Vision Sciences and Applications, Department of Optics, Facultad de Ciencias (Edificio Mecenas), University of Granada, Avenida Fuentenueva s/n, 18071, Granada, Spain
| | - Sonia Ortiz-Peregrina
- Laboratory of Vision Sciences and Applications, Department of Optics, Facultad de Ciencias (Edificio Mecenas), University of Granada, Avenida Fuentenueva s/n, 18071, Granada, Spain
| | - Carolina Ortiz
- Laboratory of Vision Sciences and Applications, Department of Optics, Facultad de Ciencias (Edificio Mecenas), University of Granada, Avenida Fuentenueva s/n, 18071, Granada, Spain
| | - Rosario G Anera
- Laboratory of Vision Sciences and Applications, Department of Optics, Facultad de Ciencias (Edificio Mecenas), University of Granada, Avenida Fuentenueva s/n, 18071, Granada, Spain
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Sangiuolo R, Amore F, Bacci M, Brusini P, Cruciani F, Gualtieri G, Lancia M, Sangiuolo G, Sangiuolo M. A New System for Assessing Visual Disability Using a Digital Visor. J Clin Med 2020; 9:jcm9041086. [PMID: 32290446 PMCID: PMC7230512 DOI: 10.3390/jcm9041086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 03/31/2020] [Accepted: 04/06/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Considering the lack of universally accepted visual requirements for driving and for defining various grades of visual disability, the aim of this study is to propose a new method that provides a numerical score resulting from a combined assessment of the visual field and visual acuity loss obtained using a digital technology visor. Methods: This study presents a new system for calculating the percentage of visual disability by combining binocular visual acuity and binocular visual field assessments. A new Global Vision Evaluation System digital technology visor uses standardized, reproducible criteria to produce well-defined, numerically expressed test results. Through a specific algorithm, the device produces a numerical value expressing the percentage of visual disability. Results: Eighty-six subjects with various types of visual impairment underwent visual acuity and visual field test examinations carried out employing both traditional methods and the new digital visor. The two methods provided homogeneously similar results regarding the positioning of the subjects on the visual disability scale. Conclusions: The new digital visor seems to be a valid method to ensure that visual disability assessments are more homogeneous and reliable, and that, consequently, the resources available for this purpose are more fairly distributed.
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Affiliation(s)
- Raffaele Sangiuolo
- Italian Foundation of Digital and Robotic Ophthalmology (F.I.O.D.E.R.), 84134 Salerno, Italy;
| | - Filippo Amore
- Italian National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of the Visually Impaired—WHOCC, IAPB Italy Onlus—FPG IRCCS, 00168 Roma, Italy; (F.A.); (F.C.)
| | - Mauro Bacci
- Legal Medicine, Forensic Sciences, and Sport Medicine Section, University of Perugia, 06100 Perugia, Italy; (M.B.); (M.L.); (G.S.)
| | - Paolo Brusini
- Department of Ophthalmology, “Città di Udine” Health Clinic, 33100 Udine, Italy
- Correspondence:
| | - Filippo Cruciani
- Italian National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of the Visually Impaired—WHOCC, IAPB Italy Onlus—FPG IRCCS, 00168 Roma, Italy; (F.A.); (F.C.)
| | - Giacomo Gualtieri
- Department of Medical Sciences, Surgery and Neurosciences, Section of Legal Medicine, Santa Maria alle Scotte University Hospital of Siena, 53100 Siena, Italy;
| | - Massimo Lancia
- Legal Medicine, Forensic Sciences, and Sport Medicine Section, University of Perugia, 06100 Perugia, Italy; (M.B.); (M.L.); (G.S.)
| | - Giulia Sangiuolo
- Legal Medicine, Forensic Sciences, and Sport Medicine Section, University of Perugia, 06100 Perugia, Italy; (M.B.); (M.L.); (G.S.)
| | - Mario Sangiuolo
- Department of Ophthalmology, NHS Latina Pontino Center University of Roma “La Sapienza”, 04100 Latina, Italy;
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Devos H, Ranchet M, Bollinger K, Conn A, Akinwuntan AE. Performance-based visual field testing for drivers with glaucoma: A pilot study. TRAFFIC INJURY PREVENTION 2018; 19:715-721. [PMID: 30407083 DOI: 10.1080/15389588.2018.1508834] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 07/30/2018] [Accepted: 07/31/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Conventional visual field (VF) tests are limited in predicting on-road driving performance of individuals with glaucoma. We developed a new performance-based VF test in a driving simulator for individuals with glaucoma. The aim was to evaluate the psychometric properties of the newly developed test. METHODS In this pilot study, 17 drivers with glaucoma aged 65.24 ± 9.69 and 13 control drivers aged 61.27 ± 11.45 completed the performance-based VF task. Construct validity was determined by comparing performance on the new task with results on conventional visual and perimetry tests including Humphrey Visual Field Analyzer, Keystone Vision Screener, and Useful Field of View (UFOV). Concurrent validity was evaluated by comparing performance on the new task with on-road driving performance, scored using the Test Ride for Investigating Practical fitness-to-drive (TRIP). Ten individuals (7 with glaucoma and 3 controls) participated in the test-retest reliability assessment. RESULTS Drivers with glaucoma identified fewer symbols (P = .047) and took longer to respond to the symbols (P = .048) compared to controls. In the glaucoma group, correct responses on the performance-based VF test correlated strongly (r = -0.51, P = .046) with UFOV divided attention. Both glaucoma and control groups achieved submaximal to maximal scores on the TRIP (median [Q1-Q3], glaucoma: 193 [191-196]; controls: 196 [195-196]; P = .16). No strong correlations were found between scores on the performance-based VF test and on-road driving performance in glaucoma. The intraclass correlation coefficients ranged between 0.77 for response time and 0.92 for correct responses, indicating good to excellent test-retest reliability. CONCLUSIONS We established the construct validity and test-retest reliability of the performance-based VF test. Future studies should include a larger sample with more severe driving difficulties to demonstrate the concurrent validity between performance-based VF testing and on-road driving performance in glaucoma.
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Affiliation(s)
- Hannes Devos
- a Department of Physical Therapy and Rehabilitation Science, School of Health Professions , The University of Kansas Medical Center , Kansas City , Kansas
| | | | - Kathryn Bollinger
- c Department of Ophthalmology, Medical College of Georgia , Augusta University , Augusta , Georgia
- d Culver Vision Discovery Institute, Medical College of Georgia, Augusta University , Augusta , Georgia
| | - Amber Conn
- a Department of Physical Therapy and Rehabilitation Science, School of Health Professions , The University of Kansas Medical Center , Kansas City , Kansas
| | - Abiodun E Akinwuntan
- e Dean's Office, School of Health Professions , The University of Kansas Medical Center , Kansas City , Kansas
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20
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Seematter-Bagnoud L, Büla C. Brief assessments and screening for geriatric conditions in older primary care patients: a pragmatic approach. Public Health Rev 2018; 39:8. [PMID: 29744236 PMCID: PMC5928588 DOI: 10.1186/s40985-018-0086-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 02/12/2018] [Indexed: 01/12/2023] Open
Abstract
This paper discusses the rationale behind performing a brief geriatric assessment as a first step in the management of older patients in primary care practice. While geriatric conditions are considered by older patients and health professionals as particularly relevant for health and well-being, they remain too often overlooked due to many patient- and physician-related factors. These include time constraints and lack of specific training to undertake comprehensive geriatric assessment. This article discusses the epidemiologic rationale for screening functional, cognitive, affective, hearing and visual impairments, and nutritional status as well as fall risk and social status. It proposes using brief screening tests in primary care practice to identify patients who may need further comprehensive geriatric assessment or specific interventions.
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Affiliation(s)
- Laurence Seematter-Bagnoud
- 1Service of Geriatric Medicine and Geriatric Rehabilitation, University of Lausanne Hospital Center, Mont Paisible 16, CH-1011 Lausanne, Switzerland.,2Institute of Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland
| | - Christophe Büla
- 1Service of Geriatric Medicine and Geriatric Rehabilitation, University of Lausanne Hospital Center, Mont Paisible 16, CH-1011 Lausanne, Switzerland
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21
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Agramunt S, Meuleners LB, Fraser ML, Chow KC, Ng JQ, Raja V. First and second eye cataract surgery and driver self-regulation among older drivers with bilateral cataract: a prospective cohort study. BMC Geriatr 2018; 18:51. [PMID: 29454304 PMCID: PMC5816381 DOI: 10.1186/s12877-018-0743-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 02/06/2018] [Indexed: 11/16/2022] Open
Abstract
Background Driving a car is the most common form of transport among the older population. Common medical conditions such as cataract, increase with age and impact on the ability to drive. To compensate for visual decline, some cataract patients may self-regulate their driving while waiting for cataract surgery. However, little is known about the self-regulation practices of older drivers throughout the cataract surgery process. The aim of this study is to assess the impact of first and second eye cataract surgery on driver self-regulation practices, and to determine which objective measures of vision are associated with driver self-regulation. Methods Fifty-five older drivers with bilateral cataract aged 55+ years were assessed using the self-reported Driving Habits Questionnaire, the Mini-Mental State Examination and three objective visual measures in the month before cataract surgery, at least one to three months after first eye cataract surgery and at least one month after second eye cataract surgery. Participants’ natural driving behaviour in four driving situations was also examined for one week using an in-vehicle monitoring device. Two separate Generalised Estimating Equation logistic models were undertaken to assess the impact of first and second eye cataract surgery on driver-self-regulation status and which changes in visual measures were associated with driver self-regulation status. Results The odds of being a self-regulator in at least one driving situation significantly decreased by 70% after first eye cataract surgery (OR: 0.3, 95% CI: 0.1–0.7) and by 90% after second eye surgery (OR: 0.1, 95% CI: 0.1–0.4), compared to before first eye surgery. Improvement in contrast sensitivity after cataract surgery was significantly associated with decreased odds of self-regulation (OR: 0.02, 95% CI: 0.01–0.4). Conclusions The findings provide a strong rationale for providing timely first and second eye cataract surgery for older drivers with bilateral cataract, in order to improve their mobility and independence.
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Affiliation(s)
- Seraina Agramunt
- Curtin-Monash Accident Research Centre (C-MARC), Curtin University, GPO BOX U1987, PERTH, WA, 6845, Australia
| | - Lynn B Meuleners
- Curtin-Monash Accident Research Centre (C-MARC), Curtin University, GPO BOX U1987, PERTH, WA, 6845, Australia.
| | - Michelle L Fraser
- Curtin-Monash Accident Research Centre (C-MARC), Curtin University, GPO BOX U1987, PERTH, WA, 6845, Australia
| | - Kyle C Chow
- Curtin-Monash Accident Research Centre (C-MARC), Curtin University, GPO BOX U1987, PERTH, WA, 6845, Australia
| | - Jonathon Q Ng
- Eye & Vision Epidemiology Research (EVER) Group, Perth, WA, Australia.,School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Vignesh Raja
- Sir Charles Gairdner Hospital, Perth, WA, Australia
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22
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Wood JM, Owsley C. Vision and driving: a look at the research road ahead. Clin Exp Optom 2017; 99:393-4. [PMID: 27593521 DOI: 10.1111/cxo.12450] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Joanne M Wood
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia.
| | - Cynthia Owsley
- Department of Ophthalmology, University of Alabama, Birmingham, Alabama, USA
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23
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Stage of visual field loss and age at diagnosis in 1988 patients with different glaucomas: implications for glaucoma screening and driving ability. Int Ophthalmol 2017; 38:429-441. [DOI: 10.1007/s10792-017-0477-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 02/16/2017] [Indexed: 10/20/2022]
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Eye-Tracking as a Tool to Evaluate Functional Ability in Everyday Tasks in Glaucoma. J Ophthalmol 2017; 2017:6425913. [PMID: 28293433 PMCID: PMC5331274 DOI: 10.1155/2017/6425913] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 11/26/2016] [Accepted: 12/21/2016] [Indexed: 11/23/2022] Open
Abstract
To date, few studies have investigated the eye movement patterns of individuals with glaucoma while they undertake everyday tasks in real-world settings. While some of these studies have reported possible compensatory gaze patterns in those with glaucoma who demonstrated good task performance despite their visual field loss, little is known about the complex interaction between field loss and visual scanning strategies and the impact on task performance and, consequently, on quality of life. We review existing approaches that have quantified the effect of glaucomatous visual field defects on the ability to undertake everyday activities through the use of eye movement analysis. Furthermore, we discuss current developments in eye-tracking technology and the potential for combining eye-tracking with virtual reality and advanced analytical approaches. Recent technological developments suggest that systems based on eye-tracking have the potential to assist individuals with glaucomatous loss to maintain or even improve their performance on everyday tasks and hence enhance their long-term quality of life. We discuss novel approaches for studying the visual search behavior of individuals with glaucoma that have the potential to assist individuals with glaucoma, through the use of personalized programs that take into consideration the individual characteristics of their remaining visual field and visual search behavior.
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