Binocular superior visual field areas associated with driving self-regulation in patients with primary open-angle glaucoma

Abstract

Background/aimsThe aim of our study was to investigate the associations between driving self-regulation and glaucoma severity, and between driving self-regulation and glaucomatous visual field (VF) defect patterns.MethodsIn 247 patients with primary open-angle glaucoma included in this prospective observational study, a battery of ophthalmic examination was performed, including visual acuity (VA) and VF. Integrated binocular VF was constructed and mean of total deviation (mTD) values in four sectors was calculated (mTDsup-peri, mTDsup-centre, mTDinf-peri and mTDinf-centre). In addition, all participants answered seven questions regarding their avoidance in driving. (1) at night, (2) in rain, (3) in fog, (4) on freeways, (5) lane changing, (6) at high speed and (7) close to the car in front. The associations between these driving behaviours and 10 variables (age, gender, best VA, worst VA, the four sectorial average TD values, years holding a driver’s licence and distance driven per week) were analysed using the generalised linear model with binomial distribution, followed by the model section method using the corrected Akaike information criterion.ResultsAs a result of the model selection, it was suggested that deterioration of mTDsup-peri was associated with (1) avoiding driving at night and (2) avoiding driving in rain. On the other hand, mTDsup-centre was related to (3) avoiding driving in fog.ConclusionDamage in visual function was related with driving behaviours in patients with glaucoma.

Comparison of the Structure-Function Relationship Between Advanced Primary Open Angle Glaucoma and Normal Tension Glaucoma

“…The significance of the affected subfields on visual disability and daily activities in glaucoma patients are well recognized. 33,[38][39][40][41][42][43] Loss of vision in the inferior hemifield is associated with difficulties in walking down stairs, falls, fallrelated injuries, and worse physical function and thus have a greater impact on the ability to perform general daily activities. 33,40,41 Yuki et al 40 have shown that VF damage in the inferior peripheral area is related to fear of falling.…”

“…Yuki et al40 have shown that VF damage in the inferior peripheral area is related to fear of falling. Moreover, superior hemifield vision is more important for near activities that require close-up vision and for driving ability 38,42,43. Yamasaki et al43 recently reported that VF deterioration in the superior periphery was associated with avoidance of driving at night and in rain.…”

“…Moreover, superior hemifield vision is more important for near activities that require close-up vision and for driving ability. 38,42,43 Yamasaki et al 43 recently reported that VF deterioration in the superior periphery was associated with avoidance of driving at night and in rain. Considering that damage in different subfields of the VF significantly contributed to the success in performing different daily tasks, our findings may help clinicians understand the difficulties encountered by patients with different subtypes of glaucoma and may provide clinically meaningful information to minimize glaucoma-related visual disability.…”