Skip to main content

Advertisement

SpringerLink
Log in

Relationship between retinal nerve fiber layer thickness and driving ability in patients with human immunodeficiency virus infection

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Background

The aim of this work is to study the possible association between retinal nerve fiber layer (NFL) thickness and driving ability.

Methods

Thirty-eight drivers including 22 HIV-positive (HIV+) and 16 age-matched HIV-negative controls participants underwent a full ophthalmologic evaluation, including assessment of retinal NFL thickness. In the undilated state with standard optical correction and under standard illumination they also completed a computer-based, wide field-of-view driving simulation in which they were to obey traffic laws, engage in crash avoidance, and pass slower automobiles. Crashes, speeding and traffic light tickets, and off-road excursions contributed to a weighted score of driving errors.

Results

HIV-seropositive participants had a significantly higher weighted error score than control participants (18.4 [9.2] vs. 11.1 [4.5], p = 0.006). NFL thickness was significantly correlated with driving errors (r = −0.51, p = 0.025); there was a trend for participants with a CD4 nadir <100 to have more errors than those with a nadir >100 (29.7 [13.2] vs. 19.3 [8.4], p = 0.056). The highest number of driving errors occurred in individuals with both CD4 <100 and NFL thickness <80.

Conclusions

Driving ability may be impacted by reductions in retinal nerve fiber layer thickness. Physicians should consider the potential impact that more complex ophthalmologic conditions in HIV-infected patients may have on driving performance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Freeman WR, Van Natta ML, Jabs D, Sample PA, Sadun AA, Thorne J, Shah KH, Holland GN, Grp SR (2008) Vision function in HIV-infected individuals without retinitis: report of the Studies of Ocular Complications of AIDS Research Group. Am J Ophthalmol 145(3):453–462

    Article  PubMed  Google Scholar 

  2. Plummer DJ, Sample PA, Arevalo JF, Grant I, Quiceno JI, Dua R, Freeman WR (1996) Visual field toss in HIV-positive patients without infectious retinopathy. Am J Ophthalmol 122(4):542–549

    PubMed  CAS  Google Scholar 

  3. Geier SA, Nohmeier C, Lachenmayr BJ, Klauss V, Goebel FD (1995) Deficits in perimetric performance in patients with symptomatic human-immunodeficiency-virus infection or acquired-immunodeficiency-syndrome. Am J Ophthalmol 119(3):335–344

    PubMed  CAS  Google Scholar 

  4. Geier SA, Kronawitter U, Bogner JR, Hammel G, Berninger T, Klauss V, Goebel FD (1993) Impairment of color contrast sensitivity and neuroretinal dysfunction in patients with symptomatic HIV infection or AIDS. Br J Ophthalmol 77(11):716–720

    Article  PubMed  CAS  Google Scholar 

  5. Shah KH, Holland GN, Yu F, Van Natta M, Nusinowitz S (2006) Contrast sensitivity and color vision in HIV-infected individuals without infectious retinopathy. Am J Ophthalmol 142(2):284–292

    Article  PubMed  Google Scholar 

  6. Mueller AJ, Plummer DJ, Dua R, Taskintuna I, Sample PA, Grant I, Freeman WR (1997) Analysis of visual dysfunctions in HIV-positive patients without retinitis. Am J Ophthalmol 124(2):158–167

    PubMed  CAS  Google Scholar 

  7. Sample PA, Plummer DJ, Mueller AJ, Matsubara KI, Sadun A, Grant I, Freeman WR (1999) Pattern of early visual field loss in HIV-infected patients. Arch Ophthalmol 117(6):755–760

    PubMed  CAS  Google Scholar 

  8. Kozak I, Bartsch DU, Cheng LY, Kosobucki BR, Freeman WR (2005) Objective analysis of retinal damage in HIV-positive patients in the HAART era using OCT. Am J Ophthalmol 139(2):295–301

    Article  PubMed  Google Scholar 

  9. Kozak I, Bartsch DUG, Cheng L, McCutchan A, Weinreb RN, Freeman WR (2007) Scanning laser polarimetry demonstration of retinal nerve fiber layer damage in human immunodeficiency virus-positive patients without infectious retinitis. Retina 27(9):1267–1273

    Article  PubMed  Google Scholar 

  10. Gomez ML, Mojana F, Bartsch DU, Freeman WR (2009) Imaging of long-term retinal damage after resolved cotton wool spots. Ophthalmology 116(12):2407–2414

    Article  PubMed  Google Scholar 

  11. Marcotte TD, Heaton RK, Wolfson T, Taylor MJ, Alhassoon O, Arfaa K, Grant I (1999) The impact of HIV-related neuropsychological dysfunction on driving behavior. J Int Neuropsychol Soc 5(7):579–592

    Article  PubMed  CAS  Google Scholar 

  12. Marcotte TD, Wolfson T, Rosenthal TJ, Heaton RK, Gonzalez R, Ellis RJ, Grant I (2004) A multimodal assessment of driving performance in HIV infection. Neurology 63(8):1417–1422

    PubMed  CAS  Google Scholar 

  13. Marcotte TD, Lazzaretto D, Scott JC, Roberts E, Woods SP, Letendre S (2006) Visual attention deficits are associated with driving accidents in cognitively-impaired HIV-Infected individuals. J Clin Exp Neuropsychol 28(1):13–28

    Article  PubMed  Google Scholar 

  14. Dobbs AR, Heller RB, Schopflocher D (1998) A comparative approach to identify unsafe older drivers. Accid Anal Prev 30(3):363–370

    Article  PubMed  CAS  Google Scholar 

  15. Baldock MR, Mathias JL, McLean AJ, Berndt A (2006) Self-regulation of driving and its relationship to driving ability among older adults. Accid Anal Prev 38(5):1038–1045

    Article  PubMed  CAS  Google Scholar 

  16. Kay L, Bundy A, Clemson L, Jolly N (2008) Validity and reliability of the on-road driving assessment with senior drivers. Accid Anal Prev 40(2):751–759

    Article  PubMed  Google Scholar 

  17. Kozak I, Sample PA, Hao J, Freeman WR, Weinreb RN, Lee TW, Goldbaum MH (2007) Machine learning classifiers detect subtle field defects in eyes of HIV individuals. Trans Am Ophthalmol Soc 105:111–118, discussion 119–120

    PubMed  Google Scholar 

  18. Heaton RK, Clifford DB, Franklin DR Jr, Woods SP, Ake C, Vaida F, Ellis RJ, Letendre SL, Marcotte TD, Atkinson JH (2010) HIV-associated neurocognitive disorders persist in the era of potent antiretroviral therapy: CHARTER Study. Neurology 75(23):2087–2096

    Article  PubMed  Google Scholar 

  19. Shechtman OCS, Awadzi K, Mann W (2009) Comparison of driving errors between on-the-road and simulated driving assessment: a validation study. Traffic Inj Prev 10(4):379–385

    Article  PubMed  Google Scholar 

  20. Lee H (2003) The validity of driving simulator to measure on-road driving performance of older drivers. Transp Eng Aust 8(2):89–100

    CAS  Google Scholar 

Download references

Funding

National Institutes of Health (NIH) Grant No. EY007366. NOT-OD-09-060-Recovery Act Administrative Supplement for undergraduate summer research fund. MH 62512 - HIV Neurobehavioral Research Center (HNRC).

Author information

Authors and Affiliations

  1. UCSD Department of Ophthalmology, Joan and Irwin Jacobs Retina Center at the Shiley Eye Center, La Jolla, CA, USA

    Sarah Cheng, Helaina Klein, Dirk-Uwe Bartsch, Igor Kozak & William R. Freeman

  2. UCSD Department of Psychiatry, HIV Neurobehavioral Research Center, La Jolla, CA, USA

    Thomas D. Marcotte

  3. Jacobs Retina Center at Shiley Eye Center, UCSD School of Medicine, University of California at San Diego, La Jolla, CA, 92037, USA

    Igor Kozak

Authors
  1. Sarah Cheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Helaina Klein
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dirk-Uwe Bartsch
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Igor Kozak
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Thomas D. Marcotte
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. William R. Freeman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Igor Kozak.

Electronic supplementary material

Below is the link to the electronic supplementary material.

ESM 1

(DOC 22.5 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cheng, S., Klein, H., Bartsch, DU. et al. Relationship between retinal nerve fiber layer thickness and driving ability in patients with human immunodeficiency virus infection. Graefes Arch Clin Exp Ophthalmol 249, 1643–1647 (2011). https://doi.org/10.1007/s00417-011-1735-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-011-1735-4

Keywords

Search

Navigation