Individuals with age-related macular degeneration (AMD) may have a higher risk of depression, particularly when the condition is accompanied by severe visual disability, according to research published in Ophthalmology.
“The future outlook of the disease is not optimistic, even in the early form of AMD, as it currently either leads to a gradual loss of central vision over several decades without available treatment or sudden, unpredictable deterioration of visual function in the case of exudative AMD,” according to the researchers. “Therefore, being diagnosed with AMD itself may place individuals under anxiety and psychological stress and could increase the risk of developing depression.”
The researchers retroscopically reviewed data from 3,599,589 individuals (mean age, 60.39 years; 51.15% men) enrolled in a South Korean universal medical care system who did not have a depression diagnosis. The team identified individuals with AMD using diagnostic codes and examined associations between varying levels of visual disability and new-onset depression during a mean follow-up period of 8.52 years.
Among the cohort, 40,771 individuals (1.13%) had AMD. A total of 2974 study participants with AMD had an accompanying visual disability — 1725 and 1249 with mild and severe disability severities, respectively. An AMD diagnosis increased the risk for new onset-depression (hazard ratio [HR], 1.15; 95% CI, 1.13-1.17), and AMD with accompanying visual disability increased this risk even more (HR, 1.21 and 1.25 for mild and severe visual disability, respectively).
Age younger than 65 years (P =.021) and male sex (P <.001) were significant factors for developing depression in participants with AMD, according to the report.
“Earlier recognition and adequate referral could significantly reduce depressive symptoms and help maintain quality of life in patients with AMD,” according to the researchers. “Therefore, ophthalmologists are encouraged not only to care for ocular conditions but also to pay attention to the depressive symptoms of individuals diagnosed with AMD.”
Study limitations include an inability to verify diagnostic codes or stratify patients according to AMD subtype.
References:
Hwang S, Kang SW, Kim SJ, et al. Impact of age-related macular degeneration and related visual disability on the risk of depression: a nationwide cohort study. Ophthalmol. Published online January 27, 2023. doi:10.1016/j.ophtha.2023.01.014