Takahashi Aya, Yuki Kenya, Awano-Tanabe Sachiko, Ono Takeshi, Shiba Daisuke, Tsubota Kazuo
Department of Ophthalmology, Keio University School of Medicine, Shinanomachi 35, Shinjyuku-ku, Tokyo, Japan.
BMC Ophthalmol. 2018 May 23;18(1):122. doi: 10.1186/s12886-018-0788-0.
The aim of this study, which included a baseline cross-sectional study and a 3-year follow-up prospective study, was to investigate the association between glaucomatous visual field damage and driving cessation in subjects with primary open-angle glaucoma (POAG).
A total of 211 POAG subjects divided into 3 groups according to POAG severity (mild, moderate, or severe) in the better eye were enrolled along with 148 control subjects; subjects were asked about changes in their driving status. In the 3-year follow-up study, 185 of the POAG subjects and 80 of the controls annually reported their driving status. Adjusted odds ratios and 95% confidence intervals for the prevalence and incidence of driving cessation were estimated with a multiple logistic regression model.
In the original cross-sectional study, 11/148 (7%) members of the control group reported having given up driving over the previous 5 years; the corresponding figures for the mild POAG, moderate POAG, and severe POAG groups were 9/173 (5%), 0/22 (0%), and 5/16 (31%), respectively (p = 0.001, Fisher's exact test), with severe POAG found to be associated with driving cessation after adjustment for age, gender, systemic hypertension, and diabetes mellitus (odds ratio 11.52 [95% CI 2.87-46.35], ref. control, p = 0.001). In the follow-up study, the proportions of subjects who ceased driving were 1/80 (1.3%) in the control group, 8/152 (5.3%) in the mild POAG group, 5/22 (22.7%) in the moderate POAG group, and 2/11 (18.2%) in the severe POAG group (p = 0.001, Fisher's exact test). Moderate POAG and severe POAG in the better eye were found to be associated with driving cessation after adjustment for age, gender, systemic hypertension, and diabetes mellitus (moderate POAG in the better eye: odds ratio 37.7 [95% CI 3.7-383.8], ref. control, p = 0.002, and severe POAG in the better eye: odds ratio 52.8 [95% CI 3.5-797.0], ref. control, p = 0.004).
Moderate and Severe POAG in the better eye is associated with driving cessation.
本研究包括一项基线横断面研究和一项为期3年的随访前瞻性研究，旨在调查原发性开角型青光眼（POAG）患者青光眼性视野损害与停止驾驶之间的关联。
根据较好眼的POAG严重程度（轻度、中度或重度）将211例POAG患者分为3组，并纳入148例对照受试者；询问受试者驾驶状态的变化。在为期3年的随访研究中，185例POAG患者和80例对照受试者每年报告他们的驾驶状态。采用多元逻辑回归模型估计停止驾驶患病率和发病率的调整比值比及95%置信区间。
在最初的横断面研究中，对照组11/148（7%）的成员报告在过去5年中放弃了驾驶；轻度POAG组、中度POAG组和重度POAG组的相应数字分别为9/173（5%）、0/22（0%）和5/16（31%）（p = 0.001，Fisher精确检验），在对年龄、性别、系统性高血压和糖尿病进行调整后，发现重度POAG与停止驾驶有关（比值比11.52 [95% CI 2.87 - 46.35]，参照对照组，p = 0.001）。在随访研究中，对照组停止驾驶受试者所占比例为1/80（1.3%），轻度POAG组为8/152（5.3%），中度POAG组为5/22（22.7%），重度POAG组为2/11（18.2%）（p = 0.001，Fisher精确检验）。在对年龄、性别、系统性高血压和糖尿病进行调整后，发现较好眼中度POAG和重度POAG与停止驾驶有关（较好眼中度POAG：比值比37.7 [95% CI 3.7 - 383.8]，参照对照组，p = 0.002，较好眼重度POAG：比值比52.8 [95% CI 3.5 - 797.0]，参照对照组，p = 0.004）。
较好眼中度和重度POAG与停止驾驶有关。
