Bowers Alex R, Bronstad P Matthew, Spano Lauren P, Huq Bidisha, Tang Xiaolan, Doherty Amy, Peli Eli, Luo Gang
Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts.
Karolinska Institute, Stockholm, Sweden.
Optom Vis Sci. 2018 Sep;95(9):785-794. doi: 10.1097/OPX.0000000000001230.
A new driving simulator paradigm was developed and evaluated that will enable future investigations of the effects of the ring scotoma in bioptic drivers with diverse vision impairments and different telescope designs.
The ring scotoma may impair detection of peripheral hazards when viewing through a bioptic telescope. To investigate this question, we developed and tested a sign-reading and pedestrian-detection paradigm in a driving simulator.
Twelve normally sighted subjects with simulated acuity loss (median 20/120) used a 3.0× monocular bioptic to read 36 road signs while driving in a simulator. Thirteen of 21 pedestrian hazards appeared and ran on the road for 1 second within the ring scotoma while participants were reading signs through the bioptic. Head movements were analyzed to determine whether the pedestrian appeared before or only while using the bioptic. Six subjects viewed binocularly, and six viewed monocularly (fellow eye patched). Two patients with real visual acuity loss in one eye and no light perception in the other performed the same tasks using their own telescopes.
For the monocular simulated acuity loss group, detection rates were significantly higher when the pedestrian appeared before using the bioptic than when it appeared while using the bioptic and was likely within the area of the ring scotoma (77% vs. 28%, P < .001). For the binocular simulated acuity loss group, there was no significant difference in detection rates for pedestrians that appeared before or while using the bioptic (80% vs. 91%, P = .20). The two monocular patients detected only 17% of pedestrians that appeared while looking through the bioptic.
Our results confirm the utility of the testing paradigm and suggest that the fellow eye of normally sighted observers with simulated acuity loss was able to compensate for the ring scotoma when using a monocular bioptic telescope in a realistic driving task.
开发并评估了一种新的驾驶模拟器范式，这将使未来能够研究环形暗点对具有不同视力障碍和不同望远镜设计的双眼视觉驾驶员的影响。
通过双眼视觉望远镜观察时，环形暗点可能会妨碍对周边危险的察觉。为了研究这个问题，我们在驾驶模拟器中开发并测试了一种路标阅读和行人检测范式。
12名模拟视力丧失（中位数为20/120）的正常视力受试者在模拟器中驾驶时，使用3.0倍单眼双眼视觉望远镜阅读36个路标。21个行人危险中有13个出现在环形暗点区域内并在路上跑1秒钟，而参与者通过双眼视觉望远镜阅读路标。分析头部运动以确定行人是在使用双眼视觉望远镜之前出现还是仅在使用时出现。6名受试者双眼观察，6名单眼观察（另一只眼睛遮挡）。两名一只眼睛有实际视力丧失而另一只眼睛无光感的患者使用他们自己的望远镜执行相同任务。
对于单眼模拟视力丧失组，行人在使用双眼视觉望远镜之前出现时的检测率显著高于在使用时出现且可能在环形暗点区域内时的检测率（77%对28%，P<.001）。对于双眼模拟视力丧失组，行人在使用双眼视觉望远镜之前或使用时出现的检测率没有显著差异（80%对91%，P = 0.20）。两名单眼患者仅检测到通过双眼视觉望远镜观察时出现的行人的17%。
我们的结果证实了测试范式的实用性，并表明模拟视力丧失的正常视力观察者的另一只眼睛在现实驾驶任务中使用单眼双眼视觉望远镜时能够补偿环形暗点。
