Depressive Symptoms in Patients With Neovascular Age-Related Macular Degeneration
abstract
This abstract is available on the publisher's site.
Access this abstract nowPURPOSE
To examine the prevalence and risk factors for depressive symptoms in patients with neovascular age-related macular degeneration (nAMD) presenting for anti-vascular endothelial growth factor (anti-VEGF) therapy.
METHODS
In a clinic-based cohort of 547 patients with nAMD who presented for treatment, the Centre of Epidemiological Studies Depression 10-point scale (CES-D-10) and Mental Health Index (MHI) component of the 36-item Short Form Survey were administered to assess for the presence of depressive symptoms. Logistic regression analyses were used to calculate odds ratios and 95% confidence intervals for factors associated with an increased likelihood of depressive symptoms.
RESULTS
The prevalence of depressive symptoms was 42.04% and 31.78% as per the CES-D-10 and MHI scales, respectively. Poor self-rated health (SRH) is associated with increased odds of depressive symptoms [multivariable-adjusted OR: 3.00 (95% CI 1.90-4.73) for CES-D-10; OR: 2.67 (95% CI 1.67-4.28) for MHI]. Impaired activities of daily living (ADLs) [multivariable-adjusted OR: 2.62 (95% CI 1.56-4.38) for CES-D-10; OR: 3.59 (95% CI 2.10-6.15) for MHI] and a visual function score within the two lowest quartiles were also associated with increased odds of depressive symptoms using both scales.
CONCLUSION
A high prevalence of depressive symptoms was observed among nAMD patients presenting for treatment. Poorer SRH, ADL impairment and reduced visual function were associated with increased odds of depressive symptoms.
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Additional Info
Disclosure statements are available on the authors' profiles:
Prevalence and Risk Factors for Depressive Symptoms in Patients With Neovascular Age-Related Macular Degeneration Who Present for Anti-VEGF Therapy
Acta Ophthalmol 2020 Sep 27;[EPub Ahead of Print], KV Vu, P Mitchell, H Dharamdasani Detaram, G Burlutsky, G Liew, B GopinathFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
The findings that patients with neovascular age-related macular degeneration (nAMD), despite being treated with anti-VEGF injections, are depressed because of self-rated challenges with health and activities of daily living due to poor visual functioning is not surprising, given that injections alone do not necessarily modify all of the reasons for depressive symptoms. Unfortunately, being depressed can impact on health and functioning, creating a vicious cycle. It is a curious finding that late AMD in the better eye acts as a preventive factor for depression. The explanation given is that these patients have “lower levels of emotional distress” because of the length of time they have had the disease, and a longer time with a visual impairment seems to help them cope with the impact of vision loss. Given that the authors used screening tools to measure both depressive symptoms and functional status, research should be done combining the best items of each questionnaire to come up with a manageable screening tool to help identify these issues. This could encourage the treating practitioner to discuss some of the options to maximize functioning and activities of daily living, thereby helping to minimize depression; an obvious option is low vision rehabilitation.