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R.W. Bremer, M.B. Gorin, A.W. Eller, T.R. Friberg, R.J. Noecker, B.L. Rollman, J.S. Schuman, H.A. Pincus; Pilot Study of the Relationship Among Depression and Visual Impairment in Older Adults . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3463.
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A small number of recent studies have demonstrated high rates of depression in patients with age–related vision impairment. However, the relative contribution of self reported vision–specific functioning measures and objective visual acuity has not been well examined. This pilot study investigates the relation between depression and a self–report vision functioning measure versus objective visual functioning in patients with age–related visual impairment.
Subjects were recruited from the University of Pittsburgh Medical Center (UPMC) Eye Center if they had at least some vision impairment and a diagnosis of age–related macular degeneration or glaucoma. Visual acuity data was obtained from the patient’s medical record. The 25–item National Eye Institute Visual Functioning Questionnaire (NEI–VFQ) was used to assess self–report vision functioning. Depression was categorized as positive if the subjects reported a Center for Epidemiologic Studies Depression Scale (CESD) score > 16.
Thirty–seven subjects to date have completed the assessment battery. Overall, 35% (N=13) of the sample had a CESD>16. There was a significant relationship between the NEI–VFQ and the CESD after controlling for significant covariates, including visual acuity (F=13.08, p=0.0011). Depression severity scores were not associated with best eye visual acuity (r=–.06, p=.71). Stratifying between better vision (better than 20/200) versus worse vision (20/200 or worse), NEI–VFQ scores were moderately correlated with worse vision (r=.49, p=.05), but highly correlated with better vision (r=.81, p<.001).
Depressive symptoms are common in patients with vision loss. However, depressive symptoms are not related to visual acuity, but rather the patient’s evaluation of their daily vision functioning. This study shows the high prevalence of depressive symptoms in an academic medical center ophthalmology clinic. It also suggests the importance of obtaining low vision rehabilitation before vision loss is severe. Future studies need to examine the direction of this relationship and if depression treatment can impact self–report vision functioning.
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