title: Prediction of driving safety in individuals with homonymous hemianopia and quadrantanopia from clinical neuroimaging.
abstract: Background. This study aimed to determine whether it is possible to predict driving safety of individuals with homonymous hemianopia or quadrantanopia based upon a clinical review of neuroimages that are routinely available in clinical practice. Methods. Two experienced neuroophthalmologists viewed a summary report of the CT/MRI scans of 16 participants with homonymous hemianopic or quadrantanopic field defects which indicated the site and extent of the lesion and they made predictions regarding whether participants would be safe/unsafe to drive. Driving safety was independently defined at the time of the study using state-recorded motor vehicle crashes (all crashes and at-fault) for the previous 5 years and ratings of driving safety determined through a standardized on-road driving assessment by a certified driving rehabilitation specialist. Results. The ability to predict driving safety was highly variable regardless of the driving safety measure, ranging from 31% to 63% (kappa levels ranged from -0.29 to 0.04). The level of agreement between the neuroophthalmologists was only fair (kappa = 0.28). Conclusions. Clinical evaluation of summary reports of currently available neuroimages by neuroophthalmologists is not predictive of driving safety. Future research should be directed at identifying and/or developing alternative tests or strategies to better enable clinicians to make these predictions.
authors.affiliation: Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA ; Department of Neurology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Vaphiades
authors.affiliation: Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
authors.forename: Lanning B
authors.initials: LB
authors.lastname: Kline
authors.affiliation: Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA ; Department of Surgery, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
authors.forename: Gerald
authors.initials: G
authors.lastname: McGwin
authors.affiliation: Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Owsley
authors.affiliation: Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
authors.forename: Ritu
authors.initials: R
authors.lastname: Shah
authors.affiliation: School of Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia ; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia.
authors.forename: Joanne M
authors.initials: JM
authors.lastname: Wood