Abstract
Purpose :
To ascertain the relationship between disease activity based on automated imaging metrics and the mental health of chronic uveitis patients to evaluate for risk factors and effects of ocular treatment on depression.
Methods :
This study is an analysis of two IRB approved prospective studies (Imaging Quantification of Inflammation Study [IQI] Phase 1 and Phase 2, NCT04704609). Patients received clinical evaluation and imaging evaluation with OCT (Optical Coherence Tomography), AS-OCT (Anterior Segment OCT), and FA (Fluorescein Angiography) as well as completed the PHQ-9 for depression screening and the NEI VFQ-25 for subjective visual functioning. Imaging analysis was performed using customized software to measure inflammation activity. Depression survey was completed at every visit. All patients received treatment for active inflammation using corticosteroids or systemic steroid sparing agents. Changes in ocular anatomy, visual acuity, and PHQ-9 scores were tracked through treatment and compared with demographic data. A conventional cutoff score of 10 on the PHQ-9 is used to denote major depression.
Results :
43 patients from the IQI phases 1 & 2 studies were included in this analysis. 7 of 43 patients (16.3%) indicated depression at the first screening and 9 patients (20.9%) (8 female) indicated major depression at any point. Of the 9 patients who indicated depression, 5 (55%) were African American and 4 (45%) were Caucasian. There was a moderate correlation between the PHQ-9 and VFQ-25 with higher VFQ scores corresponding to lower PHQ scores (R2 = 0.34). Analysis showed worsening of leakage in month 1 corresponds to an associated increase in PHQ-9 scores 6 months later in the patient’s worse eye at initial study visit (r=0.29 ([-0.069, 0.577], P = 0.11)).
Conclusions :
Our analysis showed an increased rate of depression amongst patients with uveitis compared to the national population. We saw a much higher rate of clinically relevant depression amongst females with 30% of them indicating depression while only 6.25%. A majority of the patients with depression were of African American (56%) descent despite being only 9 of the 43 patients (21%), suggesting a potential high risk group. There was a trend for worsening initial leakage leading to worsening PHQ-9 scores 6 months later. This and other trends warrant further assessment in a larger study with a greater sample size.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.