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Wang S, Moharrer M, Baliutaviciute V, Dougherty BE, Cybis W, Bowers AR, Luo G. Bioptic Telescope Use in Naturalistic Driving by People with Visual Impairment. Transl Vis Sci Technol 2020; 9:11. [PMID: 32818098 PMCID: PMC7396197 DOI: 10.1167/tvst.9.4.11] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 12/12/2019] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to investigate the telescope use behaviors in natural daily driving of people with reduced visual acuity licensed to drive with a bioptic (a small spectacle-mounted telescope). Methods A large dataset (477 hours) of naturalistic driving was collected from 19 bioptic drivers (visual acuity 20/60 to 20/160 without the telescope). To reduce the data volume, a multiloss 50-layer deep residual neural network (ResNet-50) was used to detect potential bioptic telescope use events. Then, a total of 120 hours of selected video clips were reviewed and annotated in detail. Results The frequency of looking through their telescopes ranged from 4 to 308 times per hour (median: 27, interquartile range [IQR], 19-75), with each bioptic use lasting median 1.4 seconds (IQR, 1.2-1.8). Thus, participants spent only 1.6% (IQR, 0.7%-3.5%) driving time with their telescopes aiding their vision. Bioptic telescopes were used most often for checking the road ahead (84.8%), followed by looking at traffic lights (5.3%), and reading road signs (4.6%). Conclusions In daily driving, the bioptic drivers mostly (>98% of driving time) drove under low visual acuity conditions. The bioptic telescope was mainly used for observing road and traffic conditions in the distance for situational awareness. Only a small portion of usage was for road sign reading. Translational Relevance This study provides new insights into how the vision rehabilitation device-bioptic telescopes are used in daily driving. The findings may be helpful for designing bioptic driving training programs.
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Affiliation(s)
- Shuhang Wang
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Mojtaba Moharrer
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Vilte Baliutaviciute
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | | | - Walter Cybis
- Nazareth and Louis-Braille Institute, Longueuil, Quebec, Canada
| | - Alex R. Bowers
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Gang Luo
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
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Tang X, Bronstad PM, Doherty AL, Moharrer M, Peli E, Luo G, Bowers AR. Hazard Detection With Monocular Bioptic Telescopes in a Driving Simulator. Transl Vis Sci Technol 2020; 9:26. [PMID: 32818113 PMCID: PMC7396188 DOI: 10.1167/tvst.9.4.26] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 12/18/2019] [Indexed: 11/24/2022] Open
Abstract
Purpose In most states, people with reduced visual acuity may legally drive with the aid of a bioptic telescope. However, concerns have been raised that the ring scotoma may impair detection of peripheral hazards. Using a driving simulator, we tested the hypothesis that the fellow eye would be able to compensate for the ring scotoma when using a monocular telescope. Methods Sixteen bioptic users completed three drives with binocular viewing interleaved between three drives with monocular viewing. Forty pedestrians appeared and ran on the road for 1 second, including 26 within the ring scotoma, while participants were reading road signs through their own monocular telescopes. Head movements were analyzed to determine whether the pedestrian appeared before or only while using the telescope. Results For pedestrians that appeared only during bioptic use and were likely in the area of the ring scotoma, detection rates were significantly higher in binocular (fellow eye can compensate) than monocular (fellow eye patched) viewing (69% vs. 32%; P < 0.001); this was true for both current and noncurrent drivers. For pedestrians appearing before or after bioptic use, detection rates did not differ in binocular and monocular viewing. However, detection rates were even higher and reaction times shorter when the telescope was not being used. Conclusions Both current and noncurrent drivers' fellow eyes were able to compensate, at least in part, for the ring scotoma. Translational Relevance When using monocular telescopes, the fellow eye reduces the impact of the ring scotoma on hazard detection in binocular viewing.
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Affiliation(s)
- Xiaolan Tang
- College of Information Engineering, Capital Normal University, Beijing, China
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - P Matthew Bronstad
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Amy L Doherty
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Mojtaba Moharrer
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Eli Peli
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Gang Luo
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Alex R Bowers
- Schepens Eye Research Institute of Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
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Evaluation of a Paradigm to Investigate Detection of Road Hazards when Using a Bioptic Telescope. Optom Vis Sci 2018; 95:785-794. [PMID: 29863502 DOI: 10.1097/opx.0000000000001230] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
SIGNIFICANCE A new driving simulator paradigm was developed and evaluated that will enable future investigations of the effects of the ring scotoma in bioptic drivers with diverse vision impairments and different telescope designs. PURPOSE The ring scotoma may impair detection of peripheral hazards when viewing through a bioptic telescope. To investigate this question, we developed and tested a sign-reading and pedestrian-detection paradigm in a driving simulator. METHODS Twelve normally sighted subjects with simulated acuity loss (median 20/120) used a 3.0× monocular bioptic to read 36 road signs while driving in a simulator. Thirteen of 21 pedestrian hazards appeared and ran on the road for 1 second within the ring scotoma while participants were reading signs through the bioptic. Head movements were analyzed to determine whether the pedestrian appeared before or only while using the bioptic. Six subjects viewed binocularly, and six viewed monocularly (fellow eye patched). Two patients with real visual acuity loss in one eye and no light perception in the other performed the same tasks using their own telescopes. RESULTS For the monocular simulated acuity loss group, detection rates were significantly higher when the pedestrian appeared before using the bioptic than when it appeared while using the bioptic and was likely within the area of the ring scotoma (77% vs. 28%, P < .001). For the binocular simulated acuity loss group, there was no significant difference in detection rates for pedestrians that appeared before or while using the bioptic (80% vs. 91%, P = .20). The two monocular patients detected only 17% of pedestrians that appeared while looking through the bioptic. CONCLUSIONS Our results confirm the utility of the testing paradigm and suggest that the fellow eye of normally sighted observers with simulated acuity loss was able to compensate for the ring scotoma when using a monocular bioptic telescope in a realistic driving task.
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Min X, Fan H, Zhao G, Liu G. Identification of 2 Potentially Relevant Gene Mutations Involved in Strabismus Using Whole-Exome Sequencing. Med Sci Monit 2017; 23:1719-1724. [PMID: 28391287 PMCID: PMC5395132 DOI: 10.12659/msm.902823] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background The etiology of strabismus has a genetic component. Our study aimed to localize the candidate causative gene mutant in a Chinese family with strabismus and to describe its underlying etiology. Material/Methods Genomic DNA was extracted from the affected individual and his parents in a Chinese pedigree with strabismus. The resulting exomes were sequenced by whole-exome sequencing. After variant calling and filtering, the candidate causative gene mutations were selected for the rarity and predicted damaging effect, which complied with the model of recessive disease transmission. Results We examined a Chinese strabismus pedigree with the parents unaffected and 2 offspring affected. Whole-exome sequencing and bioinformatics filtering identified 2 variants including Abelson helper integration site 1 (AHI1) gene and nebulin (NEB) gene. The variant in the AHI1 gene, c.A3257G (p.E1086G), and the altered amino acid had a damaging effect on the encoded protein predicted by Polyphen2. Moreover, this change was located in the conserved SH3 domain of AHI1. Biallelic pathogenic variant in AHI1 gene can cause Joubert syndrome-related disorders with oculomotor apraxia characteristics. Additionally, c.A914G mutation was found in nebulin (NEB) gene. Therefore, we concluded that AHI1 c.3257A>G and NEB c.914 A>G were potential causal variants in this strabismus pedigree. Conclusions We detected an AHI1 homozygous mutation in the affected individual. Whole-exome sequencing is a powerful way to identify causally relevant genes, improving the understanding of this disorder.
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Affiliation(s)
- Xiangrong Min
- Department of Ophthalmology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China (mainland).,Department of Ophthalmology, Jining No. 1 People's Hospital, Jining, Shandong, China (mainland)
| | - Haiying Fan
- Department of Ophthalmology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China (mainland)
| | - Guiqiu Zhao
- Department of Ophthalmology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China (mainland)
| | - Guixiang Liu
- Department of Ophthalmology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China (mainland)
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Doherty AL, Peli E, Luo G. Hazard detection with a monocular bioptic telescope. Ophthalmic Physiol Opt 2015; 35:530-9. [PMID: 26303448 DOI: 10.1111/opo.12232] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 07/01/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE The safety of bioptic telescopes for driving remains controversial. The ring scotoma, an area to the telescope eye due to the telescope magnification, has been the main cause of concern. This study evaluates whether bioptic users can use the fellow eye to detect in hazards driving videos that fall in the ring scotoma area. METHODS Twelve visually impaired bioptic users watched a series of driving hazard perception training videos and responded as soon as they detected a hazard while reading aloud letters presented on the screen. The letters were placed such that when reading them through the telescope the hazard fell in the ring scotoma area. Four conditions were tested: no bioptic and no reading, reading without bioptic, reading with a bioptic that did not occlude the fellow eye (non-occluding bioptic), and reading with a bioptic that partially-occluded the fellow eye. Eight normally sighted subjects performed the same task with the partially occluding bioptic detecting lateral hazards (blocked by the device scotoma) and vertical hazards (outside the scotoma) to further determine the cause-and-effect relationship between hazard detection and the fellow eye. RESULTS There were significant differences in performance between conditions: 83% of hazards were detected with no reading task, dropping to 67% in the reading task with no bioptic, to 50% while reading with the non-occluding bioptic, and 34% while reading with the partially occluding bioptic. For normally sighted, detection of vertical hazards (53%) was significantly higher than lateral hazards (38%) with the partially occluding bioptic. CONCLUSIONS Detection of driving hazards is impaired by the addition of a secondary reading like task. Detection is further impaired when reading through a monocular telescope. The effect of the partially-occluding bioptic supports the role of the non-occluded fellow eye in compensating for the ring scotoma.
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Affiliation(s)
- Amy L Doherty
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, USA
| | - Eli Peli
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, USA
| | - Gang Luo
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, USA
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Abstract
PURPOSE Google Glass provides a platform that can be easily extended to include a vision enhancement tool. We have implemented an augmented vision system on Glass, which overlays enhanced edge information over the wearer's real-world view, to provide contrast-improved central vision to the Glass wearers. The enhanced central vision can be naturally integrated with scanning. METHODS Google Glass' camera lens distortions were corrected by using an image warping. Because the camera and virtual display are horizontally separated by 16 mm, and the camera aiming and virtual display projection angle are off by 10°, the warped camera image had to go through a series of three-dimensional transformations to minimize parallax errors before the final projection to the Glass' see-through virtual display. All image processes were implemented to achieve near real-time performance. The impacts of the contrast enhancements were measured for three normal-vision subjects, with and without a diffuser film to simulate vision loss. RESULTS For all three subjects, significantly improved contrast sensitivity was achieved when the subjects used the edge enhancements with a diffuser film. The performance boost is limited by the Glass camera's performance. The authors assume that this accounts for why performance improvements were observed only with the diffuser filter condition (simulating low vision). CONCLUSIONS Improvements were measured with simulated visual impairments. With the benefit of see-through augmented reality edge enhancement, natural visual scanning process is possible and suggests that the device may provide better visual function in a cosmetically and ergonomically attractive format for patients with macular degeneration.
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