The Relationship between Central Visual Field Damage and Motor Vehicle Collisions in Primary Open-Angle Glaucoma Patients

<div><p>Purpose</p><p>To investigate the relationship between visual field (VF) damage and history of motor vehicle collisions (MVCs) in subjects with primary open-angle glaucoma (POAG).</p><p>Methods</p><p>MVC history and driving habits were recorded using patient questionnaires in 247 POAG patients. Patients' driving attitudes (carefulness) were estimated using Rasch analysis. The relationship between MVC outcomes and 52 total deviation (TD) values of integrated binocular VF (IVF), better and worse visual acuities (VAs), age and gender was analyzed using principal component analysis and logistic regression.</p><p>Results</p><p>51 patients had the history of MVCs. Significant difference was observed between patients with and without history of MVCs only for: better VA, a single TD value in the superior-right VF, and the typical distance driven in a week (unpaired t-test, p = 0.002, 0.015 and 0.006, respectively). There was not a significant relationship between MVCs and mean deviation (MD) of IVF (p = 0.41, logistic regression). None of the principal components were significantly correlated with MVC outcome (p>0.05, polynomial logistic regression analysis). There was a significant relationship between IVF MD and Rasch derived Person parameter (R² = 0.023, p = 0.0095). There was also a significant positive relationship between MVCs and the distance driven in a week (p = 0.005, logistic regression).</p><p>Conclusions</p><p>In this study of POAG patients, MVCs were not related to central binocular VF damage. These results suggest the relationship between visual function and driving is not straightforward, and careful consideration should be given when predicting patients' driving ability using their VF.</p></div

Cumulative proportion of variance and the coefficients of variance of the principal components in the polynomial logistic analysis against a previous history of MVCs.

<p>Cumulative variance reached 90% with 17 principal components. None of these 17 principal components was significantly correlated with the MVC in the polynomial logistic regression analysis.</p><p>Abbreviations.</p><p>PCA: principal component analysis.</p><p>Cumulative proportion of variance and the coefficients of variance of the principal components in the polynomial logistic analysis against a previous history of MVCs.</p

Comparison of variables between fallers with and without a history of injury.

<p>Chi square test was used for the variable of gender, alcohol intake, and prevalence of hypertension. Fisher's exact test was used for the variable of smoking status, prevalence of diabetes mellitus, sedative use, and sleeping aid use. Unpaired t-test was used for other comparisons.</p><p>** represents p < 0.01.</p><p>Abbreviations s.d.: standard deviation, VA: visual acuity, LogMar: the logarithm of the minimum angle of resolution, BMI: body-mass index, MD: mean deviation, IVF: integrated visual field, TD: total deviation,</p><p>Comparison of variables between fallers with and without a history of injury.</p

Exact IVF-TD values of MVC+ and MVC- groups.

<p>Upper row in each grid represents mean (standard deviation) value in MVC+ group, middle row represents those in MVC- group and bottom row shows the p value obtained by comparing two groups using the unpaired t-test with Benjamini's correction <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0115572#pone.0115572-Benjamini1" target="_blank">[44]</a>.</p><p>Abbreviations.</p><p>IVF: integrated visual field, MVC: motor vehicle collisions.</p><p>IVF-TD, Integrated visual field-total deviation, MVCs, motor vehicle collisions.</p><p>Exact IVF-TD values of MVC+ and MVC- groups.</p

Comparison of various visual function measures and person variables between the patients with and without a history of MVCs.

#<p>Glaucoma severity was categorized using Mills Glaucoma Staging system <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0115572#pone.0115572-Mills1" target="_blank">[20]</a>.</p><p>Chi square test was used for the variable of gender and unpaired t-test was used for other comparisons.</p><p>*represents p<0.05 with Benjamini's correction <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0115572#pone.0115572-Benjamini1" target="_blank">[44]</a>.</p><p>Abbreviations.</p><p>s.d.: standard deviation, VA: visual acuity, LogMar: the logarithm of the minimum angle of resolution, MD: mean deviation, IVF: integrated visual field, TD: total deviation, MVC: motor vehicle collision, Person parameter: Rasch analysis derived index of paying attention to avoid traffic accident.</p><p>Comparison of various visual function measures and person variables between the patients with and without a history of MVCs.</p

Comparison of variables between patients with and without a history of falls.

<p>Chi square test was used for the variable of gender, smoking status, alcohol intake, prevalence of diabetes mellitus, and prevalence of hypertension. Fisher's exact test was used for the variable of sedative use, and sleeping aid use. Unpaired t-test was used for other comparisons.</p><p>* represents p < 0.05.</p><p>Abbreviations</p><p>s.d.: standard deviation, VA: visual acuity, LogMar: the logarithm of the minimum angle of resolution, BMI: body-mass index, MD: mean deviation, IVF: integrated visual field, TD: total deviation,</p><p>Comparison of variables between patients with and without a history of falls.</p

Subjects demographics.

<p>Abbreviations.</p><p>POAG: primary open angle glaucoma, s.d.: standard deviation, VA: visual acuity, LogMar: the logarithm of the minimum angle of resolution, MD: mean deviation, dB: decibel, IVF: integrated visual field.</p><p>Subjects demographics.</p

Additional file 1: of Clinical safety and efficacy of vitamin D3 analog ointment for treatment of obstructive meibomian gland dysfunction

Detailed data of the subjects at pre-, one months after and two months after treatment with Vit D3. (XLSX 18 kb

Demographics of the study population.

Demographics of the study population.</p

The Silmee™ Bar type Lite (TDK, Tokyo, Japan) device.

This biosensor automatically calculates heartbeat intervals, pulse wave intervals, and autonomic nerve activity by measuring and analyzing electrocardiograms, pulse waves, acceleration, and/or skin temperature.</p