Patnaik Jennifer L, Pecen Paula E, Hanson Kara, Lynch Anne M, Cathcart Jennifer N, Siringo Frank S, Mathias Marc T, Mandava Naresh
Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado.
Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado.
Ophthalmol Retina. 2019 Apr;3(4):336-342. doi: 10.1016/j.oret.2018.11.004. Epub 2018 Nov 17.
To assess driving status, habitual visual acuity (VA) in the better-seeing eye, and self-reported driving difficulty among patients diagnosed with age-related macular degeneration (AMD).
Cross-sectional cohort study of 553 AMD patients' habitual VA, self-reported driving status, and driving difficulty at time of interview.
Patients diagnosed with AMD and recruited into the University of Colorado registry.
Measurement of habitual VA by median logarithm of the minimum angle of resolution (logMAR) and Snellen equivalent, as well as 3 categories: 20/40 or better, 20/50 or 20/60, and worse than 20/60. Driving difficulty was self-reported on the 25-item National Eye Institute Visual Function Questionnaire.
Self-reported driving status and driving difficulty.
A total of 394 patients (71.2%) reported currently driving at time of study interview. Drivers were significantly younger than nondrivers (mean age, 76.7 years vs. 83.9 years; P < 0.0001) and were more likely to be men (42.6% vs. 25.8%; P = 0.0002). Median habitual VA in the better-seeing eye was better among drivers: 0.097 logMAR (Snellen equivalent, 20/25) versus 0.301 logMAR (Snellen equivalent, 20/40) for nondrivers (P < 0.0001). Among drivers, habitual VA was 20/40 or better for 87.6% of patients, 20/50 to 20/60 for 9.6% of participants, and worse than 20/60 for 2.8% of participants. Driving patients with habitual VA in the better-seeing eye of 20/40 or better reported less difficulty driving compared with patients with 20/50 or worse VA.
In our study, most patients with AMD who were currently driving had at least 20/40 VA in the better-seeing eye. However, 12.4% of patients had VA of 20/50 or worse and reported more difficulties with driving. As the aging population continues to grow with increasing lifespan, the number of patients with AMD will increase, and discussion of driving and VA will become more clinically and legally pertinent.
评估年龄相关性黄斑变性（AMD）患者的驾驶状况、较好眼的习惯性视力（VA）以及自我报告的驾驶困难程度。
对553例AMD患者在访谈时的习惯性视力、自我报告的驾驶状况和驾驶困难程度进行横断面队列研究。
被诊断为AMD并纳入科罗拉多大学登记处的患者。
通过最小分辨角对数（logMAR）中位数和Snellen等效值测量习惯性视力，并分为3类：20/40及以上、20/50或20/60、低于20/60。驾驶困难程度通过25项国家眼科研究所视觉功能问卷进行自我报告。
自我报告的驾驶状况和驾驶困难程度。
共有394例患者（71.2%）在研究访谈时报告目前仍在驾驶。驾驶者的年龄显著低于非驾驶者（平均年龄分别为76.7岁和83.9岁；P<0.0001），且男性比例更高（分别为42.6%和25.8%；P=0.0002）。驾驶者较好眼的习惯性视力中位数更好：驾驶者为0.097 logMAR（Snellen等效值，20/25），非驾驶者为0.301 logMAR（Snellen等效值，20/40）（P<0.0001）。在驾驶者中，87.6%的患者习惯性视力为20/40及以上，9.6%的参与者为20/50至20/60，2.8%的参与者低于20/60。较好眼习惯性视力为20/40及以上的驾驶患者报告的驾驶困难程度低于视力为20/50及以下的患者。
在我们的研究中，大多数目前仍在驾驶的AMD患者较好眼的视力至少为20/40。然而，12.4%的患者视力为20/50及以下，并报告驾驶困难更多。随着老年人口寿命延长持续增长，AMD患者数量将会增加，关于驾驶和视力的讨论在临床和法律方面将变得更加相关。
