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(申请人提供)：眩光是白内障患者经历的最大损害。夜间驾驶时，车头灯眩光可能会严重影响驾驶员和行人的安全。行人和其他与驾驶有关的特征(如车道标志、交通标志)的显着性总体降低会影响白内障患者，因为他们的 视力(VA)和对比敏感度(CS)。尽管人们普遍认为，迎面而来的汽车造成的前灯眩光是夜间驾驶的主要危险，但关于司机如何与迎面而来的汽车前灯产生的眩光相互作用，以及这种眩光如何影响司机的表现，人们知之甚少。白内障是少数几种患者的视力和CS可以通过手术恢复到正常水平的眼科疾病之一。因此，通过在与驾驶模拟器同时运行的物理验证的、新颖的实时车灯眩光模拟器中以渐进的方式测量他们的夜间驾驶行为和表现，可以有效地研究由白内障引起的迎面而来的前灯眩光的影响，同时剔除影响夜间驾驶的其他个体变异性。我们计划从以下几个方面定量衡量双眼早期至中期白内障患者受到眩光的影响：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)，以及3)眼睛和头部移动(眼睛和头部朝向眩光和远离眩光的运动)，以及它们与其他指标的相互作用。我们将测量有或没有模拟白内障的正常视力受试者的驾驶表现和凝视运动(研究1)； 双眼白内障(研究2)；双眼白内障患者在白内障手术前(研究3)和手术后 第一眼摘除手术(研究4)；第二次手术后(研究5)。数据 会比较有没有前灯眩光的情况。除了直接的性能和行为比较，还将评估临床视觉功能测量(例如，VA、CS、光应激测试、眼内散光测量)预测实际驾驶性能的能力，以及现实世界和模拟条件下眩光困难自我评级之间的一致性。这一结果将为白内障患者夜间驾驶时车灯眩光对功能的影响提供第一组全面的数据，并将具有广泛的好处，为白内障手术、驾驶员培训、眩光控制装置的设计、驾驶员测试和驾驶法规提供有价值的指导。一旦 在成功测量影响的情况下，为建议的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，如年龄相关性黄斑变性(AMD)，这是一种已知会出现眩光并发症，包括长时间的光应激恢复。此外，它还可用于测量夜间驾驶时助视器和多焦点人工晶状体的安全性。