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Barry W. Rovner, MD; Robin J. Casten, PhD; William S. Tasman, MD

Arch Ophthalmol. 2002;120:1041-1044.

Objectives  To report the prevalence rate of depression in older patients with recent vision loss due to age-related macular degeneration (AMD) and to describe the effect of depression on self-reported vision function during 6 months.

Methods  Prospective cohort study of 51 older patients with recent-onset bilateral AMD attending the Retina Clinic of Wills Eye Hospital, Philadelphia, Pa. Main outcome measures included the Center for Epidemiological Studies Depression Scale, visual acuity, Functional Vision Screening Questionnaire, Chronic Disease Score, and Community Disability Scale.

Results  Seventeen patients (33%) were depressed at baseline and had worse visual acuity (P = .04) and greater levels of vision-specific (P = .03) and general (P = .002) physical disability than nondepressed patients. The correlations of Center for Epidemiological Studies Depression Scale score with visual acuity and visual-specific disability, however, were not significant after controlling for general physical disability. An increase in depressive symptoms over time predicted decline in self-reported vision function independent of changes in visual acuity or medical status (P<.05).

Conclusions  The prevalence and disabling effects of depression in older patients with AMD are substantial. Recognizing that depression is a treatable disorder that exacerbates the effects of AMD will lead to improved outcomes. Innovative interventions to prevent or treat depression in specialty eye clinics are possible.

From the Departments of Psychiatry and Human Behavior (Drs Rovner and Casten) and Ophthalmology (Dr Tasman), Jefferson Medical College, Thomas Jefferson University, and Wills Eye Hospital (Dr Tasman), Philadelphia, Pa.

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