Bowers Alex R, Mandel Aaron J, Goldstein Robert B, Peli Eli
Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts 02114, USA.
Invest Ophthalmol Vis Sci. 2009 Nov;50(11):5137-47. doi: 10.1167/iovs.09-3799. Epub 2009 Jul 15.
This study was designed to examine the effect of homonymous hemianopia (HH) on detection of pedestrian figures in multiple realistic and hazardous situations within the controlled environment of a driving simulator.
Twelve people with complete HH and without visual neglect or cognitive decline and 12 matched (age, sex, and years of driving experience) normally sighted (NV) drivers participated. They drove predetermined city and rural highway routes (total, 120 minutes) during which pedestrian figures appeared at random intervals along the roadway (R-Peds; n = 144) and at intersections (I-Peds; n = 10). Detection rates and response times were derived from participant horn presses.
Drivers with HH exhibited significantly (P < 0.001) lower R-Ped detection rates on the blind side than did NV drivers (range, 6%-100%). Detection of I-Peds on the blind side was also poor (8%-55%). Age and blind-side detection rates correlated negatively (Spearman r = -0.71, P = 0.009). Although blind-side response times of drivers with HH were significantly (P < 0.001) longer than those of NV drivers, most were within a commonly used 2.5-second guideline.
Most participants with HH had blind-side detection rates that seem incompatible with safe driving; however, the relationship of our simulator detection performance measures to on-road performance has yet to be established. In determining fitness to drive for people with HH, the results underscore the importance of individualized assessments including evaluations of blind-side hazard detection.
本研究旨在考察在驾驶模拟器的可控环境中，同向性偏盲（HH）对在多种现实且危险的情况下检测行人的影响。
12名患有完全性HH且无视觉忽视或认知衰退的人以及12名匹配的（年龄、性别和驾驶经验年限）视力正常（NV）的驾驶员参与了研究。他们驾驶预定的城市和乡村公路路线（总计120分钟），在此期间行人随机出现在道路沿线（道路行人；n = 144）和十字路口（路口行人；n = 10）。检测率和反应时间来自参与者按喇叭的情况。
患有HH的驾驶员在盲区的道路行人检测率显著低于NV驾驶员（P < 0.001）（范围为6% - 100%）。在盲区对路口行人的检测也很差（8% - 55%）。年龄与盲区检测率呈负相关（斯皮尔曼r = -0.71，P = 0.009）。虽然患有HH的驾驶员在盲区的反应时间显著长于NV驾驶员（P < 0.001），但大多数都在常用的2.5秒指导标准内。
大多数患有HH的参与者的盲区检测率似乎与安全驾驶不相符；然而，我们模拟器检测性能指标与实际道路表现之间的关系尚未确立。在确定HH患者的驾驶适宜性时，结果强调了包括对盲区危险检测评估在内的个性化评估的重要性。
