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Faster visual field loss associated with depressive symptoms in glaucoma patients
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Fast progression of visual field loss may be associated with depressive symptoms in patients with glaucoma, according to a study.
The prospective, observational cohort study included 204 eyes of 102 patients who had glaucoma-related visual field defects on standard automated perimetry (SAP).
Fifty-five patients were men and 47 were women. Mean age of the patients was 67.4 years at baseline.
Patients completed the Geriatric Depression Scale (GDS) questionnaire, and researchers obtained visual field tests.
Mean follow-up was 2.2 years, measured from the first visual field test to the last visual field test closest to the GDS questionnaire.
At baseline, binocular mean sensitivity was 29.2 dB and the GDS score was 2.3 units.
Over the follow-up period, a change of 1 dB/year in binocular SAP mean sensitivity was associated with a change of 2 units in the GDS score (P = .025).
After a multivariable model was adjusted for baseline disease severity, visual acuity change, age, gender, race, Montreal Cognitive Assessment score, education, income and comorbidity index, each change of 1 dB/year in binocular SAP mean sensitivity was associated with a change of 3 units in the GDS score (P = .019).
“Patients with rapidly progressing disease showed an increase in the incidence of depressive symptoms,” the study authors said. “Our findings indicate that assessment of rates of visual field progression in glaucoma may be important for indicating patients at risk for developing depressive symptoms over time.” – by Nhu Te
Disclosure: The authors report no relevant financial disclosures.
Perspective
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Carl H. Jacobsen, OD, FAAO
Getting old is a drag. In addition to trivial concerns of expanding waistline and receding hairline, aging is also associated with cognitive loss, mobility loss and catastrophic health events. It’s all rather depressing.
Studies have found that having glaucoma poses a psychological burden on patients, and that the severity of glaucoma-related vision loss correlates with the degree of depression.
Diniz-Filho and associates, in their prospective observational study, give us additional insight. They found that patients with faster progressing glaucoma-related vision loss suffered more depressive symptoms.
It’s depressing to lose your vision, and faster vision loss means more depression. This conclusion initially seems obvious and intuitive. However, many of us in the glaucoma world (myself included) marvel at how patients with significant glaucoma-related vision loss appear unaffected.
Are our patients unaffected or are we unaware? I challenge you to carefully discuss depression with your glaucoma patients, especially when this disease is rapidly progressing. Your patients may be saddened by their glaucoma, whether they tell you about it or not.
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Diniz-Filho A, et al. Ophthalmology. 2016;doi:10.1016/j.ophtha.2015.12.014.
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