Motor Vehicle Collision Involvement among Persons with Hemianopia and Quadrantanopia.

Gerald Mcgwin Jr,Joanne Wood,Carrie Huisingh,Cynthia Owsley

doi:10.3390/geriatrics1030019

Abstract

Persons with homonymous quadrantanopia and hemianopia experience driving restrictions, yet there is little scientific evidence to support driving prohibition among persons with these conditions. This retrospective cohort study compares motor vehicle collision (MVC) rates among 27 current licensed drivers with hemianopic and quadrantanopic field defects, who were ≥6 months from the brain injury date with that of 27 age-matched drivers with normal visual fields. Information regarding all police-reported MVCs that occurred over a period of nine years was obtained. MVC rates per year and per mile travelled were calculated and compared using conditional Poisson regression. Drivers with hemianopia or quadrantanopia had more MVCs per mile driven compared to drivers with normal visual fields; specifically their overall MVC rate was 2.45-times (95% confidence interval (CI) 0.89–3.95) higher and their at-fault MVC rate was 2.64-times (95% CI 1.03–6.80) higher. This study indicates that drivers with hemianopia or quadrantanopia have elevated MVC rates. This is consistent with previous research despite studies showing wide individual variability from excellent to poor driving skills. Future research should focus on the functional and driving performance characteristics associated with superior driving skills and/or those that may be amenable to improvement via behavioral and/or engineering interventions.

Highlights

Persons with homonymous quadrantanopia and hemianopia experience visual field defects where one-quarter or one-half of the binocular visual field, respectively, is absent
The sample consisted of 20 participants with hemianopic field loss, seven with quadrantanopic field loss and 27 age-matched participants with normal visual fields; the average follow-up time was 6.7 (7.5) years, 6.5 (6.0) years and 8.8 (8.8) years, respectively
The results of the current study suggest that drivers with visual field loss attributable to homonymous hemianopia and quadrantanopia have elevated motor vehicle collision (MVC) rates compared to aged drivers with normal visual fields, when rates are defined in terms of person-miles of driving

Summary

Introduction

Persons with homonymous quadrantanopia and hemianopia experience visual field defects where one-quarter or one-half of the binocular visual field, respectively, is absent. These defects result from post-chiasmal injury to the visual pathways and are typically secondary to acute events such as a stroke or traumatic brain injury or the result of a tumor [1]. The incidence of stroke and subsequent hemianopia is likely to increase [3]. Persons with these conditions commonly report mobility limitations and reduced quality of life, including driving problems [4,5]. A better understanding how adults manage these visual difficulties, especially while driving, is needed

Objectives

Results

Conclusion