June 2020
Volume 61, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2020
Association Between Anxiety, Depression, and Severity of Diabetic Retinopathy
Author Affiliations & Notes
  • Daniel Olson
    Ophthalmology, University of North Carolina, Chapel Hill, North Carolina, United States
  • Patrick Le
    School of Medicine, University of North Carolina, Chapel Hill, North Carolina, United States
  • Thoai Vu
    University of North Carolina, Chapel Hill, North Carolina, United States
  • Eric Van Buren
    Biostatistics, University of North Carolina, Chapel Hill, North Carolina, United States
  • Feng-Chang Lin
    Biostatistics, University of North Carolina, Chapel Hill, North Carolina, United States
  • Alice Zhang
    Ophthalmology, University of North Carolina, Chapel Hill, North Carolina, United States
  • Footnotes
    Commercial Relationships   Daniel Olson, None; Patrick Le, None; Thoai Vu, None; Eric Van Buren, None; Feng-Chang Lin, None; Alice Zhang, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 3836. doi:
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      Daniel Olson, Patrick Le, Thoai Vu, Eric Van Buren, Feng-Chang Lin, Alice Zhang; Association Between Anxiety, Depression, and Severity of Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3836.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Associations between diabetic retinopathy and presence of anxiety and depression are inconsistent and controversial in the literature. The aim of this retrospective cohort study is to determine associations between diabetic retinopathy severity and psychological comorbidities of anxiety and depression.

Methods : A retrospective study including 95,575 subjects age 18 and older with eye exams on record was performed. Subjects were identified with diagnoses of diabetic retinopathy, anxiety, depression, and any combination of these diseases between July 2008-July 2017 using ICD-9 and ICD-10 codes. Subjects were stratified by gender and age. Odds ratios (OR) were calculated for subjects with anxiety and/or depression in subjects with diabetic retinopathy while adjusting for age. Subjects were then stratified by disease severity. Sub-analysis was performed comparing the prevalence of anxiety and/or depression in subjects with diabetic retinopathy with and without cystoid macular edema.

Results : Of the 95,575 subjects reviewed, 54,617 (57.1%) were female and 22,454 (23.5%) were diagnosed with diabetes mellitus, 17,972 (18.8%) with anxiety, 20,052 (21.0%) with depression, and 4,315 (4.5%) with diabetic retinopathy. Of the subjects with diabetic retinopathy, 1,334 (30.9%) were documented to have diabetic macular edema. ORs were calculated for subjects with anxiety and mild NPDR (OR 1.381; CI 1.171,1.628; p<0.001), moderate NPDR (OR 0.898, CI 0.664, 1.215; p<0.001), severe NPDR (OR 1.399, CI 0.860, 2.273; p<0.001), and PDR (OR 0.956, CI 0.830, 1.101; p<0.001), respectively. OR were also calculated for subjects with depression and mild NPDR (OR 1.840, CI 1.585, 2.136; p<0.001), moderate NPDR (OR 1.452, CI 1.128, 1.870; p<0.001), severe NPDR (OR 1.984, CI 1.281, 3.074; p<0.001), and PDR (OR 1.410, CI 1.249, 1.591; p<0.001).

Conclusions : In this study, patients with all levels of diabetic retinopathy are more likely to have depression although there was no linear correlation between the severity of disease and presence of depression. There was no significant correlation between severity of diabetic retinopathy and anxiety. Male patients with diabetic retinopathy are more likely to have depression, and younger patients were more likely to have anxiety, depression or both.

This is a 2020 ARVO Annual Meeting abstract.

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