The role of specific visual subfields in collisions with oncoming cars during simulated driving in patients with advanced glaucoma

Abstract

Background/aimsTo assess the role of specific visual subfields in collisions with oncoming cars during simulated driving in patients with advanced glaucoma.MethodsNormal 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.ResultsThe 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).ConclusionsOur data suggest that the inferior hemifield was associated with the incidence of motor vehicle collisions with oncoming cars in patients with advanced glaucoma.

The effect of concentric constriction of the visual field to 10 and 15 degrees on simulated motor vehicle accidents

“…A DS system (HONDA Safety Navi ‘glaucoma edition 2’, Honda Motor Co., Tokyo) was used for which details have been previously reported [ 2 – 3 ]. The simulation used a semi-automatically-controlled speed; subjects only had to brake in case of a vehicle suddenly appearing.…”

“…However, VF impairment can be artificially created by having subjects wear pinhole (PH) glasses. Comparison of involvement in MVAs during DS tests [ 3 ] between the same subjects with and without PH glasses would allow investigation of the effects of VF impairment, while adjusting for all traffic-, automobile- and subject-related conditions other than VF impairment. It is important to note that the PH of the same aperture can create a different level of VF constriction between individuals ( Fig 1 ).…”

“…In the current study, we simulated concentric constriction of binocular VFs to central 10° or 15° with PH glasses. We then studied the effects of concentric constriction of binocular VFs on MVAs, after adjusting for effects of other confounding factors, using a DS system for which utility in studying visual function and MVA relationship had been previously confirmed [ 3 ].…”

Effects of driver compensatory behaviour on risks of critical pedestrian collisions under simulated visual field defects

“…However, a myriad of studies has reported the difficulties-e.g. driving within lane positions [14], coping with the sudden appearance of a pedestrian or vehicle [2,[15][16], an oncoming vehicle turned right crossing the driver's path at intersection [17], immediate reaction to divided attention [18], or obstacle avoidance [18][19][20][21]. The difficulty due to visual field defects is closely related to a driver's hazard perception; thus it is reported as one of the causes of traffic accidents [12,15,22].…”

“…The aim of the current study is to examine the effects of compensatory behaviour of drivers under visual field defects on avoiding unexpected traffic hazards during simulated driving. The main hazardous events were designed in accordance with the previous findings that patients with visual field defects have difficulty in avoiding the sudden appearance of a pedestrian or other vehicle from the sides [2,16,38], and that pedestrian collision is one of the most frequent types of traffic accidents [45]. We hypothesised that performing frequent head movements leads to a certain level of driving performance-i.e.…”