Eyeworld

N EWS 24 | EYEWORLD | NOVEMBER 2019 RESEARCH HIGHLIGHTS by Maxine Lipner EyeWorld Senior Contributing Writer AMD patients on the road: How visual acuity factors in J ust because a patient has been diag- nosed with age-related macular degen- eration (AMD) doesn't mean they've given up driving. In a study published in Ophthalmology Retina, 1 71.2% of pa- tients were found to currently still get behind the wheel, according to Jennifer Patnaik, PhD. Of these patients, 12.4% were reported as having Snellen acuity of less than 20/40. After routinely administering the Nation- al Eye Institute visual function questionnaire to patients, investigators noticed that when patients were asked about visual functionality with regular daily activities, scores surround- ing driving were lowest for those with AMD. Given that driving can be a safety concern with normal acuity, investigators decided to examine how this was impacted by the condition, Dr. Patnaik said. Considering driving issues For this ongoing study, investigators drew from a registry of AMD patients seeking care at the Department of Ophthalmology of the Univer- sity of Colorado School of Medicine beginning in 2014. "The registry also includes control data from patients who have cataracts but who don't have AMD," Dr. Patnaik said, adding that there are currently more than 1,000 patients enrolled in the study, including 553 with macular degen- eration. Study participants were asked to self-report how they felt about their driving when they were in different situa- tions. Investi- gators were surprised about some of those who had given up driv- ing. "Among patients who reported that they weren't driving at all, almost half of them, 46%, met the Colorado state vision requirement and had visual acuity of 20/40 or better," Dr. Patnaik said. Beyond vision, cognitive and physical functioning also play a role in patients determining whether they feel able to continue driving. Also, some elected not to drive in certain circumstances, such as at night, on highways, or in unfamiliar areas, Dr. Patnaik said. Investigators found that among the 394 AMD patients who were still driving, those who had visual acuity that didn't meet the state requirement of 20/40 or better experienced more difficulties, especially at night. Of those still driving, 87.6% had visual acuity of 20/40 or better, 9.6% had acuity of 20/50 to 20/60, and 2.8% had vision of less than this. Weighing intervention "When a patient comes in and they want to continue to drive and they can't pass a standard state regulation test, they're referred to our low-vision specialist to test additional visual function and determine whether they can drive or not," Dr. Patnaik said. In cases where an ophthalmic practitioner is concerned that a patient's vision may present safety concerns for driving, they can advise a patient not to drive but can't actually force them to give it up, she stressed. "Giving up driving can be difficult for patients; it's giving up their independence," Dr. Patnaik said. "So it might require a team approach involving practitioners and the patient's family." Dr. Patnaik hopes the study elucidates for practitioners the problems that many macular degenera- tion patients can face while driving, even if the vision in their better eye does meet About the source Jennifer Patnaik, PhD Assistant professor Department of Ophthalmology University of Colorado School of Medicine Aurora, Colorado Reference 1. Patnaik JL, et al. Driving and visual acuity in patients with age-related macular degen- eration. Ophthalmol Retina. 2019;3:336–342. Relevant financial interests Patnaik: None Contact information Patnaik: Jennifer.Patnaik@cuanschutz.edu

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