The Driving Visual Field and a History of Motor Vehicle Collision Involvement in Older Drivers: A Population-Based Examination

摘要

Purpose.: We designed a visual field test focused on the field utilized while driving to examine associations between field impairment and motor vehicle collision involvement in 2000 drivers aged 70 years or older. Methods.: The a??driving visual field testa?? involved measuring light sensitivity for 20 targets in each eye, extending 15?° superiorly, 30?° inferiorly, 60?° temporally, and 30?° nasally. The target locations were selected on the basis that they fell within the field region utilized when viewing through the windshield of a vehicle or viewing the dashboard while driving. Monocular fields were combined into a binocular field based on the more sensitive point from each eye. Severe impairment in the overall field or a region was defined as average sensitivity in the lowest quartile of sensitivity. At-fault collision involvement for 5 years prior to enrollment was obtained from state records. Poisson regression was used to calculate crude and adjusted rate ratios (RRs) examining the association between field impairment and at-fault collision involvement. Results.: Drivers with severe binocular field impairment in the overall driving visual field had a 40% increased rate of at-fault collision involvement (RR, 1.40; 95% confidence interval [CI]: 1.07a??1.83). Impairment in the lower and left fields was associated with elevated collision rates (RR, 1.40; 95% CI: 1.07a??1.82 and RR, 1.49; 95% CI: 1.15a??1.92, respectively), whereas impairment in the upper and right field regions was not. Conclusions.: Results suggest that older drivers with severe impairment in the lower or left region of the driving visual field are more likely to have a history of at-fault collision involvement.