Measuring Functional Impact of Oncoming Headlight Glare for Cataract Patients

测量迎面车灯眩光对白内障患者的功能影响

• 批准号: 8760684
• 负责人: ELI PELI
• 金额: $ 49.25万
• 依托单位: SCHEPENS EYE RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8760684
• 关键词: Affect; Age related macular degeneration; Attention; Automobile Driving; Behavior; Behavioral; Bilateral; Cataract; Cataract Extraction; Clinical; Complication; Contrast Sensitivity; Data; Decision Making; Detection; Devices; Effectiveness; Evaluation; Eye; Glare; Goals; Goggles; Head; Head Movements; Impairment; Implant; Individual; Intraocular lens implant device; Knowledge; Laser In Situ Keratomileusis; Light; Measures; Movement; Operative Surgical Procedures; Optics; Patients; Performance; Pilot Projects; Policies; Positioning Attribute; Procedures; Questionnaires; Reaction Time; Recovery; Regulation; Research; Research Design; Risk Factors; Running; Safety; Series; Simulate; Source; Speed; Stress; Testing; Time; Training; Vision; Visual; Visual Acuity; Walking; base; design; disability; driving behavior; evaluation/testing; experience; gaze; hazard; novel; public health relevance; research study; response; sample fixation; tool; trafficking; vision aid

DESCRIPTION (provided by applicant): Glare is the biggest impairment experienced by cataract patients. In nighttime driving, headlight glare may severely affect the safety of the driver and pedestrians. Overall reduction of conspicuity of the pedestrians and other driving related features (e.g. lane markers, traffic signs) affects cataract patients due to their reduced visual acuity (VA) and contrast sensitivity (CS). Although it is widely accepted that headlight glare caused by oncoming cars is a primary nighttime driving hazard, much less is known about how drivers are able to interact with glare from an oncoming car's headlights, and how this glare affects the driver's performance. Cataract is one of the few eye conditions where a patient's VA and CS can be restored to normal levels by surgical procedures. Therefore, the impact of glare from the oncoming headlight caused by cataract can be effectively studied, while factoring out other individual variability that affect nighttime driving, by measuring their nighttime driving behaviors and performances in progressive way along their corrective surgeries in a physically validated, novel, real-time headlight glare simulator that runs concurrently with a driving simulator. We plan to quantitatively measure the impacts of headlight glare on early-to-mid bilateral cataract patients in the following ways: 1) detection performance (hazard detection rates and reaction times), 2) vehicle control (speed, lane position, steering stability), and 3) ey and head movements (gaze movements toward and away from the glare), and their interactions with the other measures. We will measure driving performance and gaze movements of normally sighted subjects with or without simulated cataracts (Study 1); {a pilot group of patients with bilateral cataract (Study 2)}; bilateral cataract patients before (Study 3) and after cataract extraction surgery for the first eye (Study 4); and after their second surgery (Study 5). The data will be compared between with and without headlight glare conditions. In addition to the direct performance and behavioral comparisons, the power of the clinical vision function measures (e.g. VA, CS, photostress test, intraocular straylight measure) to predict actual driving performance, and the coherence between self-ratings of glare difficulties in real-world and in simulated conditions will be evaluated. The results will provide the first set of comprehensive data on the functional impact of oncoming headlight glare in cataract patients during nighttime driving, and will have widespread benefits, providing valuable guidance for cataract surgery, driver training, design of glare control devices, driver testing and driving regulations. Once the effects are successfully measured, the testing platform developed for the proposed studies can easily converted to a reliable evolutional tool for other vision conditions such as age-related macular degeneration (AMD), which is known to have glare complications including prolonged photo stress recovery. Also it can be used for measuring the safety of vision-aid devices and multifocal intraocular lenses during nighttime driving.

描述（由申请人提供）：眩光是白内障患者经历的最大损害。 在夜间行车时，前照灯眩光会严重影响驾驶员和行人的安全。 行人和其他驾驶相关特征（例如车道标记、交通标志）的显著性的总体降低会影响白内障患者，因为他们的视觉效果降低。 视力（VA）和对比敏感度（CS）。 虽然人们普遍认为迎面而来的汽车引起的前灯眩光是主要的夜间驾驶危险，但对驾驶员如何与迎面而来的汽车前灯的眩光相互作用以及这种眩光如何影响驾驶员的表现知之甚少。 白内障是少数几种通过手术可以将患者的VA和CS恢复到正常水平的眼部疾病之一。 因此，可以有效地研究由白内障引起的来自迎面而来的前灯的眩光的影响，同时排除影响夜间驾驶的其他个体可变性，通过在与驾驶模拟器同时运行的物理验证的新颖的实时前灯眩光模拟器中以渐进的方式沿着他们的矫正手术来测量他们的夜间驾驶行为和表现。 我们计划通过以下方式定量测量头灯眩光对早期至中期双侧白内障患者的影响：1）检测性能（危险检测率和反应时间），2）车辆控制（速度，车道位置，转向稳定性），3）眼睛和头部运动（朝向和远离眩光的凝视运动），以及它们与其他措施的相互作用。 我们将测量具有或不具有模拟白内障的正常视力受试者的驾驶性能和注视运动（研究1）; 双侧白内障患者（研究2）;双侧白内障患者在白内障之前（研究3）和之后 第一只眼睛的摘除手术（研究4）;以及第二次手术后（研究5）。 数据 将在有和没有前灯眩光条件之间进行比较。 除了直接的性能和行为比较外，还将评估临床视觉功能测量（例如VA、CS、光应力测试、眼内杂散光测量）预测实际驾驶性能的能力，以及真实世界和模拟条件下眩光困难自我评级之间的一致性。 研究结果将提供第一组关于夜间驾驶时迎面而来的前照灯眩光对白内障患者功能影响的综合数据，并将产生广泛的益处，为白内障手术、驾驶员培训、眩光控制装置设计、驾驶员测试和驾驶法规提供有价值的指导。 一旦 如果成功地测量了这些影响，则为拟议研究开发的测试平台可以很容易地转换为其他视力状况的可靠进化工具，例如年龄相关性黄斑变性（AMD），已知其具有眩光并发症，包括延长的光应激恢复。 此外，它还可用于测量夜间驾驶期间视力辅助设备和多焦点人工晶状体的安全性。