Bro Tomas, Andersson Jan
Department of Ophthalmology, Eksjö, Region Jönköping County, Sweden.
Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Acta Ophthalmol. 2022 Mar;100(2):218-224. doi: 10.1111/aos.14765. Epub 2021 Feb 2.
To examine the effects of different stages of visual field loss (VFL) from advanced glaucoma on performance in a driving simulator.
Data on performance and safety from a traffic simulator test for 104 participants with withdrawn driver's licences due to visual field loss from advanced glaucoma were compared with data from 83 individuals without visual deficits in a cross-sectional study. Individuals with glaucoma that regained their driving licences after a successful simulator test were then followed in a national accident database.
Glaucoma participants passed the test in 71% (95% confidence interval 61-79%) of the cases. Younger participants were more successful than older. No significant differences on safety or performance measures were detected between glaucoma- and normally sighted participants. Compared with passed glaucoma participants, failed glaucoma participants had more collisions, more critical failed to give way events, longer time headways, and longer reaction times. This group had also a higher extent of central visual field loss. None of the participants with a regained licence were involved in a motor vehicle accident during the 2 to 4 year follow-up after the simulator test.
Severity of glaucoma predicts driver safety on a group level. However, even individuals with severe visual field loss from glaucoma might drive safely, which highlights the need for individual assessments for licencing purposes.
研究晚期青光眼不同阶段视野缺损（VFL）对驾驶模拟器表现的影响。
在一项横断面研究中，将104名因晚期青光眼视野缺损而被吊销驾照的参与者在交通模拟器测试中的表现和安全性数据，与83名无视力缺陷者的数据进行比较。对在模拟器测试成功后恢复驾照的青光眼患者，随后在国家事故数据库中进行跟踪。
青光眼参与者在71%（95%置信区间61 - 79%）的病例中通过了测试。年轻参与者比年长参与者更成功。青光眼患者和视力正常参与者在安全或表现指标上未检测到显著差异。与通过测试的青光眼参与者相比，未通过测试的青光眼参与者碰撞更多、关键的未让路事件更多、车头时距更长、反应时间更长。该组中央视野缺损程度也更高。在模拟器测试后的2至4年随访期间，恢复驾照的参与者均未发生机动车事故。
青光眼的严重程度在群体层面可预测驾驶安全性。然而，即使是患有严重青光眼视野缺损的个体也可能安全驾驶，这凸显了出于驾照发放目的进行个体评估的必要性。
