Effect of peripheral refractive errors on driving performance

The effect of peripheral refractive errors on driving while performing secondary tasks at 40° of eccentricity was studied in thirty-one young drivers. They drove a driving simulator under 7 different induced peripheral refractive errors (baseline (0D), spherical lenses of +/- 2D, +/- 4D and cylindrical lenses of +2D and +4D). Peripheral visual acuity and contrast sensitivity were also evaluated at 40°. Driving performance was significantly impaired by the addition of myopic defocus (4D) and astigmatism (4D). Worse driving significantly correlated with worse contrast sensitivity for the route in general, but also with worse visual acuity when participants interacted with the secondary task. Induced peripheral refractive errors may negatively impact driving when performing secondary tasks.FEDER/Junta de Andalucia-Consejeria de Transformacion Economica, Industria, Conocimiento y Universidades MCIN/AEI/10.13039/501100011033 PID2020-115184RB-I00Agencia Estatal de Investigacion A-FQM-532-UGR20Fundacion Seneca PID2019-105684RB-I00/AEI/10.13039/501100011033 19897/GERM/1

Visual performance after the deterioration of retinal image quality: induced forward scattering using Bangerter foils and fog filters

We induced and evaluated different levels of retinal-image degradation using Bangerter foils and fog filters. We found increased straylight and an important deterioration in visual performance, assessed by means of visual acuity, contrast threshold, and visual discrimination capacity. Bangerter foils induced forward scattering levels comparable to those observed in mature to severe cataracts, with an important impact of halos and starbursts. Fog filters induced lower levels of intraocular scattering, although luminous veils and circular halos were reported. The visual disturbance index positively correlated with intraocular scattering and straylight. Our results show retinal-image quality has an important influence on night-vision performance.Ministerio de Economía y Competitividad 10.13039/501100003329 (FIS2017-85058-R

Changes in Visual Performance under the Effects of Moderate–High Alcohol Consumption: The Influence of Biological Sex

The purpose of this study was to analyze the changes in visual functions under the effects of moderate–high breath alcohol concentrations (BrACs), and the influence of biological sex on visual deterioration, considering different factors. A total of 37 healthy habitual alcohol users were enrolled in the experiment. The participants underwent a baseline session and a second session after an intake of 450 mL of red wine, so that all of them reached a BrAC above 0.25 mg/L. Visual performance was assessed by measuring the contrast sensitivity function, the halo perception, the stereopsis, and finally the retinal image quality. A Visual Deterioration Score (VDS) was calculated using the deterioration of these visual variables. All visual functions analyzed were significantly impaired following alcohol consumption (p < 0.05). The VDS was associated with the BrAC (ρ = −0.476). The VDS was also significantly higher in females, with the BrAC having a significant effect on the variability of the VDS in males and females (p 0.05). Visual functions were significantly impaired under the influence of alcohol, and this deterioration was greater in females. The deterioration depends on the BrAC reached, being the primary thing responsible for the differences observed between males and females.Ministry of Economy and Competitiveness (Spain)European Regional Development Fund (ERDF) (FIS2017-85058-R

Driver distraction by smartphone use (WhatsApp) in different age groups

This paper investigates the effect that texting with WhatsApp, one of the most common applications for instant messaging, exerts on driving performance. Because distracted driving also affects older drivers, who can have seriously compromised vision, we also analysed the associations between visual-function parameters and driving performance. A total of 75 drivers, experienced in sending WhatsApp messages (≥10WhatsApp messages/week), participated in this study and were divided into four age categories. Visual-function tests included contrast sensitivity with and without glare, retinal straylight and objective assessment of optical quality. Simulated driving performance was assessed under a baseline driving condition (without distraction) as well as a texting condition (WhatsApp messages) while driving. The participants used their own mobile phone. Lastly, objective results of driving performance were compared with subjective self-report data from the Driver Behaviour Questionnaire (DBQ). The analysis indicated that functional changes occurring with age, such as a lower contrast sensitivity and greater retinal straylight, were correlated with a higher number of collisions, longer distances driven outside the lane, and greater standard deviation of lateral position (SDLP). The results showed a significant main effect of age for the driving-performance parameters. Also, compared to the baseline, texting WhatsApp messages while driving worsens driving performance for all age groups, most notably among older participants. Thus, the older drivers' SDLP was ~14% higher than that for the baseline average of all the other drivers and rose to 29% under distraction, reflecting the impact of secondary tasks. The negative effect of the use of the smartphone during driving was also reflected in the number of collisions, with a greater risk of accidents in all the groups of drivers (by 8.3% for young adults, 25.0% for adults, 80.5% for middle-aged adults, and 134.5% for older drivers). Lastly, participants' subjective responses indicated that younger drivers (18–24 years) had a higher risk of deliberately violating safe driving practices (p<0.05). The present study demonstrates that texting WhatsApp messages while driving significantly impairs the ability to drive safely, with older drivers being the group most adversely affected. It would be recommendable to include other nonstandard vision tests, which have shown associations with driving performance, in the examination for driver licensing. This would help raise the awareness of older drivers concerning their visual limitations, permitting them to adopt compensatory measures to improve their driving safety. Nevertheless, it is also necessary to raise awareness among the younger drivers of the risks involved in behaviour behind the wheel

The Relationship between Anxiety, Visual Function, and Symptomatology in University Students

Mental health concerns have emerged at the university level, with the psychological wellbeing of students being increasingly affected. This cross-sectional study investigated the proportion of university students having anxiety, and its effects on their visual function and symptomatology. We included 41 students (26.1 4.8 years), and their visual function was assessed through several tests to produce a general visual performance index (VPI). The visual symptomatology was studied using the Conlon Visual Discomfort Survey and the Quality of Vision (QoV) questionnaire. The students were classified into two groups according to the Generalized Anxiety Disorder Screener (GAD-7) test (“no anxiety” and “anxiety” groups). The visual function evaluation indicated significantly worse VPI in the anxiety group (p = 0.047). These students also showed significantly higher scores in the Conlon survey (p = 0.004) and two subscales of the QoV questionnaire: symptom severity (p = 0.041) and symptom bothersomeness (p = 0.013). Moreover, the multiple linear regression model showed a significant association between visual discomfort according to the Conlon questionnaire and the level of anxiety (r = 0.405; R2 = 0.164; B = 0.405; p = 0.012). It is important to study the influence of psychological factors on vision, not only for refractive error, but also for binocular and accommodative disorder

Effects of cannabis on visual function and self-perceived visual quality

Cannabis is one of the most used drugs of abuse in the world. The objective of this study was to analyze the effects of smoking cannabis on vision and to relate these to those perceived by the user. Thirty-one cannabis users participated in this study. Visual function assessment was carried out in a baseline session as well as after smoking cannabis. We evaluated static visual acuity, contrast sensitivity, stereoacuity, accommodative response, straylight, night-vision disturbances (halos) and pupil size. The participants were also divided into two groups depending on whether they perceived their vision to have worsened after smoking cannabis. A logistic regression analysis was employed to identify which visual test could best predict self-perceived visual effects. The study found that smoking cannabis has significant adverse effects on all the visual parameters analyzed (p < 0.05). Self-perceived visual quality results revealed that about two thirds of the sample think that smoking cannabis impairs their vision. Contrast sensitivity, specifically for the spatial frequency 18 cpd, was identified as the only visual parameter significantly associated with self-perceived visual quality (Odds Ratio: 1.135; p = 0.040). Smoking cannabis is associated with negative effects on visual function. Self-perceived visual quality after smoking cannabis could be related to impaired contrast sensitivity

Contrast sensitivity and retinal straylight after alcohol consumption: effects on driving performance

El objetivo de este estudio es investigar los efectos del consumo de alcohol en la función visual y en el rendimiento en la conducción, así como la relación entre ambas funciones. Un total de 40 participantes sanos participaron en las tres sesiones experimentales llevadas a cabo en el estudio: una sesión de control (sin consumo de alcohol), y otras dos sesiones más tras consumir alcohol (una tras consumir 300ml de vino tino y otra tras consumo de 450ml del mismo vino). Se midió el contenido de alcohol en aire espirado (BrAC, en mg/l) usando un etilómetro. Para caracterizar la función visual se midieron la sensibilidad al contraste así como el velo luminoso o luz difundida hacia la retina (retinal straylight), debido este último a la difusión luminosa intraocular. El rendimiento en la conducción fue evaluado en tres escenarios (autovía, carretera de montaña y entorno urbano) usando un simulador de conducción. Los resultados mostraron un deterioro tras consumo de alcohol en la sensibilidad al contraste y en el velo luminoso retiniano (aumento del retinal straylight), además de una deteriorada habilidad para conducir, especialmente para la ingesta mayor de alcohol. También se observó que, bajo los efectos del consumo de alcohol, el rendimiento deteriorado en la conducción dependía de la sensibilidad al contraste y del velo luminoso retiniano, indicando que estas variables visuales pueden parcialmente predecir el rendimiento en la conducción en estas condiciones.In this study, we aimed to investigate the effects of alcohol intake on visual function and driving performance, as well as on the relationship between these. A total of 40 healthy participants took part in three experimental sessions: one baseline session and two further sessions after consuming two different quantities of alcohol (300 ml and 450 ml of red wine). The breath alcohol content (BrAC) was measured using a breath analyzer. The contrast sensitivity and retinal straylight due to the forward intraocular scattering were measured to characterize visual function, and driving performance was assessed in three different scenarios using a driving simulator. The results showed a deterioration in contrast sensitivity and retinal straylight after drinking alcohol, in addition to an impaired ability to drive, especially for the highest alcohol intake. We also observed that the deteriorated driving performance was a function of the contrast sensitivity and retinal straylight under the effects of alcohol, indicating that these visual variables can partially predict driving performance in these conditions.Ministerio de Economía y Competitividad; European Regional Development Fund (ERDF) (referencia FIS2017-85058-R

Intraocular scattering as a predictor of driving performance in older adults with cataracts

Cataracts can limit a person's ability to perform vision-dependent tasks safely, affecting the quality of life of older people. This study examines the relationship between visual function and driving, by studying which visual parameters might be important for predicting driving performance in older drivers with and without cataracts, ascertaining whether the objective measurement of intraocular scattering should be considered in assessment procedures for older drivers. This cross-sectional study involved a total of 20 older drivers (10 patients with bilateral cataracts and 10 control subjects). All participants were examined for visual acuity, contrast sensitivity, visual discrimination capacity, and intraocular scattering. Driving performance was also tested using a driving simulator. To study the relationship between visual parameters and driving performance, a correlation analysis and regression model were used. Drivers with cataracts showed a significantly impaired (p<0.05) visual function, with an Objective Scattering Index (OSI) 3.5 times greater than the control group. Driving performance was also significantly worse (p<0.05) in drivers with cataracts, reflected by a notable deterioration in lane keeping. The correlation analysis showed significant associations between driving performance and all the visual parameters studied. Finally, the regression model revealed that the OSI was the best predictor of driving performance, accounting for 51.3% of its variance. Visual function and driving performance are markedly deteriorated when cataracts are present. Our results demonstrate that the objective scattering index (OSI) has a high predictive power when it comes to simulated driving performance in older drivers, both with and without cataracts, suggesting that scatter measurements could be important in helping better understand visual limitations in older drivers

Impact of Age-Related Vision Changes on Driving

Aging leads to impaired visual function, which can affect driving—a very visually demanding task—and has a direct impact on an individual’s quality of life if their license is withdrawn. This study examined the associations between age-related vision changes and simulated driving performance. To this end, we attempted to determine the most significant visual parameters in terms of evaluating elderly drivers’ eyesight. Twenty-one younger drivers (aged 25–40) were compared to 21 older drivers (aged 56–71). Study participants were assessed for visual acuity, contrast sensitivity, halos, and intraocular straylight, which causes veiling luminance on the retina and degrades vision. Driving performance was evaluated using a driving simulator. The relationships between simulated driving performance and the visual parameters tested were examined with correlation analyses and linear regression models. Older drivers presented impairment in most visual parameters (p < 0.05), with straylight being the most significantly affected (we also measured the associated effect size). Older drivers performed significantly worse (p < 0.05) in the simulator test, with a markedly lower performance in lane stability. The results of the multiple linear regression model evidenced that intraocular straylight is the best visual parameter for predicting simulated driving performance (R2 = 0.513). Older drivers have shown significantly poorer results in several aspects of visual function, as well as difficulties in driving simulator performance. Our results suggest that the non-standardized straylight evaluation could be significant in driver assessments, especially at the onset of age-related vision changes.ministry of economy and competitiveness (spain)European Union (EU) FIS2017-85058-Rministry of science, innovation and universities (spain) FPU15/0557

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality