Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, USA.
Br J Ophthalmol. 2013 Sep;97(9):1173-6. doi: 10.1136/bjophthalmol-2013-303601. Epub 2013 Jul 5.
Little is known about motor vehicle collision (MVC) risk in older drivers with age-related macular degeneration (AMD). The purpose of this study is to examine associations between MVC involvement and AMD presence and severity.
In a retrospective cohort study pooling the samples from four previous studies, we examined associations between MVC rate and older drivers with early, intermediate or advanced AMD as compared with those in normal eye health. MVC data were based on accident reports obtained from the state agency that compiles this information.
MVC rate was highest among those in normal eye health and progressively declined among those with early and intermediate disease, and then increased for those with advanced AMD. However, only for drivers with intermediate AMD was the MVC rate significantly different (lower) as compared with those in normal eye health, regardless of whether the rate was defined in terms of person-years (RR 0.34, 95% CI 0.13 to 0.89) or person-miles (RR 0.35, 95% CI 0.13 to 0.91) of driving.
These results suggest that older drivers with intermediate AMD have a reduced risk of collision involvement. Further research should investigate whether self-regulatory driving practices by these drivers (avoiding challenging driving situations) underlies this reduced risk.
对于与年龄相关性黄斑变性(AMD)相关的老年驾驶员,有关机动车碰撞(MVC)风险的信息知之甚少。本研究的目的是研究 MVC 参与度与 AMD 存在和严重程度之间的关联。
在一项回顾性队列研究中,我们汇集了四项先前研究的样本,研究了与早期、中期或晚期 AMD 相比,MVC 发生率与老年驾驶员正常视力之间的关系。MVC 数据基于从汇总此类信息的州机构获得的事故报告。
在正常视力的驾驶员中,MVC 发生率最高,随着疾病进入早期和中期阶段,该发生率逐渐下降,而对于晚期 AMD 患者,该发生率则上升。然而,只有在中期 AMD 患者中,MVC 发生率与正常视力患者显著不同(较低),无论以人年(RR 0.34,95%CI 0.13 至 0.89)还是人英里(RR 0.35,95%CI 0.13 至 0.91)为单位计算发生率。
这些结果表明,患有中期 AMD 的老年驾驶员发生碰撞的风险降低。进一步的研究应该调查这些驾驶员是否通过自我监管的驾驶行为(避免具有挑战性的驾驶情况)来降低这种风险。