Functional Assessment of FECD in the National Advanced Driving Simulator: Initial Study of Nighttime Glare and Scheimpflug Imaging.

IF 1.9 3区医学 Q2 OPHTHALMOLOGY

Cornea Pub Date : 2025-05-23 DOI:10.1097/ICO.0000000000003894

Simran R Sarin, Matthew Kigin, Evan Balk, Ryan Diel, Jennifer Ling, Mark A Greiner, Elliott H Sohn, Mark E Wilkinson, Timothy Brown, Christopher S Sales

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引用次数: 0

Abstract

Purpose: The aim of this study was to quantify nighttime driving differences in patients with Fuchs endothelial corneal dystrophy (FECD) using the FDA-validated National Advanced Driving Simulator MiniSim.

Methods: We conducted a pilot study to calculate sample size, followed by a prospective study with 6 patients with FECD and 6 controls. Participants underwent Snellen visual acuity (VA) testing, Mars contrast sensitivity (CS) assessment, and Scheimpflug tomography. Participants completed 3 simulated driving scenarios, identifying hazards while detection distances were tracked. Driving scenarios simulated glare conditions from oncoming headlights at night: "variable glare" modulated glare intensity with passing traffic, "constant glare" kept glare intensity fixed, and "no glare." The primary outcome was hazard recognition under "variable glare."

Results: Age, CS, and VA did not differ significantly between groups. Anterior and posterior densitometry were worse in the FECD group versus controls (anterior: 37.9 ± 6.0 vs. 28.9 ± 1.5, P = 0.01; posterior: 20.1 ± 3.1 vs. 16.5 ± 1.0, P = 0.02). Patients with FECD recognized 14% fewer hazards than controls (variable glare: 81.8 ± 12.1 vs. 95.8 ± 4.7%, P = 0.03). Patients with FECD required being nearly twice as close to hazards to recognize them versus controls (76.5 ± 38.8 vs. 137.7 ± 51.9 ft; P = 0.04). Tomographic markers of subclinical corneal edema (r = -0.61, P = 0.03) and higher anterior densitometry values (r = -0.61; P = 0.04) correlated with shorter hazard detection distance under "constant glare." Thicker central corneal thickness (variable glare: r = -0.60, P = 0.04) and higher posterior densitometry values correlated with lower hazard recognition scores (variable glare: r = -0.67, P = 0.02; constant glare: r = -0.65, P = 0.02).

Conclusions: Despite normal VA and CS, patients with FECD performed significantly worse in driving simulations than controls. Driving disability was associated with tomographic measures of subclinical corneal edema and abnormal corneal densitometry.

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国家先进驾驶模拟器中FECD的功能评估：夜间眩光和Scheimpflug成像的初步研究。

目的：本研究的目的是使用fda认证的国家高级驾驶模拟器MiniSim来量化Fuchs内皮性角膜营养不良（FECD）患者夜间驾驶的差异。方法：我们进行了一项初步研究来计算样本量，随后进行了一项前瞻性研究，包括6名FECD患者和6名对照组。参与者接受了Snellen视力（VA）测试、Mars对比敏感度（CS）评估和Scheimpflug断层扫描。参与者完成了3个模拟驾驶场景，在跟踪检测距离的同时识别危险。驾驶场景模拟了夜间迎面灯的眩光条件：“可变眩光”根据过往车辆调制眩光强度，“恒定眩光”保持眩光强度固定，“无眩光”。主要结果是在“可变眩光”下的危险识别。结果：年龄、CS、VA组间差异无统计学意义。FECD组前、后密度测量较对照组差(前密度：37.9±6.0比28.9±1.5,P = 0.01；后侧：20.1±3.1 vs. 16.5±1.0,P = 0.02)。FECD患者识别的危害比对照组低14%（可变眩光：81.8±12.1比95.8±4.7%,P = 0.03）。与对照组相比，FECD患者需要接近危险源近两倍才能识别危险源(76.5±38.8英尺对137.7±51.9英尺；P = 0.04)。亚临床角膜水肿的断层扫描标记（r = -0.61, P = 0.03）和较高的前路密度测量值(r = -0.61；P = 0.04)与“恒定眩光”下较短的危险探测距离相关。较厚的中央角膜厚度（可变眩光：r = -0.60, P = 0.04）和较高的后视密度测量值与较低的危险识别评分相关(可变眩光：r = -0.67, P = 0.02；恒定眩光：r = -0.65, P = 0.02)。结论：尽管VA和CS正常，FECD患者在驾驶模拟中的表现明显差于对照组。驾驶障碍与亚临床角膜水肿的断层扫描测量和异常角膜密度测量有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cornea 医学-眼科学

CiteScore

5.20

自引率

10.70%

发文量

354

审稿时长

3-6 weeks

期刊介绍： For corneal specialists and for all general ophthalmologists with an interest in this exciting subspecialty, Cornea brings together the latest clinical and basic research on the cornea and the anterior segment of the eye. Each volume is peer-reviewed by Cornea''s board of world-renowned experts and fully indexed in archival format. Your subscription brings you the latest developments in your field and a growing library of valuable professional references. Sponsored by The Cornea Society which was founded as the Castroviejo Cornea Society in 1975.