Ophthalmology, Keio Univeristy School of Medicine, Tokyo, Shinjuku-ku, Japan.
Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan.
Br J Ophthalmol. 2021 Jan;105(1):135-140. doi: 10.1136/bjophthalmol-2019-315187. Epub 2020 Mar 25.
BACKGROUND/AIMS: The aim of our study was to investigate the associations between driving self-regulation and glaucoma severity, and between driving self-regulation and glaucomatous visual field (VF) defect patterns.
In 247 patients with primary open-angle glaucoma included in this prospective observational study, a battery of ophthalmic examination was performed, including visual acuity (VA) and VF. Integrated binocular VF was constructed and mean of total deviation (mTD) values in four sectors was calculated (mTDsup-peri, mTDsup-centre, mTDinf-peri and mTDinf-centre). In addition, all participants answered seven questions regarding their avoidance in driving. (1) at night, (2) in rain, (3) in fog, (4) on freeways, (5) lane changing, (6) at high speed and (7) close to the car in front. The associations between these driving behaviours and 10 variables (age, gender, best VA, worst VA, the four sectorial average TD values, years holding a driver's licence and distance driven per week) were analysed using the generalised linear model with binomial distribution, followed by the model section method using the corrected Akaike information criterion.
As a result of the model selection, it was suggested that deterioration of mTDsup-peri was associated with (1) avoiding driving at night and (2) avoiding driving in rain. On the other hand, mTDsup-centre was related to (3) avoiding driving in fog.
Damage in visual function was related with driving behaviours in patients with glaucoma.
背景/目的：本研究旨在探讨驾驶自我调节与青光眼严重程度之间的关系，以及与青光眼视野（VF）缺损模式之间的关系。
在这项前瞻性观察研究中，纳入了 247 名原发性开角型青光眼患者，对他们进行了一系列眼科检查，包括视力（VA）和 VF。构建了双眼整合 VF，并计算了四个象限的平均总偏差（mTD）值（mTDsup-peri、mTDsup-centre、mTDinf-peri 和 mTDinf-centre）。此外，所有参与者都回答了七个关于他们在驾驶中避免行为的问题。（1）夜间，（2）雨天，（3）雾天，（4）高速公路，（5）变道，（6）高速，（7）靠近前车。使用具有二项分布的广义线性模型分析这些驾驶行为与 10 个变量（年龄、性别、最佳 VA、最差 VA、四个象限的平均 TD 值、持驾照年限和每周行驶里程）之间的关系，然后使用校正后的 Akaike 信息准则进行模型分段法。
通过模型选择，结果表明 mTDsup-peri 的恶化与（1）夜间避免驾驶和（2）雨天避免驾驶有关。另一方面，mTDsup-centre 与（3）雾天避免驾驶有关。
青光眼患者的视觉功能损伤与驾驶行为有关。
