Quinze-Vingts National Ophthalmology Hospital, Clinical Center for Investigations 503, Paris, France.
Am J Ophthalmol. 2013 Jul;156(1):184-189.e3. doi: 10.1016/j.ajo.2013.02.019. Epub 2013 May 22.
A specific simulator was used to assess the driving visual performance in patients with dry eye disease (DED) and to determine clinical predictors of visual impairments while driving.
Prospective case-control study.
The study was conducted in the Center for Clinical Investigation of Quinze-Vingts National Ophthalmology Hospital, Paris, France. Twenty dry eye patients and 20 age- and sex-matched control subjects were included. Vision-related driving ability was assessed using a specific driving simulator displaying randomly located targets with a progressive increase in contrast to be identified. Other examinations included clinical examinations, serial measurements of corneal higher-order aberrations (HOAs), and vision-related quality-of-life questionnaire (Ocular Surface Disease Index [OSDI]). Data collected during driving test (ie, the number of targets seen, their position, and the response time) were compared between groups and analyzed according to clinical data, aberration dynamics, and quality-of-life index.
The percentage of targets missed as well as average response time were significantly increased in DED patients as compared with controls (P < .01). More specifically, the visual function of DED patients was more impaired in specific situations, such as crossroad or roundabout approaches. In DED patients, the response time was found to positively correlate with the progression index for HOAs (P < .01) and with the OSDI "symptoms" subscale (P < .05).
Degradation of ocular optical qualities related to DED is associated with visual impairments during driving. This study objectively has demonstrated the impact of tear film-related aberration changes on activities of daily living in DED.
使用特定模拟器评估干眼症（DED）患者的驾驶视觉表现，并确定导致驾驶时视觉障碍的临床预测因素。
前瞻性病例对照研究。
该研究在法国巴黎 Quinze-Vingts 国家眼科医院临床研究中心进行。共纳入 20 例干眼患者和 20 名年龄和性别匹配的对照组。使用特定的驾驶模拟器评估与驾驶相关的视觉能力，该模拟器可显示随机定位的目标，目标对比度逐渐增加以进行识别。其他检查包括临床检查、角膜高阶像差（HOA）的连续测量和与视觉相关的生活质量问卷（眼表疾病指数[OSDI]）。对驾驶测试期间收集的数据（即，看到的目标数量、位置和响应时间）进行了组间比较，并根据临床数据、像差动态和生活质量指数进行了分析。
与对照组相比，DED 患者错过的目标百分比和平均响应时间均显著增加（P <.01）。更具体地说，DED 患者在特定情况下（如十字路口或环形交叉口）的视觉功能受损更为严重。在 DED 患者中，响应时间与 HOA 的进展指数呈正相关（P <.01），与 OSDI“症状”子量表呈正相关（P <.05）。
与 DED 相关的眼光学质量下降与驾驶时的视觉障碍有关。本研究客观地证明了泪膜相关像差变化对 DED 患者日常生活活动的影响。
