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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‚ÄČkm 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

Percent of satisfactory responses to unexpected hazardous events on the blind side in the sham prism (SP) and real prism (RP) drives for the eight participants with blindside events in both drives. The diagonal line represents identical performance in the two drives. Six drivers (three current and three noncurrent) had a higher proportion of satisfactory responses in the RP than the SP drive (data points above the diagonal; P = 0.03).
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fig5: Percent of satisfactory responses to unexpected hazardous events on the blind side in the sham prism (SP) and real prism (RP) drives for the eight participants with blindside events in both drives. The diagonal line represents identical performance in the two drives. Six drivers (three current and three noncurrent) had a higher proportion of satisfactory responses in the RP than the SP drive (data points above the diagonal; P = 0.03).

Mentions: Of the 80 unexpected hazards, 68 could be attributed to an event on either the blind (9 with and 34 without an intervention) or seeing side (9 with and 16 without an intervention). On the blind side, although the total number of events was similar for the RP and SP drives, the proportion of satisfactory responses was significantly higher in the RP drive (80% versus 30%; z = 3.25, P = 0.001; Figure 4); the same was true when only the participants with stroke were included (93% versus 32%; z = 3.52, P < 0.001). These analyses were for data pooled across participants, irrespective of whether or not there was an unexpected hazardous event on the blind side in both the RP and SP drives. When data for only those participants with blindside events in both the SP and RP drives (n = 8) were considered, the proportion of satisfactory responses for data pooled across participants was still significantly higher in the RP drive (78% versus 32%; z = 2.90, P = 0.002) and the proportion of satisfactory responses per participant was also significantly higher in the RP drive (Wilcoxon signed ranks test, z = 1.88, P = 0.03; Figure 5). Taken together, these results indicate a beneficial effect of the RP glasses on detection of blindside hazards. By comparison, on the seeing side, there were no significant differences in the proportion of satisfactory responses for the RP and SP drives (64% and 57%, resp.; data pooled across all participants; z = 0.33, P = 0.371; Figure 4).


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)

Percent of satisfactory responses to unexpected hazardous events on the blind side in the sham prism (SP) and real prism (RP) drives for the eight participants with blindside events in both drives. The diagonal line represents identical performance in the two drives. Six drivers (three current and three noncurrent) had a higher proportion of satisfactory responses in the RP than the SP drive (data points above the diagonal; P = 0.03).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig5: Percent of satisfactory responses to unexpected hazardous events on the blind side in the sham prism (SP) and real prism (RP) drives for the eight participants with blindside events in both drives. The diagonal line represents identical performance in the two drives. Six drivers (three current and three noncurrent) had a higher proportion of satisfactory responses in the RP than the SP drive (data points above the diagonal; P = 0.03).
Mentions: Of the 80 unexpected hazards, 68 could be attributed to an event on either the blind (9 with and 34 without an intervention) or seeing side (9 with and 16 without an intervention). On the blind side, although the total number of events was similar for the RP and SP drives, the proportion of satisfactory responses was significantly higher in the RP drive (80% versus 30%; z = 3.25, P = 0.001; Figure 4); the same was true when only the participants with stroke were included (93% versus 32%; z = 3.52, P < 0.001). These analyses were for data pooled across participants, irrespective of whether or not there was an unexpected hazardous event on the blind side in both the RP and SP drives. When data for only those participants with blindside events in both the SP and RP drives (n = 8) were considered, the proportion of satisfactory responses for data pooled across participants was still significantly higher in the RP drive (78% versus 32%; z = 2.90, P = 0.002) and the proportion of satisfactory responses per participant was also significantly higher in the RP drive (Wilcoxon signed ranks test, z = 1.88, P = 0.03; Figure 5). Taken together, these results indicate a beneficial effect of the RP glasses on detection of blindside hazards. By comparison, on the seeing side, there were no significant differences in the proportion of satisfactory responses for the RP and SP drives (64% and 57%, resp.; data pooled across all participants; z = 0.33, P = 0.371; Figure 4).

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‚ÄČkm 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