Abstract
Purpose :
To study the extent to which patients with age-related macular degeneration (AMD) and/or primary open angle glaucoma (POAG) have seasonal affective disorder (SAD) symptoms and to correlate the reported difficulties with severity of visual symptoms and/or visual impairment.
Methods :
Cross-sectional, comparative case series of patients with intermediate to advanced AMD and/or moderate to advanced POAG identified through billing records. Each prospective participant was mailed a letter of invitation to participate in the study and asked to complete a copy of the National Eye Institute Visual Function Questionnaire (VFQ-39) and Seasonal Pattern Assessment Questionnaire (SPAQ). A multiple regression analysis was performed to create a predictive model for SAD based on the Global Seasonality Score (GSS) using the visual function questions on the VFQ-39, as well as clinical characteristics abstracted from the medical record for each participant.
Results :
103 subjects out of 350 recruited returned questionnaires (31%). The return rate was greater for subjects with AMD (36%) compared to POAG (26%) (p=0.027), this despite the former group having worse visual acuity (p<0.001). Subjects who reported symptoms of SAD (GSS >8) tended to be older (84.9±5.9 years vs. 79.4±9.5 years, p = 0.008) and had lower vision-related quality of life (VFQ-39 composite score 59.0 vs 73.6, p<0.001). Linear regression analysis failed to find an association between SAD symptoms and gender, diagnosis (AMD vs POAG), or low vision status. Exploratory factor analysis using a Principal Components Analysis showed that the items on the VFQ-39 split into two distinct dimensions that explained 59.7% of the total variance: mainly vision-related problems and those that involved quality of life. Stepwise regression was performed to assess the ability of items in the VFQ-39 to predict the presence of SAD symptoms (R2=0.887, p<0.001). Hierarchical regression modeling found that the best inclusive model for SAD included only VFA9, VFA7 and VF11 (R2=0.2227, p<0.001).
Conclusions :
Vision-related quality of life is a better predictor of symptoms related to SAD than low vision. Interestingly, the social functioning sub-scale was the best predictor of symptoms related to SAD, and not the mental health subscale, perhaps because the former focuses more on anxiety than depression about vision.
This is a 2020 ARVO Annual Meeting abstract.