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Hazard Perception in Drivers with Age-Related Macular Degeneration
Published 2023 by Halea Kohl
Co-Author(s): Rebecca Deffler, San-San Cooley, Frederick Davidorf, Bradley Dougherty
Program Number: 235210
Article Type: Scientific Program
Board: 196
PURPOSE:
Age-related macular degeneration (AMD) is the leading cause of central blindness and low vision in the United States with its prevalence expected to more than double by 2050. Hazard perception is the ability to anticipate potential road hazards to avoid a collision and has been shown to predict collision rates. The purpose of this study was to determine how hazard detection may be affected by vision changes resulting from AMD.
METHOD:
Participants licensed drivers and were recruited from the Department of Ophthalmology and the College of Optometry at the Ohio State University. ETDRS visual acuity was measured for each eye individually. Contrast sensitivity testing was performed with the Mars chart binocularly. Number of weekly trips and mileage were collected using Driving Habits Questionnaire. Hazard perception testing was conducted using 15 commercially available first-person driving video clips. Subjects signaled when they could first identify a traffic hazard requiring change of speed or direction. Hazard detection times for each clip were converted to z-scores, converted back to seconds using the average response time across all videos, and then compared among conditions. Regression models adjusting for age were used to investigate relationships among vision measures, AMD status, and hazard perception time.
RESULTS:
Eleven visually impaired licensed drivers with AMD (55% female) and seven normally-sighted control drivers (29% female) completed the study. There was no significant difference in age (mean ± SD = 75 ± 3 years for AMD drivers vs 74 ± 6 years for controls, P = 0.581) or mean deviation (-1.32 ± 2.67 for AMD drivers vs 0.34 ± 1.36 dB for controls, P = 0.098). Control drivers had better visual acuity (logMAR 0.01 ± 0.10) than AMD drivers (logMAR 0.14 ± 0.12, P = 0.029). Log contrast sensitivity was worse in AMD drivers (1.75 ± 0.04 vs 1.55 ± 0.14, P = 0.003). Standardized mean hazard response time in seconds was slower for drivers with AMD (6.2 ± 2.1) than for controls (3.5 ± 1.3), adjusted for age (P = 0.009). Visual acuity (P = 0.002), contrast sensitivity (P < 0.001), and mean deviation (P < 0.001) were all significant predictors of hazard perception time, adjusting for age.
CONCLUSION:
AMD drivers had significantly slower hazard responses on a video-based test, and measures of vision were inversely associated with response time. More work is needed to determine how this translates to on-road driving outcomes in these drivers, and whether drivers with AMD might be amenable to training in hazard perception.
PURPOSE:
Age-related macular degeneration (AMD) is the leading cause of central blindness and low vision in the United States with its prevalence expected to more than double by 2050. Hazard perception is the ability to anticipate potential road hazards to avoid a collision and has been shown to predict collision rates. The purpose of this study was to determine how hazard detection may be affected by vision changes resulting from AMD.
METHOD:
Participants licensed drivers and were recruited from the Department of Ophthalmology and the College of Optometry at the Ohio State University. ETDRS visual acuity was measured for each eye individually. Contrast sensitivity testing was performed with the Mars chart binocularly. Number of weekly trips and mileage were collected using Driving Habits Questionnaire. Hazard perception testing was conducted using 15 commercially available first-person driving video clips. Subjects signaled when they could first identify a traffic hazard requiring change of speed or direction. Hazard detection times for each clip were converted to z-scores, converted back to seconds using the average response time across all videos, and then compared among conditions. Regression models adjusting for age were used to investigate relationships among vision measures, AMD status, and hazard perception time.
RESULTS:
Eleven visually impaired licensed drivers with AMD (55% female) and seven normally-sighted control drivers (29% female) completed the study. There was no significant difference in age (mean ± SD = 75 ± 3 years for AMD drivers vs 74 ± 6 years for controls, P = 0.581) or mean deviation (-1.32 ± 2.67 for AMD drivers vs 0.34 ± 1.36 dB for controls, P = 0.098). Control drivers had better visual acuity (logMAR 0.01 ± 0.10) than AMD drivers (logMAR 0.14 ± 0.12, P = 0.029). Log contrast sensitivity was worse in AMD drivers (1.75 ± 0.04 vs 1.55 ± 0.14, P = 0.003). Standardized mean hazard response time in seconds was slower for drivers with AMD (6.2 ± 2.1) than for controls (3.5 ± 1.3), adjusted for age (P = 0.009). Visual acuity (P = 0.002), contrast sensitivity (P < 0.001), and mean deviation (P < 0.001) were all significant predictors of hazard perception time, adjusting for age.
CONCLUSION:
AMD drivers had significantly slower hazard responses on a video-based test, and measures of vision were inversely associated with response time. More work is needed to determine how this translates to on-road driving outcomes in these drivers, and whether drivers with AMD might be amenable to training in hazard perception.
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