Skip to main content
Top
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology 11/2011

01-11-2011 | Retinal Disorders

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

Authors: Sarah Cheng, Helaina Klein, Dirk-Uwe Bartsch, Igor Kozak, Thomas D. Marcotte, William R. Freeman

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 11/2011

Login to get access

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.
Appendix
Available only for authorised users
Literature
1.
go back to reference 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):453–462PubMedCrossRef 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):453–462PubMedCrossRef
2.
go back to reference 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):542–549PubMed 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):542–549PubMed
3.
go back to reference 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):335–344PubMed 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):335–344PubMed
4.
go back to reference 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):716–720PubMedCrossRef 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):716–720PubMedCrossRef
5.
go back to reference 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):284–292PubMedCrossRef 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):284–292PubMedCrossRef
6.
go back to reference 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):158–167PubMed 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):158–167PubMed
7.
go back to reference 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):755–760PubMed 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):755–760PubMed
8.
go back to reference 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):295–301PubMedCrossRef 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):295–301PubMedCrossRef
9.
go back to reference 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):1267–1273PubMedCrossRef 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):1267–1273PubMedCrossRef
10.
go back to reference Gomez ML, Mojana F, Bartsch DU, Freeman WR (2009) Imaging of long-term retinal damage after resolved cotton wool spots. Ophthalmology 116(12):2407–2414PubMedCrossRef Gomez ML, Mojana F, Bartsch DU, Freeman WR (2009) Imaging of long-term retinal damage after resolved cotton wool spots. Ophthalmology 116(12):2407–2414PubMedCrossRef
11.
go back to reference 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):579–592PubMedCrossRef 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):579–592PubMedCrossRef
12.
go back to reference 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):1417–1422PubMed 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):1417–1422PubMed
13.
go back to reference 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):13–28PubMedCrossRef 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):13–28PubMedCrossRef
14.
go back to reference Dobbs AR, Heller RB, Schopflocher D (1998) A comparative approach to identify unsafe older drivers. Accid Anal Prev 30(3):363–370PubMedCrossRef Dobbs AR, Heller RB, Schopflocher D (1998) A comparative approach to identify unsafe older drivers. Accid Anal Prev 30(3):363–370PubMedCrossRef
15.
go back to reference 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):1038–1045PubMedCrossRef 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):1038–1045PubMedCrossRef
16.
go back to reference 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):751–759PubMedCrossRef 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):751–759PubMedCrossRef
17.
go back to reference 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 119–120PubMed 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 119–120PubMed
18.
go back to reference 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):2087–2096PubMedCrossRef 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):2087–2096PubMedCrossRef
19.
go back to reference 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):379–385PubMedCrossRef 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):379–385PubMedCrossRef
20.
go back to reference Lee H (2003) The validity of driving simulator to measure on-road driving performance of older drivers. Transp Eng Aust 8(2):89–100 Lee H (2003) The validity of driving simulator to measure on-road driving performance of older drivers. Transp Eng Aust 8(2):89–100
Metadata
Title
Relationship between retinal nerve fiber layer thickness and driving ability in patients with human immunodeficiency virus infection
Authors
Sarah Cheng
Helaina Klein
Dirk-Uwe Bartsch
Igor Kozak
Thomas D. Marcotte
William R. Freeman
Publication date
01-11-2011
Publisher
Springer-Verlag
Published in
Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 11/2011
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-011-1735-4

Other articles of this Issue 11/2011

Graefe's Archive for Clinical and Experimental Ophthalmology 11/2011 Go to the issue