Siobhan Manners, Lynn B Meuleners, Jonathon Q Ng, Joanne Wood, William Morgan, Nigel Morlet
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引用次数: 0
Abstract
Purpose: Visual field loss poses a high personal cost to those affected, significantly impacting activities of daily living, including driving. However, there is conflicting evidence on the association between visual field loss and crash risk. This study examined the association between severity and location of binocular visual field loss and motor vehicle crashes in older adults aged 50+, using linked population data over a 29-year study period.
Methods: Using a database of visual field tests obtained from ophthalmologists in Western Australia (WA) between 1990 and 2019, deficits in field sensitivity were identified and classified into three severities across five regions. This was linked to other government administrative databases including crash data.
Results: Of 31,296 people, 4,307 (13.76%) older drivers were involved in 5,537 vehicle crashes. Binocular visual field loss (regardless of severity and location) significantly increased the odds of a crash by 84% (OR 1.84; 95% CI 1.71-1.97). Severe visual field loss significantly increased the odds of a crash by 98% in the upper left quadrant (OR 1.98; 95% CI 1.70-2.06), 97% in the lower left (OR 1.97; CI 1.80-2.16), 89% in the lower right (OR 1.89; CI 1.72-2.06) and 95% in the upper right quadrant (OR 1.95; CI 1.78-2.14).
Conclusion: The large population-based study provided robust estimates on the degree of severity and specific locations of visual field loss that threaten safe driving and objective evidence on the usefulness of linking large customised ophthalmic databases to crash records for developing 'fitness to drive' guidelines for older drivers.
期刊介绍：
Ophthalmic Epidemiology is dedicated to the publication of original research into eye and vision health in the fields of epidemiology, public health and the prevention of blindness. Ophthalmic Epidemiology publishes editorials, original research reports, systematic reviews and meta-analysis articles, brief communications and letters to the editor on all subjects related to ophthalmic epidemiology. A broad range of topics is suitable, such as: evaluating the risk of ocular diseases, general and specific study designs, screening program implementation and evaluation, eye health care access, delivery and outcomes, therapeutic efficacy or effectiveness, disease prognosis and quality of life, cost-benefit analysis, biostatistical theory and risk factor analysis. We are looking to expand our engagement with reports of international interest, including those regarding problems affecting developing countries, although reports from all over the world potentially are suitable. Clinical case reports, small case series (not enough for a cohort analysis) articles and animal research reports are not appropriate for this journal.
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