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Ying Qian, Tanya Glaser, Elizabeth Esterberg, Nisha Acharya; Depression and Visual Functioning in Patients with Ocular Inflammatory Disease. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4302.
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To characterize the level of depression in patients with ocular inflammatory disease and to determine predictors of depression in this population.
Consecutive patients with noninfectious ocular inflammatory disease in a university-based tertiary referral center were included in a prospective cross-sectional survey. Medical records of consenting subjects were reviewed for clinical characteristics. Subjects were given self-administered Beck Depression Inventory-II (BDI-II), National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) and additional supplemental questions. A BDI score greater than 13 indicated a positive depression screen. Univariate analyses were conducted to compare clinical characteristics between patients with and without a positive screen for depression, and a multivariate regression model was performed to determine the most significant predictors of depression.
Of the 104 participants, 54.8% were female, 49.0% were Caucasian, and 26.9% screened positive for depression with the BDI-II. There were no significant demographic differences between the depressed and not depressed groups. Of those with a positive depression screen, only 39.3% had been previously diagnosed with depression. The mean logMAR vision in the better seeing eye was 0.12 (Snellen equivalent 20/25-) in the depressed group and 0.05 (Snellen equivalent 20/25+2) in the not depressed group (P=0.02). There was no correlation between active inflammation and a positive depression screen (P = .88) or between duration of disease and depression (P = .18). Twenty-four (85.7%) subjects in the depressed group and 44 (57.9%) subjects in the not depressed group had chronic ocular inflammatory disease (P=0.01). NEI VFQ-25 scores were significantly lower in depressed patients in all subscales except driving and color vision. Predictors of depression were inadequate emotional support, lower visual functioning (VFQ composite score), history of switching immunosuppressive treatment and current oral corticosteroid use.
Depression is a significant but under-recognized comorbid condition in patients with ocular inflammatory disease. Worse visual function is a predictor of depression. We recommend that practitioners routinely inquire about symptoms of depression and have a low threshold for formal evaluation.
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