Minimal Depression and Vision Function in Age-Related Macular Degeneration
Received 2 November 2005; accepted 26 May 2006. published online 07 August 2006.
Objective
To evaluate the impact of minimal depression on subjective and objective vision function measures in age-related macular degeneration (AMD).
Design
Prospective cross-sectional study.
Participants
Two hundred six outpatients with newly diagnosed neovascular AMD in one eye and preexisting AMD in the fellow eye.
Methods
Structured clinical evaluations of visual acuity (VA), contrast sensitivity, vision function, and depression.
Main Outcome Measures
The 17-item National Eye Institute Visual Function Questionnaire (NEI VFQ 17), Melbourne Low-Vision Index (MLVI), Chronic Disease Score, and Hamilton Depression Rating Scale.
Results
Minimally depressed subjects had significantly worse vision function on both the NEI VFQ 17 and performance-based tasks of the MLVI than nondepressed subjects, independent of severity of VA, contrast sensitivity, and medical status.
Conclusions
Minimally depressed patients with AMD, who would not be considered depressed according to current diagnostic standards, suffer decrements in vision function that cannot be accounted for by the severity of their eye disease or general medical problems. These data emphasize the need to assess depressive symptoms in research studies that use vision function outcome measures and in clinical practice to identify excess vision-related disability in patients with AMD.
1Departments of Psychiatry and Neurology, Jefferson Medical College, Philadelphia, Pennsylvania.
2Department of Psychiatry and Human Behavior, Jefferson Medical College, Philadelphia, Pennsylvania.
3Departments of Psychiatry and Community & Family Medicine, Dartmouth Medical School, Hanover, New Hampshire.
4Department of Ophthalmology, Wills Eye Hospital, Jefferson Medical College, Philadelphia, Pennsylvania.
Correspondence and reprint requests to Barry W. Rovner, MD, Jefferson Hospital for Neuroscience, 900 Walnut Street, 4th Floor, Philadelphia, PA 19107.
Manuscript no. 2005-1076.
This work was supported by the National Institute of Mental Health, Bethesda, Maryland (grant no.: RO 1 MH61331); National Eye Institute, Bethesda, Maryland (grant no.: U01 EY 015839); and Farber Institute for Neurosciences of Thomas Jefferson University, Philadelphia, Pennsylvania.
ABSTRACT