Abstract
Purpose :
There is an established association between visual acuity (VA) loss and depression in patients with AMD. However, there is a paucity of research linking VA with mental health amongst the different subgroups of AMD. The goal of this study was to describe the relationship between VA and mental health questions on the NEI-VFQ-25 questionnaire in patients with different classifications of AMD, and to identify predictors of mental health subscale scores.
Methods :
Patients with AMD defined by multi-modal imaging were recruited into a Colorado AMD registry. Habitual VA was obtained by a trained certified ophthalmic technician using the Snellen VA as distance viewing. At enrollments, patients completed the 25-item NEI-VFQ-25, a visual questionnaire that includes 25 questions regarding the patient’s visual functionality with regular daily activities. Mean scores on the mental health subscale of the VFQ were calculated by AMD classification and VA groups. Univariate and multivariable general linear models were used to estimate associations between mental health scores and variables of interest.
Results :
A total of 875 patients were included in the study. Patients with bilateral both (geographic atrophy and neovascular) scored lowest on the mental health subscales with a mean ± SD of 59.6 ± 29.3. Patients with a habitual VA of 20/200 or worse scored the lowest on mental health subscales scores in both the better and worse seeing eye of 44.8 ± 25.9 and 63.9 ± 28.4 respectively. Patients with a VA of 20/20 or better had the highest scores on the mental health subscales in both the better and worse seeing eye of 85.3 ± 17.7 and 89.1 ± 13.0 respectively (Fig 1). VA of the better and worse seeing eye and AMD classification were significant predictors of mental health subscale scores (all p<0.0001 except the worse-seeing eye in multivariable model where p=0.012). Patients enrolled during the COVID pandemic had mental health scores that were 2.7 points lower than prior to the pandemic, but this difference was not significant (p=0.22).
Conclusions :
There is a significant association between mental health questionnaire scores and AMD classification, as well as VA in both the better-seeing and worse-seeing eyes in patients with AMD. It is important for clinicians to recognize feelings of worry/ frustration in these patients, so they can be appropriately diagnosed, referred, and treated for depression and/or anxiety.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.