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Observational Study
. 2016 Apr;123(4):754-9.
doi: 10.1016/j.ophtha.2015.12.014. Epub 2016 Feb 23.

Fast Visual Field Progression Is Associated with Depressive Symptoms in Patients with Glaucoma

Alberto Diniz-Filho  1 , Ricardo Y Abe  2 , Hyong Jin Cho  3 , Saif Baig  2 , Carolina P B Gracitelli  4 , Felipe A Medeiros  5
Affiliations
Observational Study

Fast Visual Field Progression Is Associated with Depressive Symptoms in Patients with Glaucoma

Alberto Diniz-Filho et al. Ophthalmology. 2016 Apr.

Abstract

Purpose: To evaluate the association between the rates of progressive visual field loss and the occurrence of depressive symptoms in patients with glaucoma followed over time.

Design: Prospective observational cohort study.

Participants: The study included 204 eyes of 102 patients with glaucomatous visual field defects on standard automated perimetry (SAP).

Methods: All patients had Geriatric Depression Scale (GDS) questionnaires and visual field tests obtained over a mean follow-up time of 2.2±0.6 years. Change in depressive symptoms was assessed by calculating the difference between GDS scores at the last follow-up visit from those at baseline. Rates of visual field loss were assessed by SAP. An integrated binocular visual field was estimated from the monocular SAP tests, and rates of change in mean sensitivity (MS) over time were obtained from linear mixed models. Regression models were used to investigate the association between progressive visual field loss and changes in depressive symptoms, adjusting for potentially confounding clinical and socioeconomic variables.

Main outcome measures: The association between rates of change in binocular SAP MS and change in GDS questionnaire scores.

Results: There was a significant correlation between change in the GDS scores during follow-up and change in binocular SAP sensitivity. Each 1 decibel (dB)/year change in binocular SAP MS was associated with a change of 2.0 units in the GDS scores during the follow-up period (P = 0.025). In a multivariable model adjusting for baseline disease severity, change in visual acuity, age, gender, race, Montreal Cognitive Assessment score, education, income, and comorbidity index, each 1 dB/year change in binocular SAP MS was associated with a change of 3.0 units in the GDS score (P = 0.019).

Conclusions: Faster visual field progression was associated with the occurrence of depressive symptoms in patients with glaucoma.

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Figures

Figure 1
Figure 1
The 15-item Geriatric Depression Scale (GDS) questionnaire consists of 15 dichotomous (yes/no) questions about depressive symptoms in the past week. Of the 15 items, 10 indicated the presence of depressive symptoms when answered positively, while questions 1, 5, 7, 11, and 13 indicated the presence of depressive symptoms when answered negatively.
Figure 2
Figure 2
Predicted changes with 95% confidence interval in the Geriatric Depression Scale (GDS) score for different values of rate of change in binocular standard automated perimetry (SAP) mean sensitivity (dB/year).
See this image and copyright information in PMC

Comment in

References

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