Prevalence and impact of depressive symptoms in patients with age-related macular degeneration

Objective: This study sought to identify the point prevalence of depressive symptoms, quality-of-life (QOL) impairment, and demographic parameters associated with depression in patients with age-related macular degeneration (AMD) attending a retina clinic in Edmonton, Alberta. Design: A cross-sectional design was used. Methods: Consecutive patients with AMD were invited to participate in the study. Demographic data, as well as ophthalmic, medical, and psychiatric histories, were collected. Participants completed the Center for Epidemiological Studies Depression Scale (CES-D) and the Visual Function Questionnaire (VFQ-25) scales to quantify the burden of depressive symptoms and vision-related QOL impairment. Results: The study enrolled 101 patients, of whom 7 (6.9%) had a previous history of depression. Twenty (21.3%) of the remaining patients endorsed severe symptoms of depression that had not yet been diagnosed. Significant differences in vision-related QOL between depressed and not depressed patients were identified. Depressed patients were also found to have worse visual acuity (p = 0.047) and were less likely to live with others (p = 0.020) than those who were not depressed. Conclusions: After excluding patients with a history of diagnosed depression, 20 (21.3%) patients demonstrated severe symptoms of depression. Development of depression screening protocols for patients with AMD would improve identification and referral of patients at risk. The finding that patients who lived with others had a lower prevalence of depressive symptoms suggests that further research into the relationship between mood symptoms and environmental supports is merited.