Association between depression, anxiety, and treatment adherence in patients with diabetic macular edema

Table 7 Mediation analysis of the relationship between depression/anxiety and visual outcomes

Pathway	Effect	SE	95%CI	P value	Mediated
Depression - BCVA change
Total effect	0.287	0.062	0.165-0.409	< 0.001	-
Direct effect	0.205	0.058	0.091-0.319	< 0.001	71.4%
Indirect effect via MARS-5	0.082	0.026	0.034-0.138	0.002	28.6%
Depression - NEI VFQ-25
Total effect	-14.32	2.48	-19.24 to -9.40	< 0.001	-
Direct effect	-10.68	2.36	-15.36 to -6.00	< 0.001	74.6%
Indirect effect via MARS-5	-3.64	1.12	-5.92 to -1.48	0.001	25.4%
Anxiety - BCVA change
Total effect	0.224	0.058	0.110-0.338	< 0.001	-
Direct effect	0.162	0.054	0.056-0.268	0.003	72.3%
Indirect effect via appointment adherence	0.062	0.022	0.021-0.108	0.004	27.7%

SE: Standard error; CI: Confidence interval; BCVA: Best-corrected visual acuity; MARS-5: Medication Adherence Report Scale-5; NEI VFQ-25: National Eye Institute Visual Function Questionnaire-25.