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Journal of Ophthalmology - Volume 2014 2014, Article ID 754042, 6 pages -

Clinical Study

Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA

Department of Neurology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA

Department of Surgery, University of Alabama at Birmingham, Birmingham, AL 35294, USA

Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35294, USA

School of Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia

Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia

Received 9 October 2013; Revised 17 December 2013; Accepted 19 December 2013; Published 5 February 2014

Academic Editor: Hermann Mucke

Copyright © 2014 Michael S. Vaphiades et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. This study aimed to determine whether it is possible to predict driving safety of individuals with homonymous hemianopia or quadrantanopia based upon a clinical review of neuroimages that are routinely available in clinical practice. Methods. Two experienced neuroophthalmologists viewed a summary report of the CT-MRI scans of 16 participants with homonymous hemianopic or quadrantanopic field defects which indicated the site and extent of the lesion and they made predictions regarding whether participants would be safe-unsafe to drive. Driving safety was independently defined at the time of the study using state-recorded motor vehicle crashes all crashes and at-fault for the previous 5 years and ratings of driving safety determined through a standardized on-road driving assessment by a certified driving rehabilitation specialist. Results. The ability to predict driving safety was highly variable regardless of the driving safety measure, ranging from 31% to 63% kappa levels ranged from −0.29 to 0.04. The level of agreement between the neuroophthalmologists was only fair kappa = 0.28. Conclusions. Clinical evaluation of summary reports of currently available neuroimages by neuroophthalmologists is not predictive of driving safety. Future research should be directed at identifying and-or developing alternative tests or strategies to better enable clinicians to make these predictions.





Autor: Michael S. Vaphiades, Lanning B. Kline, Gerald McGwin Jr., Cynthia Owsley, Ritu Shah, and Joanne M. Wood

Fuente: https://www.hindawi.com/



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