Mental health and visual acuity in patients with age-related macular degeneration.


Journal

BMC ophthalmology
ISSN: 1471-2415
Titre abrégé: BMC Ophthalmol
Pays: England
ID NLM: 100967802

Informations de publication

Date de publication:
02 Oct 2022
Historique:
received: 31 05 2022
accepted: 07 09 2022
entrez: 1 10 2022
pubmed: 2 10 2022
medline: 5 10 2022
Statut: epublish

Résumé

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 AMD when correlating VA and mental health. The goal of this study was to describe the relationship between VA and mental health questions in patients with different classifications of AMD, and to identify associations of mental health subscale scores. AMD patients classified by multi-modal imaging were recruited into an AMD registry. Habitual VA was obtained by ophthalmic technicians using the Snellen VA 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 AMD classification and VA groups. Univariate and multivariable general linear models were used to estimate associations between mental health scores and variables of interest. Eight hundred seventy-five patients were included in the study. Patients with bilateral geographic atrophy (GA) or bilateral GA and neovascular (NV) AMD scored lowest on the mental health subscales with a median (IQR) of 58.2 (38-88) and 59.3 (38-88). When stratified by VA, patients with a habitual VA of 20/200 or worse scored the lowest on mental health subscales scores: median of 43.8 (IQR: 31-62). Patients with a VA of 20/20 scored the highest: 87.5 (IQR: 81-94). Habitual VA of the better- and worse-seeing eye and AMD classification were significantly associated with mental health subscale scores (all p < 0.0001 in both the univariate and multivariable analysis, except the VA 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 (p = 0.300) or multivariable analysis (p = 0.202). There is a significant association between mental health questionnaire scores and AMD classification, as well as VA in both the better and worse-seeing eyes in patients with AMD. 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.

Sections du résumé

BACKGROUND BACKGROUND
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 AMD when correlating VA and mental health. The goal of this study was to describe the relationship between VA and mental health questions in patients with different classifications of AMD, and to identify associations of mental health subscale scores.
METHODS METHODS
AMD patients classified by multi-modal imaging were recruited into an AMD registry. Habitual VA was obtained by ophthalmic technicians using the Snellen VA 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 AMD classification and VA groups. Univariate and multivariable general linear models were used to estimate associations between mental health scores and variables of interest.
RESULTS RESULTS
Eight hundred seventy-five patients were included in the study. Patients with bilateral geographic atrophy (GA) or bilateral GA and neovascular (NV) AMD scored lowest on the mental health subscales with a median (IQR) of 58.2 (38-88) and 59.3 (38-88). When stratified by VA, patients with a habitual VA of 20/200 or worse scored the lowest on mental health subscales scores: median of 43.8 (IQR: 31-62). Patients with a VA of 20/20 scored the highest: 87.5 (IQR: 81-94). Habitual VA of the better- and worse-seeing eye and AMD classification were significantly associated with mental health subscale scores (all p < 0.0001 in both the univariate and multivariable analysis, except the VA 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 (p = 0.300) or multivariable analysis (p = 0.202).
CONCLUSION CONCLUSIONS
There is a significant association between mental health questionnaire scores and AMD classification, as well as VA in both the better and worse-seeing eyes in patients with AMD. 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.

Identifiants

pubmed: 36183081
doi: 10.1186/s12886-022-02602-9
pii: 10.1186/s12886-022-02602-9
pmc: PMC9526530
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

391

Subventions

Organisme : NEI NIH HHS
ID : R01 EY032456
Pays : United States

Investigateurs

Melanie Akau (M)
Karen L Christopher (KL)
Richard Davidson (R)
Ruth T Eshete (RT)
C Rob Graef (CR)
Scott Hauswirth (S)
Anne M Lynch (AM)
Scott N Oliver (SN)
Jeffery L Olson (JL)
Alan G Palestine (AG)
Jesse M Smith (JM)
Brandie D Wagner (BD)

Informations de copyright

© 2022. The Author(s).

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Auteurs

Cheryl N Fonteh (CN)

Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA. cheryl.fonteh@cuanschutz.edu.
Division of Ophthalmic Epidemiology, Department of Ophthalmology, University of Colorado School of Medicine, Mail Stop F731, 1675 Aurora Court, Aurora, CO, 80045, USA. cheryl.fonteh@cuanschutz.edu.

Marc T Mathias (MT)

Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA.

Naresh Mandava (N)

Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA.

Niranjan Manoharan (N)

Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA.

Anne M Lynch (AM)

Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA.

Roxanne Navo (R)

Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA.

Jennifer L Patnaik (JL)

Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA.

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Classifications MeSH