Gangeddula Viswa, Ranchet Maud, Akinwuntan Abiodun E, Bollinger Kathryn, Devos Hannes
Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas CityKS, United States.
Laboratoire Ergonomie et Sciences Cognitives pour les Transports (LESCOT), IFSTTAR, TS2, Université de LyonLyon, France.
Front Aging Neurosci. 2017 Aug 30;9:286. doi: 10.3389/fnagi.2017.00286. eCollection 2017.
To investigate the effect of cognitive demand on functional visual field performance in drivers with glaucoma. This study included 20 drivers with open-angle glaucoma and 13 age- and sex-matched controls. Visual field performance was evaluated under different degrees of cognitive demand: a static visual field condition (C1), dynamic visual field condition (C2), and dynamic visual field condition with active driving (C3) using an interactive, desktop driving simulator. The number of correct responses (accuracy) and response times on the visual field task were compared between groups and between conditions using Kruskal-Wallis tests. General linear models were employed to compare cognitive workload, recorded in real-time through pupillometry, between groups and conditions. Adding cognitive demand (C2 and C3) to the static visual field test (C1) adversely affected accuracy and response times, in both groups ( < 0.05). However, drivers with glaucoma performed worse than did control drivers when the static condition changed to a dynamic condition [C2 vs. C1 accuracy; glaucoma: median difference (Q1-Q3) 3 (2-6.50) vs.
2 (0.50-2.50); = 0.05] and to a dynamic condition with active driving [C3 vs. C1 accuracy; glaucoma: 2 (2-6) vs.
1 (0.50-2); = 0.02]. Overall, drivers with glaucoma exhibited greater cognitive workload than controls ( = 0.02). Cognitive demand disproportionately affects functional visual field performance in drivers with glaucoma. Our results may inform the development of a performance-based visual field test for drivers with glaucoma.
为研究认知需求对青光眼患者驾驶员功能性视野表现的影响。本研究纳入了20名开角型青光眼患者驾驶员以及13名年龄和性别匹配的对照者。使用交互式桌面驾驶模拟器，在不同程度的认知需求下评估视野表现：静态视野条件（C1）、动态视野条件（C2）以及主动驾驶的动态视野条件（C3）。使用Kruskal-Wallis检验比较组间和不同条件下视野任务的正确反应数量（准确性）和反应时间。采用一般线性模型比较通过瞳孔测量实时记录的组间和不同条件下的认知工作量。在静态视野测试（C1）中增加认知需求（C2和C3）对两组的准确性和反应时间均产生不利影响（<0.05）。然而，当静态条件转变为动态条件时[C2与C1准确性比较；青光眼组：中位数差异（Q1-Q3）为3（2-6.50），而对照组为2（0.50-2.50）；P = 0.05]以及转变为主动驾驶的动态条件时[C3与C1准确性比较；青光眼组：2（2-6），而对照组：1（0.50-2）；P = 0.02]，青光眼患者驾驶员的表现比对照驾驶员更差。总体而言，青光眼患者驾驶员表现出比对照组更大的认知工作量（P = 0.02）。认知需求对青光眼患者驾驶员的功能性视野表现产生不成比例的影响。我们的结果可能为开发基于表现的青光眼患者驾驶员视野测试提供参考。
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