Study on Depression and Age-related Macular Degeneration

The risk of depression in the elderly that is exacerbated by the presence of age-related macular degeneration suggests a recent study published in the BMC Ophthalmology.

Visual acuity (VA) loss has been associated with depression in patients with age-related macular degeneration (AMD). However, previous studies did not incorporate subgroups of age-related macular degeneration when correlating Visual acuity and mental health. The goal of this study was to describe the relationship between Visual acuity and mental health questions in patients with different classifications of age-related macular degeneration, and to identify associations of mental health subscale scores.

AMD patients classified by multi-modal imaging were recruited into an age-related macular degeneration registry. Habitual VA was obtained by ophthalmic technicians using the Snellen Visual acuity at distance. At enrollment, patients completed the NEI-VFQ-25, which includes 25 questions regarding the patient's visual functionality. Median with interquartile-range (IQR) scores on the mental health subscale of the VFQ were calculated by age-related macular degeneration classification and Visual acuity groups. Univariate and multivariable general linear models were used to estimate associations between mental health scores and variables of interest.

Results

Eight hundred seventy-five patients were included in the study. Patients with bilateral geographic atrophy (GA) or bilateral GA and neovascular (NV) age-related macular degeneration scored lowest on the mental health subscales with a median (IQR) of 58.2 (38–88) and 59.3 (38–88).

• When stratified by Visual acuity, patients with a habitual Visual acuity of 20/200 or worse scored the lowest on mental health subscales scores: median of 43.8
• Patients with a Visual acuity of 20/20 scored the highest: 87.5

Habitual Visual acuity of the better- and worse-seeing eye and age-related macular degeneration classification were significantly associated with mental health subscale scores (all p < 0.0001 in both the univariate and multivariable analysis, except the Visual acuity of the worse-seeing eye in multivariable model p = 0.027).

Patients enrolled during the COVID pandemic had mental health scores that were 2.7 points lower than prior to the pandemic, but this difference was not significant in univariate or multivariable analysis.

There is a significant association between mental health questionnaire scores and age-related macular degeneration classification, as well as Visual acuity in both the better and worse-seeing eyes in patients with age-related macular degeneration. It is important for clinicians to recognize feelings of worry/frustration in these patients, so they can be appropriately referred, screened, and treated for mental health problems.

Reference

Fonteh, C.N., Mathias, M.T., Mandava, N. et al. Mental health and visual acuity in patients with age-related macular degeneration. BMC Ophthalmol 22, 391 (2022). https://doi.org/10.1186/s12886-022-02602-9

Keywords

• Age-related macular degeneration
• Mental health
• Retina
• Vision function questionnaires
• Fonteh, C.N.
• Mathias, M.T.
• Mandava, N.