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The purpose of the study was (1) to determine thresholds for discriminating speed in peripheral fields of patients with dry AMD and (2) to examine the driving skills of licensed drivers with early dry AMD using a driving simulator and to investigate how their healthy counterparts perform on the same driving tasks. We hypothesized that speed discrimination may be better in patients with dry AMD than in healthy control subjects.
This observational study has two goals:
Two tasks will be used: 1) A speed discrimination test. (Glaucoma patient are not asked to perform this task as it assesses the peripheral visual fields, which is affected by the disease.) 2) A driving simulation session. Participant will undergo both tests on the same day, no later than a month after the initial recruitement visit.
For both diseases, patients will be compared to healthy controls matched for age and gender, but also to a younger control group. The latter group was added in order to take into account the normal aging impact on driving skills (visual and cognitive).
Our hypothesis is that AMD patient will show a better speed discriminating threshold than matched control and maybe better or equal to the younger control groups. We also hypothesize that driving skills involving peripheric speed awareness, such as passing another car, will be enhanced in the AMD group when compared to glaucoma patients and age-matched control group.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| AMD controls | 15 patients with early to intermediate AMD (grade 2-8) were enrolled using the Age-Related Eye Disease Study (AREDS) severity scale for AMD. |
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| Age-matched controls | 15 drivers without ocular disease. |
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| Young controls | 15 drivers without ocular disease. Between 18 and 25 years old. |
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| Glaucoma patients | 15 patients having a Humphrey visual field mean deviation between -10 and -12 (better eye). |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Speed discrimination test | Other | The participant has to stare in the middle of two screens, i.e the reference screen and the test screen. Dots are moving from the center to the edge of the screens at different speeds. The participant is forced to determine if the dots of the test screen are moving faster or slower than the reference screen. The test is designed in Psychtoolbox3. Data analyses performed using MATLAB. Two-alternative forced choice paradigm. |
| Measure | Description | Time Frame |
|---|---|---|
| Speed discrimination threshold | 75% point is taken as a measure of the discrimination threshold. | Before driving simulation |
| Measure | Description | Time Frame |
|---|---|---|
| Driving performance | Probe reaction time task. Speed limits. Respect of traffic safety rules. | After speed discrimination task |
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Inclusion Criteria:
Exclusion Criteria:
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Patients (with glaucoma or AMD) were recruited from the Centre Universitaire d'Ophtalmologie (CUO), Saint-Sacrement Hospital in Quebec City.
Participants in control groups are residents of Quebec City.
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| Name | Affiliation | Role |
|---|---|---|
| Gilles Lalonde, MD | Centre Universitaire d'Ophtalmologie (CUO), Saint-Sacrement Hospital, Quebec City. | Principal Investigator |
| Marc Hébert, PhD | Centre Universitaire d'Ophtalmologie (CUO), Saint-Sacrement Hospital, Quebec City | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre universitaire d'ophtalmologie, Hôpital du Saint-Sacrement, CHU de Québec | Québec | Quebec | G1S 4L8 | Canada |
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| ID | Term |
|---|---|
| D008268 | Macular Degeneration |
| D005901 | Glaucoma |
| ID | Term |
|---|---|
| D012162 | Retinal Degeneration |
| D012164 | Retinal Diseases |
| D005128 | Eye Diseases |
| D009798 | Ocular Hypertension |
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| Driving simulation | Behavioral | 25 km simulated car driving session. The participant is seated in the driver compartment of a real car featuring all the actual components (steering wheel, pedals regulating speed and brakes). He is instructed to respect road regulations as well as safety rules and must perform some driving manoeuvres, such has turning at intersections, stopping when necessary, passing another car, etc. Software Drive 3.0 by Systems Technology Inc., Hawthorne, California, USA. Magnetic head tracker (Flock of Birds, Ascension Technology Corporation, Burlington, Vermont, USA). A fixed-base driving simulator. 2 driving scenarios: a practice (10 minutes) and a main scenario including rural and urban sections (35 minutes). |
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