ORCID Profile
0000-0002-1623-9302
Current Organisations
University of Rwanda
,
University of St Andrews
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Publisher: BMJ
Date: 08-2023
DOI: 10.1136/BMJOPEN-2022-065210
Abstract: To systematically investigate the associations between vision impairment and risk of motor vehicle crash (MVC) involvement, and evaluate vision-related interventions to reduce MVCs. Medline (Ovid), EMBASE and Global Health electronic databases were systematically searched from inception to March 2022 for observational and interventional English-language studies. Screening, data extraction and appraisals using the Joanna Briggs Institute appraisal tools were completed by two reviewers independently. Where appropriate, measures of association were converted into risk ratios (RRs) or ORs for meta-analysis. Drivers of four-wheeled vehicles of all ages with no cognitive declines. MVC involvement (primary) and driving cessation (secondary). 101 studies (n=778 052) were included after full-text review. 57 studies only involved older drivers (≥65 years) and 85 were in high-income settings. Heterogeneity in the data meant that most meta-analyses were underpowered as only 25 studies, further split into different groups of eye diseases and measures of vision, could be meta-analysed. The limited evidence from the meta-analyses suggests that visual field defects (four studies RR 1.51 (95% CI 1.23, 1.85) p .001 I 2 =46.79%), and contrast sensitivity (two studies RR 1.40 (95% CI 1.08, 1.80) p=0.01, I 2 =0.11%) and visual acuity loss (five studies RR 1.21 (95% CI 1.02, 1.43) p=0.03, I 2 =28.49%) may increase crash risk. The results are more inconclusive for available evidence for associations of glaucoma (five studies, RR 1.27 (95% CI 0.67, 2.42) p=0.47 I 2 =93.48%) and cataract (two studies RR 1.15 (95% CI 0.97, 1.36) p=0.11 I 2 =3.96%) with crashes. Driving cessation may also be linked with glaucoma (two studies RR 1.62 (95% CI 1.20, 2.19) p .001, I 2 =22.45%), age-related macular degeneration (AMD) (three studies RR 2.21 (95% CI 1.47, 3.31) p .001, I 2 =75.11%) and reduced contrast sensitivity (three studies RR 1.30 (95% CI 1.05, 1.61) p=0.02 I 2 =63.19%). Cataract surgery halved MVC risk (three studies RR 0.55 (95% CI 0.34, 0.92) p=0.02 I 2 =97.10). Ranibizumab injections (four randomised controlled trials) prolonged driving in persons with AMD. Impaired vision identified through a variety of measures is associated with both increased MVC involvement and cessation. Cataract surgery can reduce MVC risk. Despite literature being highly heterogeneous, this review shows that detection of vision problems and appropriate treatment are critical to road safety. CRD42020172153.
Publisher: BMJ
Date: 11-2020
DOI: 10.1136/BMJOPEN-2020-040881
Abstract: Driving is one of the main modes of transport with safe driving requiring a combination of visual, cognitive and physical skills. With population ageing, the number of people living with vision impairment is set to increase in the decades ahead. Vision impairment may negatively impact an in idual’s ability to safely drive. The association between vision impairment and motor vehicle crash involvement or driving participation has yet to be systematically investigated. Further, the evidence for the effectiveness of vision-related interventions aimed at decreasing crashes and driving errors has not been synthesised. A search will be conducted for relevant studies on Medline (Ovid), EMBASE and Global Health from their inception to March 2020 without date or geographical restrictions. Two investigators will independently screen abstracts and full texts using Covidence software with conflicts resolved by a third investigator. Data extraction will be conducted on all included studies, and their quality assessed to determine the risk of bias using the Joanna Briggs Institute Critical Appraisal Tools. Outcome measures include crash risk, driving cessation and surrogate measures of driving safety (eg, driving errors and performance). The results of this review will be reported using the Preferred Reporting Items for Systematic Review and Meta-Analysis guideline. Meta-analysis will be undertaken for outcomes with sufficient data and reported following the Meta-analyses of Observational Studies in Epidemiology guideline. Where statistical pooling is not feasible or appropriate, narrative summaries will be presented following the Synthesis Without Meta-analysis in systematic reviews guideline. This review will only report on published data thus no ethics approval is required. Results will be included in the Lancet Global Health Commission on Global Eye Health, published in a peer-reviewed journal and presented at relevant conferences. CRD42020172153.
Publisher: Elsevier BV
Date: 2022
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for GATERA Fiston KITEMA.