Abstract
Purpose :
Vision loss from diabetic eye disease exerts significant psychosocial stress, including disrupted roles and relationships, social isolation, and dependence. As a result, the rate of depression in those with diabetic retinopathy (DR) is higher than those without. However, the predictors of depression in DR have not been well characterized. Here, we investigate the prevalence and predictors of depression in participants with DR.
Methods :
Data was gathered from the National Health and Nutrition Examination Survey 2005-2008. This study included participants age ≥40, who underwent fundus photography and Patient Health Questionnaire (PHQ)-9. PHQ-9 score ≥10 determined the presence of depression. Self-reported measures of visual function were measured from the Visual Function Questionnaire (VFQ-25). Multivariable logistic regression was used to evaluate whether DR was a significant risk factor for depression and to evaluate the risk factors for depression in those with DR.
Results :
A total of 5704 participants, 47% male, 523% female, and mean age 56.5 years were included in this study. Persons with moderate, severe non-proliferative diabetic retinopathy (NPDR), or proliferative retinopathy (PDR) had higher prevalence of depression than participants with mild retinopathy or no retinopathy (14.3% vs 6.9% vs 7.0%). In a multivariable logistic regression model controlling for age, ethnicity, and gender, moderate to severe NPDR or PDR (OR: 2.21 (95% CI: 1.02, 4.78), p=0.04) was associated with greater odds of depression when compared with persons without retinopathy. Among persons with DR, best corrected visual acuity (BCVA) (p=0.67) and HbA1c (p=0.97) were not associated with depression after controlling for age, ethnicity, and gender. However, self-reported measures of vision were predictive of depression: poor or very poor visual function (OR: 9.45 (95% CI: 2.34, 37.24), p=0.002), vision limits activities most of the time or all the time (OR: 7.09 (95% CI: 1.35 37.20), p=0.022).
Conclusions :
A significant proportion of patients with DR in the NHANES population had co-morbid major depression. Objective measures of visual function were not predictive of depression in those with DR, while subjective, self-reported measures of visual function were highly predictive of depression, suggesting that subjective measures are a better determinant of low mood and poor functional status than BCVA.
This is a 2020 ARVO Annual Meeting abstract.