Driving self-restriction and age: a study of emergency department patients

Betz, Marian E.; Carpenter, Christopher R.; Genco, Emma K.; Carr, David B.

doi:10.1186/s40621-014-0018-z

Cited by 7 publications

(2 citation statements)

References 33 publications

(70 reference statements)

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“…However, in the foveal-sparing analysis, LLVA was the most important variable for all scales in the univariate. Vision problems under low luminance are well-documented in elderly patients, 38–40 and VRQoL related to low luminance activities is more likely to decline over time than for daytime activities. 40 In patients with GA secondary to AMD, difficulty performing tasks under low luminance is seen at all stages of disease, 41 and baseline deficit in LLVA is a strong predictor of future reductions in visual acuity.…”

Section: Discussionmentioning

confidence: 99%

Impact of lesion location and functional parameters on vision-related quality of life in geographic atrophy secondary to AMD

Künzel,

Broadbent,

Möller

et al. 2023

Preprint

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Background/Aims: The primary objective was to determine how structural and functional parameters influence the vision-related quality of life (VRQoL) in patients with geographic atrophy (GA) secondary to age-related macular degeneration (AMD). Methods: This prospective, non-interventional, natural-history "Directional Spread in Geographic-Atrophy" study was conducted at the University Eye Hospital in Bonn, enrolling 82 patients with bilateral GA. Parameters such as GA location (assessed by the Early Treatment Diabetic Retinopathy Study grid), best-corrected visual acuity (BCVA), low-luminance visual acuity (LLVA), reading acuity, and speed were examined. The association between these parameters and VRQoL, as gauged using the National Eye Institute Visual Function Questionnaire 25 (NEI VFQ-25), was analyzed through the least absolute shrinkage and selection operator with linear mixed-effects models. Results: The average total GA area observed was 2.9 +/- 1.2 mm2 (better eye) and 3.1 +/- 1.3 mm2 (worse eye). The VRQoL scores for distance and near activities were most associated with the inner lower and inner left subfields of the better eye. For foveal-sparing patients, the LLVA of the better eye was the predominant determinant impacting all VRQoL scales. Conclusion: GA location, specifically the inner lower and inner left subfields of the better eye, has a notable effect on VRQoL in GA patients. LLVA stands out as especially vital in foveal-sparing patients, underscoring the importance for clinicians to incorporate considerations of GA location and functional parameters into their risk-benefit assessments for emerging treatments.

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Section: Discussionmentioning

confidence: 99%

Impact of lesion location and functional parameters on vision-related quality of life in geographic atrophy secondary to AMD

Künzel,

Broadbent,

Möller

et al. 2023

Preprint

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“…They frequently report experiencing vision problems at night and under low environmental light levels. For example, they cite difficulty with night driving and often avoid it [ 1 – 3 ] and report task difficulties under low illumination (e.g., reading a menu in a dimly lit restaurant) [ 4 ]. Psychophysical studies confirm that older adults, even when free of significant ocular conditions, tend to exhibit decreased scotopic and mesopic light sensitivity, contrast sensitivity, and acuity, as compared to younger adults [ 5 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

Vision-targeted health related quality of life in older adults: patient-reported visibility problems in low luminance activities are more likely to decline than daytime activities

Owsley

McGwin

2016

BMC Ophthalmol

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BackgroundCommonly used vision-targeted health-related quality of life questionnaires almost exclusively focus items on vision under daytime conditions. Older adults even when in good eye health frequently report experiencing vision problems at night and under low environmental light levels, and psychophysical studies also document these visibility problems. Here we compare the progression of self-reported low luminance visibility problems and self-reported visibility problems under daytime conditions in older adults.MethodsTrained interviewers administered two questionnaires to older adults in normal eye health: the National Eye Institute Visual Function Questionnaire – 25 (NEI VFQ-25) where items are almost entirely focused on difficulties in daytime activities, and the Low Luminance Questionnaire (LLQ) where items are focused on difficulties seeing at night and under low luminance conditions. The following visual functions were also measured: visual acuity, low luminance visual acuity, low luminance deficit, contrast sensitivity, light sensitivity in the macula, and rod-mediated dark adaptation. The protocol was repeated 3 years later.ResultsScores on the NEI VFQ-25 composite and its subscales were unchanged between baseline and 3-year follow-up, whereas scores on the LLQ composite and 5 of 6 subscales significantly decreased (corresponding to less functionality) at the 3-year follow-up. Participants were more likely to display a ≥ 5 point decrease on the LLQ composite than on the NEI VFQ-25 over 3 years. Visual functional tests were largely unrelated to changes in NEI VFQ-25 and LLQ scores from baseline to follow-up.ConclusionsOlder adults’ vision-targeted quality of life as measured by questionnaire is more likely to exhibit a practically significant decrease over 3 years using a questionnaire that focused on low luminance activities (LLQ) than one focused on daytime activities (NEI VFQ-25). That the results of visual functional testing did not correspond to older adults’ decline in self-reported problems in low luminance activities emphasizes the importance of questionnaires in understanding visual difficulties from the patients’ own perspective.

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