Szlyk J P, Pizzimenti C E, Fishman G A, Kelsch R, Wetzel L C, Kagan S, Ho K
Department of Ophthalmology and Visual Sciences, University of Illinois, Chicago Eye Center, USA.
Arch Ophthalmol. 1995 Aug;113(8):1033-40. doi: 10.1001/archopht.1995.01100080085033.
To determine the effects of age and central vision loss on driving skills.
Ten subjects with age-related macular degeneration and average binocular visual acuity of 20/70, and 11 age-similar subjects with normal vision, were examined with a battery of cognitive and visual tests, an interactive driving simulator, and an on-road driving test. Data were collected on the frequency of real-world accidents and convictions for traffic violations.
There were no significant differences between the two groups on any of the cognitive tests. The age-related macular degeneration group demonstrated poorer performance on the driving simulator, including delayed braking response times to stop signs, slower speeds, and more of both lane boundary crossings and simulator accidents. The age-related macular degeneration group also demonstrated poorer overall on-road test performance, including having significantly more points deducted for driving too slowly and for not maintaining proper lane position. However, these effects on the simulator and the on-road test did not translate into an increased risk of real-world accidents for the age-related macular degeneration group. Significantly more control subjects than patients with age-related macular degeneration were involved in self-reported accidents, and significantly more control subjects had state convictions for traffic violations. There was evidence of compensation in the age-related macular degeneration group in four major areas: (1) not driving in unfamiliar areas; (2) traveling at slow speeds; (3) self-restricting their nighttime driving, and (4) taking fewer risks while driving (eg, not changing lanes). There was also evidence of compensation in the older control group.
Vision, simulator, and on-road test variables combined with subjective risk taking predicted self-reported real-world accidents in a logistic regression analysis. However, risk taking, rather than simulator or road-test performance, was the most significant predictor for both patients with age-related macular degeneration and the control group.
确定年龄和中心视力丧失对驾驶技能的影响。
对10名患有年龄相关性黄斑变性且双眼平均视力为20/70的受试者，以及11名年龄相仿的视力正常受试者，进行了一系列认知和视觉测试、交互式驾驶模拟器测试及道路驾驶测试。收集了现实世界中事故发生频率和交通违规定罪的数据。
两组在任何认知测试中均无显著差异。年龄相关性黄斑变性组在驾驶模拟器上表现较差，包括对停车标志的制动反应时间延迟、速度较慢、车道边界穿越和模拟器事故更多。年龄相关性黄斑变性组在道路测试中的总体表现也较差，包括因车速过慢和未保持正确车道位置而被扣除的分数显著更多。然而，这些对模拟器和道路测试的影响并未转化为年龄相关性黄斑变性组现实世界事故风险的增加。自我报告发生事故的对照组受试者明显多于年龄相关性黄斑变性患者，且有交通违规定罪的对照组受试者也明显更多。年龄相关性黄斑变性组在四个主要方面有代偿证据：（1）不在不熟悉的区域驾驶；（2）低速行驶；（3）自我限制夜间驾驶，以及（4）驾驶时减少冒险行为（如不换车道）。老年对照组也有代偿证据。
在逻辑回归分析中，视力、模拟器和道路测试变量与主观冒险行为相结合可预测自我报告的现实世界事故。然而，冒险行为而非模拟器或道路测试表现，是年龄相关性黄斑变性患者和对照组最显著的预测因素。
