Skip to main content

Advertisement

SpringerLink
Log in

Agreement of driving simulator and on-road driving performance in patients with binocular visual field loss

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

Abstract

Purpose

On-road testing is considered the standard for assessment of driving performance; however, it lacks standardization. In contrast, driving simulators provide controlled experimental settings in a virtual reality environment. This study compares both testing conditions in patients with binocular visual field defects due to bilateral glaucomatous optic neuropathy or due to retro-chiasmal visual pathway lesions.

Methods

Ten glaucoma patients (PG), ten patients with homonymous visual field defects (PH), and 20 age- and gender-matched ophthalmologically normal control subjects (CG and CH, respectively) participated in a 40-min on-road driving task using a dual brake vehicle. A subset of this sample (8 PG, 8 PH, 8 CG, and 7 CH) underwent a subsequent driving simulator test of similar duration. For both settings, pass/fail rates were assessed by a masked driving instructor.

Results

For on-road driving, hemianopia patients (PH) and glaucoma patients (PG) showed worse performance than their controls (CH and CG groups): PH 40%, CH 30%, PG 60%, CG 0%, failure rate. Similar results were obtained for the driving simulator test: PH 50%, CH 29%, PG 38%, CG 0%, failure rate. Twenty-four out of 31 participants (77%) showed concordant results with regard to pass/fail under both test conditions (p > 0.05; McNemar test).

Conclusions

Driving simulator testing leads to results comparable to on-road driving, in terms of pass/fail rates in subjects with binocular (glaucomatous or retro-chiasmal lesion-induced) visual field defects. Driving simulator testing seems to be a well-standardized method, appropriate for assessment of driving performance in individuals with binocular visual field loss.

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

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

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

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Kulkarni KM, Mayer JR, Lorenzana LL, Myers JS, Spaeth GL (2012) Visual field staging systems in glaucoma and the activities of daily living. Am J Ophthalmol 154:445–451

    Article  Google Scholar 

  2. Silveira S, Jolly N, Heard R, Clunas NJ, Kay L (2007) Current licensing authority standards for peripheral visual field and safe on-road senior aged automobile driving performance. Clin Exp Ophthalmol 35:612–620

    Article  Google Scholar 

  3. DeLaey JJ, Colenbrander A (2006) Visual standards: Vision requirements for driving safety with emphasis on individual assessment www.icoph.org/pdf/visionfordriving.pdf. Assessed 18 June 2018

  4. Kasneci E, Sippel K, Aehling K et al (2014) Driving with binocular visual field loss? A study on a supervised on-road parcours with simultaneous eye and head tracking. PLoS One 9:e87470

    Article  Google Scholar 

  5. de Haan GA, Melis-Dankers BJM, Brouwer WH, Bredewoud RA, Tucha O, Heutink J (2014) Car driving performance in hemianopia: an-on road driving study. Invest Ophthalmol Vis Sci 55:6482–6489

    Article  Google Scholar 

  6. Wood JM, McGwin G Jr, Elgin J, Vaphiades MS, Braswell RA, DeCarlo DK et al (2011) Hemianopic and quadrantanopic field loss, eye and head movements, and driving. Invest Ophthalmol Vis Sci 52:1220–1225

    Article  Google Scholar 

  7. Papageorgiou E, Hardiess G, Ackermann H, Wiethoelter H, Dietz K, Mallot HA et al (2012) Collision avoidance in persons with homonymous visual field defects under virtual reality conditions. Vis Res 52:20–30

    Article  Google Scholar 

  8. Kübler TC, Kasneci E, Rosenstiel W, Heister M, Aehling K, Nagel K et al (2015) Driving with glaucoma: task performance and gaze movements. Optom Vis Sci 92:1037–1046

    Article  Google Scholar 

  9. Bedard M, Parkkari M, Weaver B, Riendeau J, Dahlquist M (2010) Brief report-assessment of driving performance using a simulator protocol: validity and reproducibility. Am J Occup Ther 64:336–340

    Article  Google Scholar 

  10. Eramudugolla R, Price J, Chopra S, Li X, Anstey KJ (2016) Comparison of a virtual older driver assessment with an on-road driving test. J Am Geriatr Soc 64:253–258

    Article  Google Scholar 

  11. Törnros J (1998) Driving behaviour in a real and a simulated road tunnel—a validation study. Accid Anal Prev 30:497–503

    Article  Google Scholar 

  12. Blana E, Golias J (2002) Differences between vehicle lateral displacement on the road and in a fixed-base simulator. Hum Factors 44:303–313

    Article  Google Scholar 

  13. Devos H, Akinwuntan AE, Nieuwboer A, Tant M, Truijen S, De Wit L et al (2009) Comparison of the effect of two driving retraining programs on on-road performance after stroke. Neurorehabil Neural Repair 23:699–705

    Article  Google Scholar 

  14. Fuermaier ABM, Piersma D, de Waard D, Davidse RJ, de Groot J, Doumen MJA et al (2017) Assessing fitness to drive—a validation study on patients with mild cognitive impairment. Traffic Inj Prev 18:145–149

    Article  Google Scholar 

  15. Freund B, Gravenstein S, Ferris R, Shaheen E (2002) Evaluating driving performance of cognitively impaired and healthy older adults: a pilot study comparing on-road testing and driving simulation. J Am Geriatr Soc 50:1309–1310

    Article  Google Scholar 

  16. Piersma D, Fuermaier ABM, de Waard D, Davidse RJ, de Groot J, Doumen MJA et al (2016) Prediction of fitness to drive in patients with Alzheimer’s dementia. PLoS One 11:e0149566

    Article  Google Scholar 

  17. Keller M, Kesselring J, Hiltbrunner B (2003) Fitness to drive with neurological disabilities. Neurorehabil Neural Repair 17:168–175

    Article  CAS  Google Scholar 

  18. Lundqvist A, Gerdle B, Rönnberg J (2000) Neuropsychological aspects of driving after a stroke—in the simulator and on the road. Appl Cogn Psychol 14:135–150

    Article  Google Scholar 

  19. Kübler TC, Kasneci E, Rosenstiel W, Aehling K, Heister M, Nagel K et al (2015) Driving with homonymous visual field defects: driving performance and compensatory gaze movements. J Eye Mov Res 5:1–11

    Google Scholar 

  20. Hird MA, Vetivelu A, Saposnik G, Schweizer TA (2014) Cognitive, on-road, and simulator-based driving assessment after stroke. J Stroke Cerebrovasc Dis 23:2654–2670

    Article  Google Scholar 

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

    Article  Google Scholar 

  22. Coeckelbergh TRM (2002) The effect of visual field defects on driving performance: a driving simulator study. Arch Ophthalmol 120:1509

    Article  Google Scholar 

  23. Szlyk JP, Mahler CL, Seiple W, Edward DP, Wilensky JT (2005) Driving performance of glaucoma patients correlates with peripheral visual field loss. J Glaucoma 14:145–150

    Article  Google Scholar 

  24. Gracitelli CPB, Tatham AJ, Boer ER, Abe RY, Diniz-Filho A, Rosen PN et al (2015) Predicting risk of motor vehicle collisions in patients with glaucoma: a longitudinal study. PLoS One 10:e0138288

    Article  Google Scholar 

  25. Szlyk JP, Pizzimenti CE, Fishman GA, Kelsch R, Wetzel LC, Kagan S et al (1995) A comparison of driving in older subjects with and without age-related macular degeneration. Arch Ophthalmol 113:1033–1040

    Article  CAS  Google Scholar 

  26. Ball K, Owsley C (1993) The useful field of view test: a new technique for evaluating age-related declines in visual function. J Am Optom Assoc 64:71–79

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors are grateful to Mr. Helmut Hanne, driving school Hanne, Tübingen/FRG, for evaluating the drivers’ performances and to the FZI, Karlsruhe/FRG, for providing the dual brake vehicle.

Katja Nagel, Daimler AG, Research and Development, Driving Simulators, Workshops & Testing RD/FFS, 059-HPC X820, D-71059 Sindelfingen/Germany.

Ulrich Schiefer, Study course Ophthalmic Optics, University of Applied Sciences, Aalen, Department of Ophthalmology, University of Tübingen, Tübingen, Germany.

Funding

This study was funded by PFIZER Pharma GmbH, Berlin, Germany, and to MSD, MERCK, SHARP and DOHME GmbH, Haar/Germany. This funding was used for compensation of the recruited subjects. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author information

Authors and Affiliations

  1. Study course Ophthalmic Optics, University of Applied Sciences, Aalen, Germany

    Judith Ungewiss

  2. Department of Computer Science, University of Tübingen, Tübingen, Germany

    Thomas Kübler, Katrin Sippel, Wolfgang Rosenstiel & Enkelejda Kasneci

  3. Department of Ophthalmology, University of Tübingen, Tübingen, Germany

    Kathrin Aehling & Martin Heister

  4. Department of Ophthalmology, University Hospital of Larissa, Mezourlo Area, 41222, Larissa, Greece

    Eleni Papageorgiou

Authors
  1. Judith Ungewiss
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Thomas Kübler
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Katrin Sippel
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kathrin Aehling
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Martin Heister
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Wolfgang Rosenstiel
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Enkelejda Kasneci
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Eleni Papageorgiou
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

The Simulator/On-road Study Group

  • Katja Nagel
  •  & Ulrich Schiefer

Corresponding author

Correspondence to Eleni Papageorgiou.

Ethics declarations

The research study was approved by the Independent Ethics Committee of the University of Tübingen and was performed according to the Declaration of Helsinki. Following verbal and written explanation of the experimental protocol, all patients gave their written consent, with the option of withdrawing from the study at any time.

Conflict of interest

Judith Ungewiss declares that she has no conflict of interest.

Thomas Kübler declares that he has no conflict of interest.

Katrin Sippel declares that she has no conflict of interest.

Kathrin Aehling declares that she has no conflict of interest.

Martin Heister declares that he has no conflict of interest.

Wolfgang Rosenstiel declares that he has no conflict of interest.

Enkelejda Kasneci declares that she has no conflict of interest.

Eleni Papageorgiou declares that she has no conflict of interest.

Katja Nagel declares that she has no conflict of interest.

Ulrich Schiefer is a consultant of the HAAG-STREIT Inc., Köniz, Switzerland. He has received personal fees for invited lectures by several pharmaceutical companies, including MSD (MERCK, SHARP & DOHME GmbH), Haar/Germany and PFIZER Pharma GmbH, Berlin, Germany.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

Clinical Trial Registration: http://www.clinicaltrials.gov.

Unique identifiers: NCT 01372319, NTC01372332

Electronic supplementary material

ESM 1

(PDF 930 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ungewiss, J., Kübler, T., Sippel, K. et al. Agreement of driving simulator and on-road driving performance in patients with binocular visual field loss. Graefes Arch Clin Exp Ophthalmol 256, 2429–2435 (2018). https://doi.org/10.1007/s00417-018-4148-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-018-4148-9

Keywords

Search

Navigation