title: The role of specific visual subfields in collisions with oncoming cars during simulated driving in patients with advanced glaucoma.
abstract: To assess the role of specific visual subfields in collisions with oncoming cars during simulated driving in patients with advanced glaucoma.
  
  
  
  Normal subjects and patients with glaucoma with mean deviation <-12 dB in both eyes (Humphrey Field Analyzer 24-2 SITA-S program) used a driving simulator (DS; Honda Motor, Tokyo). Two scenarios in which oncoming cars turned right crossing the driver's path were chosen. We compared the binocular integrated visual field (IVF) in the patients who were involved in collisions and those who were not. We performed a multivariate logistic regression analysis; the dependent parameter was collision involvement, and the independent parameters were age, visual acuity and mean sensitivity of the IVF subfields.
  
  
  
  The study included 43 normal subjects and 100 patients with advanced glaucoma. And, 5 of the 100 patients with advanced glaucoma experienced simulator sickness during the main test and were thus excluded. In total, 95 patients with advanced glaucoma and 43 normal subjects completed the main test of DS. Advanced glaucoma patients had significantly more collisions than normal patients in one or both DS scenarios (p<0.001). The patients with advanced glaucoma who were involved in collisions were older (p=0.050) and had worse visual acuity in the better eye (p<0.001) and had lower mean IVF sensitivity in the inferior hemifield, both 0°-12° and 13°-24° in comparison with who were not involved in collisions (p=0.012 and p=0.034). A logistic regression analysis revealed that collision involvement was significantly associated with decreased inferior IVF mean sensitivity from 13° to 24° (p=0.041), in addition to older age and lower visual acuity (p=0.018 and p<0.001).
  
  
  
  Our data suggest that the inferior hemifield was associated with the incidence of motor vehicle collisions with oncoming cars in patients with advanced glaucoma.
authors.affiliation: Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan.|Department of Ophthalmology, Jichi Medical University, Tochigi, Japan.
authors.forename: Shiho
authors.initials: S
authors.lastname: Kunimatsu-Sanuki
authors.affiliation: Tajimi Iwase Eye Clinic, Gifu, Japan.
authors.forename: Aiko
authors.initials: A
authors.lastname: Iwase
authors.affiliation: Kanto Central Hospital of the Mutual Aid Association of Public School Teachers, Tokyo, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Araie
authors.affiliation: Department of Ophthalmology, Jichi Medical University, Tochigi, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Aoki
authors.affiliation: Department of Ophthalmology, Jichi Medical University, Tochigi, Japan.|Hara Eye Hospital, Tochigi, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hara
authors.affiliation: Department of Ophthalmology, Niigata University, Niigata, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Fukuchi
authors.affiliation: Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Udagawa
authors.affiliation: Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Ohkubo
authors.affiliation: Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Ishikawa, Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Sugiyama
authors.affiliation: Department of Ophthalmology, Kinki University Faculty of Medicine, Osaka, Japan.
authors.forename: Chota
authors.initials: C
authors.lastname: Matsumoto
authors.affiliation: Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Nakazawa
authors.affiliation: Division of Biostatistics, Tohoku University Graduate School of Medicine, Miyagi, Japan.
authors.forename: Takuhiro
authors.initials: T
authors.lastname: Yamaguchi
authors.affiliation: Honda Motor Co., Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ono
mesh_terms: D000063:Accidents, Traffic / Q000517:prevention & control; D001334:Automobile Driving; D003198:Computer Simulation; D005260:Female; D005901:Glaucoma / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011597:Psychomotor Performance; D012372:ROC Curve; D012189:Retrospective Studies; D015348:Vision, Binocular / Q000502:physiology*; D014792:Visual Acuity; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology*
keywords: Glaucoma