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Invest Ophthalmol Vis Sci. 2018 Jan 1;59(1):273-279. doi: 10.1167/iovs.17-22751.

Effects of Age-Related Macular Degeneration on Driving Performance.

Author information

1
School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia.
2
Queensland Eye Institute, Brisbane, Queensland, Australia.
3
University of Queensland, Brisbane, Queensland, Australia.
4
Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, Alabama, United States.

Abstract

Purpose:

To explore differences in driving performance of older adults with age-related macular degeneration (AMD) and age-matched controls, and to identify the visual determinants of driving performance in this population.

Methods:

Participants included 33 older drivers with AMD (mean age [M] = 76.6 ± 6.1 years; better eye Age-Related Eye Disease Study grades: early [61%] and intermediate [39%]) and 50 age-matched controls (M = 74.6 ± 5.0 years). Visual tests included visual acuity, contrast sensitivity, visual fields, and motion sensitivity. On-road driving performance was assessed in a dual-brake vehicle by an occupational therapist (masked to drivers' visual status). Outcome measures included driving safety ratings (scale of 1-10, where higher values represented safer driving), types of driving behavior errors, locations at which errors were made, and number of critical errors (CE) requiring an instructor intervention.

Results:

Drivers with AMD were rated as less safe than controls (4.8 vs. 6.2; P = 0.012); safety ratings were associated with AMD severity (early: 5.5 versus intermediate: 3.7), even after adjusting for age. Drivers with AMD had higher CE rates than controls (1.42 vs. 0.36, respectively; rate ratio 3.05, 95% confidence interval 1.47-6.36, P = 0.003) and exhibited more observation, lane keeping, and gap selection errors and made more errors at traffic light-controlled intersections (P < 0.05). Only motion sensitivity was significantly associated with driving safety in the AMD drivers (P = 0.005).

Conclusions:

Drivers with early and intermediate AMD can exhibit impairments in their driving performance, particularly during complex driving situations; motion sensitivity was most strongly associated with driving performance. These findings have important implications for assessing the driving ability of older drivers with visual impairment.

PMID:
29340641
PMCID:
PMC5770181
DOI:
10.1167/iovs.17-22751
[Indexed for MEDLINE]
Free PMC Article

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