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A pilot evaluation of on-road detection performance by drivers with hemianopia using oblique peripheral prisms.

Bowers AR, Tant M, Peli E - Stroke Res Treat (2012)

Bottom Line: We conducted a pilot study to evaluate the effects of oblique peripheral prisms, a novel development in optical treatments for HH, on detection of unexpected hazards when driving.Results.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Schepens Eye Research Institute, Massachusetts Eye and Ear, and Department of Ophthalmology, Harvard Medical School, 20 Staniford Street, Boston, MA 02114, USA.

ABSTRACT
Aims. Homonymous hemianopia (HH), a severe visual consequence of stroke, causes difficulties in detecting obstacles on the nonseeing (blind) side. We conducted a pilot study to evaluate the effects of oblique peripheral prisms, a novel development in optical treatments for HH, on detection of unexpected hazards when driving. Methods. Twelve people with complete HH (median 49 years, range 29-68) completed road tests with sham oblique prism glasses (SP) and real oblique prism glasses (RP). A masked evaluator rated driving performance along the 25 km routes on busy streets in Ghent, Belgium. Results. The proportion of satisfactory responses to unexpected hazards on the blind side was higher in the RP than the SP drive (80% versus 30%; P = 0.001), but similar for unexpected hazards on the seeing side. Conclusions. These pilot data suggest that oblique peripheral prisms may improve responses of people with HH to blindside hazards when driving and provide the basis for a future, larger-sample clinical trial. Testing responses to unexpected hazards in areas of heavy vehicle and pedestrian traffic appears promising as a real-world outcome measure for future evaluations of HH rehabilitation interventions aimed at improving detection when driving.

No MeSH data available.


Related in: MedlinePlus

Number (median and interquartile range) of interventions in each drive for individual participants. Noncurrent drivers had fewer interventions in the real prism (RP) than the sham prism (SP) drives, and more interventions than current drivers in the SP but not the RP drives. The thick horizontal line within each box is the median; the vertical extent of the box is the interquartile range (IQR); vertical lines at box ends represent the largest nonoutlier data points within 1.5x IQR. Open triangle is a far outlier (>3x IQR).
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fig3: Number (median and interquartile range) of interventions in each drive for individual participants. Noncurrent drivers had fewer interventions in the real prism (RP) than the sham prism (SP) drives, and more interventions than current drivers in the SP but not the RP drives. The thick horizontal line within each box is the median; the vertical extent of the box is the interquartile range (IQR); vertical lines at box ends represent the largest nonoutlier data points within 1.5x IQR. Open triangle is a far outlier (>3x IQR).

Mentions: Braking was the most common intervention (Table 2) and was primarily due to failures to notice a traffic event (vehicles, pedestrians, traffic lights). By comparison, steering interventions were less common (Table 2) and were mainly a result of taking a lane position too far to the right or the left, or weaving; only 1 of 8 was a result of failing to notice a traffic event. For noncurrent drivers, there were significantly fewer interventions in the RP than the SP drives (Wilcoxon signed ranks test, z = 2.22,   P = 0.01; Table 2 and Figure 3), and they had significantly more interventions than current drivers in the SP, but not the RP drives (Mann-Whitney U test, z = 1.84, P = 0.04 and z = 0.51, P = 0.34, resp.; Figure 3).


A pilot evaluation of on-road detection performance by drivers with hemianopia using oblique peripheral prisms.

Bowers AR, Tant M, Peli E - Stroke Res Treat (2012)

Number (median and interquartile range) of interventions in each drive for individual participants. Noncurrent drivers had fewer interventions in the real prism (RP) than the sham prism (SP) drives, and more interventions than current drivers in the SP but not the RP drives. The thick horizontal line within each box is the median; the vertical extent of the box is the interquartile range (IQR); vertical lines at box ends represent the largest nonoutlier data points within 1.5x IQR. Open triangle is a far outlier (>3x IQR).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3539405&req=5

fig3: Number (median and interquartile range) of interventions in each drive for individual participants. Noncurrent drivers had fewer interventions in the real prism (RP) than the sham prism (SP) drives, and more interventions than current drivers in the SP but not the RP drives. The thick horizontal line within each box is the median; the vertical extent of the box is the interquartile range (IQR); vertical lines at box ends represent the largest nonoutlier data points within 1.5x IQR. Open triangle is a far outlier (>3x IQR).
Mentions: Braking was the most common intervention (Table 2) and was primarily due to failures to notice a traffic event (vehicles, pedestrians, traffic lights). By comparison, steering interventions were less common (Table 2) and were mainly a result of taking a lane position too far to the right or the left, or weaving; only 1 of 8 was a result of failing to notice a traffic event. For noncurrent drivers, there were significantly fewer interventions in the RP than the SP drives (Wilcoxon signed ranks test, z = 2.22,   P = 0.01; Table 2 and Figure 3), and they had significantly more interventions than current drivers in the SP, but not the RP drives (Mann-Whitney U test, z = 1.84, P = 0.04 and z = 0.51, P = 0.34, resp.; Figure 3).

Bottom Line: We conducted a pilot study to evaluate the effects of oblique peripheral prisms, a novel development in optical treatments for HH, on detection of unexpected hazards when driving.Results.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Schepens Eye Research Institute, Massachusetts Eye and Ear, and Department of Ophthalmology, Harvard Medical School, 20 Staniford Street, Boston, MA 02114, USA.

ABSTRACT
Aims. Homonymous hemianopia (HH), a severe visual consequence of stroke, causes difficulties in detecting obstacles on the nonseeing (blind) side. We conducted a pilot study to evaluate the effects of oblique peripheral prisms, a novel development in optical treatments for HH, on detection of unexpected hazards when driving. Methods. Twelve people with complete HH (median 49 years, range 29-68) completed road tests with sham oblique prism glasses (SP) and real oblique prism glasses (RP). A masked evaluator rated driving performance along the 25 km routes on busy streets in Ghent, Belgium. Results. The proportion of satisfactory responses to unexpected hazards on the blind side was higher in the RP than the SP drive (80% versus 30%; P = 0.001), but similar for unexpected hazards on the seeing side. Conclusions. These pilot data suggest that oblique peripheral prisms may improve responses of people with HH to blindside hazards when driving and provide the basis for a future, larger-sample clinical trial. Testing responses to unexpected hazards in areas of heavy vehicle and pedestrian traffic appears promising as a real-world outcome measure for future evaluations of HH rehabilitation interventions aimed at improving detection when driving.

No MeSH data available.


Related in: MedlinePlus