Janz Nancy K, Musch David C, Gillespie Brenda W, Wren Patricia A, Niziol Leslie M
Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan 48109-2029, USA.
Invest Ophthalmol Vis Sci. 2009 Apr;50(4):1718-25. doi: 10.1167/iovs.08-2575. Epub 2008 Dec 5.
To compare drivers and nondrivers, and to describe the specific concerns of drivers, among individuals with glaucoma.
Six hundred seven patients with newly diagnosed glaucoma treated at 14 clinical centers of the Collaborative Initial Glaucoma Treatment Study were randomly assigned to initial medicine or surgery and were followed up every 6 months. Driving status (drivers versus nondrivers) and patient-reported visual function were determined by the Visual Activities Questionnaire and the National Eye Institute Visual Function Questionnaire. Clinical evaluation included visual field mean deviation (MD) and visual acuity. Statistical comparisons were made using t, chi(2), and exact tests and regression and Rasch analyses.
Drivers were more likely than nondrivers to be male, white, married, employed, and more educated and to have higher incomes and fewer comorbidities. More than 50% of drivers reported at least "some" difficulty performing tasks involving glare, whereas 22% reported at least "some" difficulty with tasks requiring peripheral vision. At 54 months, drivers with moderate/severe bilateral visual field loss (VFL) reported greater difficulty with night driving and tasks involving visual search and visual processing speed than drivers with less bilateral VFL (all P<0.05). Although those who remained drivers over follow-up had better MD in both eyes than those who became nondrivers because of eyesight, a number of drivers had marked VFL.
Inquiring about specific difficulties with tasks related to glare, visual processing speed, visual search, and peripheral vision in driving, especially among patients with substantial bilateral visual field damage, will enable physicians to more effectively counsel patients regarding driving.
比较青光眼患者中驾驶者与非驾驶者的情况，并描述驾驶者的具体担忧。
协作性青光眼初始治疗研究的14个临床中心的607例新诊断青光眼患者被随机分配接受初始药物治疗或手术治疗，并每6个月随访一次。驾驶状态（驾驶者与非驾驶者）以及患者报告的视觉功能通过视觉活动问卷和美国国立眼科研究所视觉功能问卷来确定。临床评估包括视野平均缺损（MD）和视力。采用t检验、卡方检验、确切概率检验以及回归分析和拉施分析进行统计学比较。
驾驶者比非驾驶者更可能为男性、白人、已婚、有工作、受教育程度更高、收入更高且合并症更少。超过50%的驾驶者报告在执行涉及眩光的任务时至少有“一些”困难，而22%的驾驶者报告在执行需要周边视力的任务时至少有“一些”困难。在54个月时，与双侧视野缺损（VFL）较轻的驾驶者相比，患有中度/重度双侧VFL的驾驶者报告在夜间驾驶以及涉及视觉搜索和视觉处理速度的任务方面有更大困难（所有P<0.05）。尽管在随访期间仍为驾驶者的患者双眼MD比因视力原因成为非驾驶者的患者更好，但仍有一些驾驶者有明显的VFL。
询问驾驶者在与眩光、视觉处理速度、视觉搜索和周边视力相关任务方面的具体困难，尤其是在双侧视野有严重损害的患者中，将使医生能够更有效地为患者提供有关驾驶的咨询。
