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Xu S, Wang X, Xu J, Tang X, Hao W, Xiang C, Lei X, Wang M, Yang X. Causal relationships between depression, anxiety, and myopia: a two-sample Mendelian randomization study. Eye (Lond) 2025:10.1038/s41433-025-03841-y. [PMID: 40360801 DOI: 10.1038/s41433-025-03841-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2024] [Revised: 04/12/2025] [Accepted: 05/02/2025] [Indexed: 05/15/2025] Open
Abstract
OBJECTIVES To investigate the causal relationship between depression, anxiety, and myopia. METHODS The multivariable Mendelian randomization (MR) design using summary statistics from independent genome-wide association studies (GWAS) was employed. The anxiety and depression, were used as exposures, and myopia was used as the outcome. Genetic variants associated with depression were derived using GWAS summary statistics from the FinnGen consortium database. Genetic variants associated with anxiety were derived from the Psychiatric Genomics consortium. The inverse-variance-weighted method was the main applied analytic tool and was complemented with comprehensive sensitivity analyses. RESULTS A total of 21, 10 SNPs were selected as instrumental variables for depression and anxiety, respectively. Based on the IVW analysis, both depression (OR = 1.010, 95% CI = 1.002-1.018, P = 0.016) and anxiety (OR = 1.083, 95%CI = 1.022-1.149, P = 0.008) increased the risk of myopia. After adjusting in the multivariable MR, the IVW and Egger methods indicated that depression (OR = 1.004, 95%CI = 1.000-1.008, P = 0.030) or anxiety (OR = 1.004, 95%CI = 1.001-1.008, P = 0.026) was still associated with elevated risks of myopia. CONCLUSIONS The current study identified a causal relationship between anxiety, depression, and an increased risk of myopia. These observations suggest that when developing strategies to control myopia, it is also important to focus on the mental health of children. Further detailed research is needed to fully understand this issue.
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Affiliation(s)
- Shengsong Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
- Shenzhen Eye Hospital, Shenzhen Eye Medical Center, Southern Medical University, Shenzhen, China
| | - Xiao Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Jinyi Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Xianghua Tang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Wenlong Hao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Chuqi Xiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Xingyu Lei
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Mengyi Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China.
| | - Xiao Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China.
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Park H, Han KD, Park KA, Oh SY. Nonarteritic anterior ischemic optic neuropathy and the incidence of depression: a nationwide population-based study (2010-2017). Eye (Lond) 2025; 39:755-760. [PMID: 39562724 PMCID: PMC11885546 DOI: 10.1038/s41433-024-03480-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 10/24/2024] [Accepted: 11/08/2024] [Indexed: 11/21/2024] Open
Abstract
BACKGROUND/OBJECTIVES The risk of depression in patients with non-arteritic anterior ischemic optic neuropathy (NAION) has yet to be thoroughly researched. This study aimed to investigate the association between NAION and the onset of depression using a large-scale nationwide cohort in South Korea. METHODS This is a retrospective, nationwide cohort study involving 145,020 subjects without NAION and 29,004 individuals with a previous NAION diagnosis. Follow-up clinical data were collected until December 31, 2017. Multivariable adjustment models were employed to account for potential confounding factors. RESULTS The incidence of new-onset depression was significantly higher among NAION patients (incidence, 38.09 per 1000 person-years) than among non-NAION individuals (incidence, 29.91 per 1000 person-years). After adjusting for demographic factors, socioeconomic status, and comorbid diseases, the association remained significant (aHR = 1.271; 95% CI = 1.226-1.317). Notably, a subgroup analysis highlighted a particularly pronounced risk of depression in NAION patients aged 40 to 64 compared to those aged 65 or older (aHR = 1.34 vs. 1.207; interaction P = 0.0038). CONCLUSION Our findings demonstrate a significant association between NAION and an increased risk of depression, especially in relatively younger patients aged 40 to 64 years. These results highlight the importance of regular monitoring and early intervention for depressive symptoms in patients with NAION.
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Affiliation(s)
- Hansol Park
- Department of Ophthalmology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung-Do Han
- Department of Medical Statistics, Catholic University College of Medicine, Seoul, Korea
| | - Kyung-Ah Park
- Department of Ophthalmology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Sei Yeul Oh
- Department of Ophthalmology, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Wang SM, Jung Y, Han K, Ohn K, Park HYL, Park CK, Moon JI. Risk of depression in glaucoma patients with vision impairment: A nationwide cohort study. Heliyon 2025; 11:e40617. [PMID: 39758387 PMCID: PMC11699410 DOI: 10.1016/j.heliyon.2024.e40617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/14/2024] [Accepted: 11/20/2024] [Indexed: 01/07/2025] Open
Abstract
Purpose We aimed to investigate the risk of developing depression in individuals with primary open-angle glaucoma with associated vision impairment. Methods We conducted a nationwide, population-based cohort study using data from the Korean National Health Information Database and National Disability Registry. We assessed baseline characteristics such as age, sex, income level, lifestyle factors, anthropometric data, lab results, and Charlson Comorbidity Index scores through diagnostic codes and health screening data. Depression risk in relation to glaucoma and vision impairment was analyzed using a multivariable-adjusted Cox proportional hazard model. Results Among 3,680,570 individuals screened through the Korean National Health Screening Program in 2009, 681,515 were newly diagnosed with depression during follow-up. Subjects with glaucoma showed a higher risk of depression than those without glaucoma, with an adjusted hazard ratio (HR) of 2.011 (95 % confidence interval [CI]: 1.946-2.078) pre-adjustment and 1.085 (95 % CI: 1.050-1.121) post-adjustment for covariates. For those with glaucoma and vision impairment, the adjusted HR increased to 1.164 (95 % CI: 1.045-1.297) and to 1.207 (95 % CI: 1.039-1.403) with severe vision impairment. The association between glaucoma and depression was more pronounced in men (P for interaction = 0.001) and those with a Charlson Comorbidity Index <3 (P for interaction = 0.008). Conclusions Primary open-angle glaucoma increased the risk of developing depression. The risk escalated gradually with the presence and severity of concurrent vision impairment. The impact of glaucoma and vision impairment on new-onset depression was greater in men and in those with less comorbidities.
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Affiliation(s)
- Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Younhea Jung
- Department of Ophthalmology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Kyoung Ohn
- Department of Ophthalmology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hae-young Lopilly Park
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chan Kee Park
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jung Il Moon
- Department of Ophthalmology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Deng J, Qin Y. From meta-analysis to Mendelian randomization: Unidirectional perspectives on the association of glaucoma with depression and anxiety. PLoS One 2024; 19:e0310985. [PMID: 39561182 PMCID: PMC11575789 DOI: 10.1371/journal.pone.0310985] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 09/10/2024] [Indexed: 11/21/2024] Open
Abstract
BACKGROUND Glaucoma, a primary cause of blindness worldwide, has its association with depression and anxiety noted, yet the understanding of such association is still rudimentary. This study aims to provide the unidirectional perspectives on the association of glaucoma with depression and anxiety, informing public health strategies. METHODS The Meta-analysis screened observational studies from Medline, Embase, and Web of Science, using the modified Newcastle-Ottawa Scale for quality assessment. It employed R's 'meta' package to assess the association between glaucoma and depression or anxiety prevalence. The Mendelian Randomization (MR) analysis was conducted using R's 'TwoSampleMR' package, based on data from the IEU database data to explore the impact of glaucoma on depression and anxiety. RESULTS This Meta-analysis included 23 out of 379 studies involving 11,845 glaucoma patients. The combined prevalence of depression among glaucoma patients, derived from 18 cross-sectional studies, stood at 19.42%. Five case-control studies indicated that glaucoma patients had a 6.17-fold higher risk of depression compared to controls. Derived from 16 cross-sectional studies, the consolidated prevalence for anxiety was 19.07%. According to five case-control studies, glaucoma patients exhibited a 4.45-fold increased risk of anxiety compared to controls. MR analysis failed to uncover a causal effect of glaucoma on depression and anxiety. CONCLUSION This study suggests that glaucoma patients may experience higher prevalence of depression and anxiety than the general population, with no clear genetic links found. It suggests that environmental factors and non-genetic biological pathways, among others, may play significant roles in their association, though the role of genetic factors cannot be ruled out. These findings highlight the necessity of a comprehensive approach to study the complex factors influencing the association of glaucoma with depression or anxiety and underscore the importance of integrating mental health considerations into glaucoma management to improve medication adherence and disease progression.
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Affiliation(s)
- Jie Deng
- First Clinical College of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
- Graduate School, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - YuHui Qin
- First Clinical College of Traditional Chinese Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
- Graduate School, Hunan University of Chinese Medicine, Changsha, Hunan, China
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Ferreira NS, Costa VP, Miranda JF, Cintra LO, Barbosa LS, Barbosa da Silva MG, Abreu NA, Abe RY. Psychological Stress and Intraocular Pressure in Glaucoma: A Randomized Controlled Trial. Ophthalmol Glaucoma 2024; 7:518-530. [PMID: 39019157 DOI: 10.1016/j.ogla.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 06/09/2024] [Accepted: 07/08/2024] [Indexed: 07/19/2024]
Abstract
PURPOSE To evaluate the intraocular pressure (IOP) behavior after applying a standardized protocol to induce psychological stress in patients with primary open-angle glaucoma (POAG). DESIGN Randomized controlled trial. PARTICIPANTS A total of 39 patients with POAG were included: 18 in the stress group and 21 in the control group. METHODS Patients were randomized to undergo the Trier Social Stress Test (TSST) or to be included in the control group. All participants were submitted to a modified diurnal tension curve (DTC) 1-4 weeks before randomization, with 3 IOP measurements performed between 8:00 am and 2:00 pm. We evaluated the response to the TSST by measuring the levels of salivary cortisol, salivary amylase, IOP, mean arterial pressure, and heart rate before, immediately after, and 40 minutes after the TSST. The State Trait Anxiety Inventory (STAI) was applied to evaluate the levels of anxiety at the same time intervals. MAIN OUTCOME MEASURES Changes in IOP (mmHg), salivary cortisol and amylase, heart rate, mean arterial pressure, and STAI scores. RESULTS At baseline, there were no significant differences between the groups regarding age (P = 0.661), sex (P = 0.669), salivary cortisol (P = 0.104), and mean DTC IOP for the right (P = 0.439) and left (P = 0.576) eyes. We observed a significant mean IOP increase of 3.8 mmHg (right eye; P < 0.001) and 4.1 mmHg (left eye; P < 0.001) when we compared IOP measurements obtained during the DTC and immediately after TSST. Salivary cortisol (5.9 nmol/L; P = 0.004), salivary amylase (323 388 UL; P = 0.004), mean arterial pressure (10.1 mmHg; P < 0.001), and heart rate (12.9 bpm; P < 0.001) also increased significantly after the TSST. In addition, 61.1% (11 of 18) of the patients in the TSST group showed an IOP increase > 4 mmHg following the test. The STAI-state score significantly increased after the TSST compared to baseline (P < 0.001) and decreased from poststress to the recovery period (P < 0.001). CONCLUSIONS Patients with POAG present significant elevations of IOP, salivary cortisol and amylase, mean arterial pressure, heart rate, and STAI scores after psychological stress induced by the TSST. FINANCIAL DISCLOSURES Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
| | | | | | | | | | | | | | - Ricardo Yuji Abe
- Hospital Oftalmológico de Brasília, Brasília, Distrito Federal, Brazil; Department of Ophthalmology, University of Campinas, Campinas, Brazil.
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Giacometti HHAR, Coelho LF, Iankilevich LG, Valentin LSS, Ferreira LA, Balbino M, Seixas RCS. Prevalence of anxiety and depression among patients with glaucoma. Front Psychol 2024; 15:1410890. [PMID: 39246310 PMCID: PMC11378733 DOI: 10.3389/fpsyg.2024.1410890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 07/26/2024] [Indexed: 09/10/2024] Open
Abstract
Purpose This study aimed to determine the prevalence of anxiety and depression among patients with glaucoma compared to the average Brazilian prevalence (9.8% of anxiety and 5.8% of depression, according to the World Health Organization) and its correlation with the severity of the disease. Methods This was a transversal, single-arm trial of patients from four glaucoma centers in São Paulo and Curitiba-Brazil. Patients comprised adults at least 18 years of age with glaucoma diagnosis under treatment for at least 6 months. All subjects of the study answered two questionnaires (PHQ-9 and GAD-7) to evaluate the presence of anxiety and depression, and the results were analyzed accordingly to clinical and demographic characteristics. Results The protocol included a total of 210 patients. The average age was 61.6 ± 15.3 years, and the female gender was more common (68.86%). Primary open-angle glaucoma was the most common diagnosis (59.90%). The average IOP was 18.5 mmHg, and 1.5 anti-glaucoma drops were the mean treatment. The prevalence of depression and anxiety was 26.90 and 25.71%, respectively. Most patients with anxiety were classified as early glaucoma, while those with depression had severe glaucoma. Conclusion This study found that the prevalence of anxiety and depression among patients with glaucoma is higher than in the general population in our country.
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Lin B, Xu M, Chen LL, Li DK. A study exploring the causal relationship between glaucoma and anxiety disorders. Front Med (Lausanne) 2024; 11:1410607. [PMID: 39170036 PMCID: PMC11335643 DOI: 10.3389/fmed.2024.1410607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 07/29/2024] [Indexed: 08/23/2024] Open
Abstract
Background Glaucoma, a leading cause of global blindness, is characterized by optic nerve damage and visual field loss. Previous studies have suggested a potential association between glaucoma and anxiety disorders. However, the causal relationship between these two conditions remains unclear. Methods In this study, we conducted a Mendelian Randomization analysis to investigate the causal relationship between glaucoma and anxiety disorders. We sourced Genome-Wide Association Study (GWAS) datasets for glaucoma and anxiety with the largest sample sizes from the Integrative Epidemiology Unit OpenGWAS (IEU OpenGWAS) project website. Instrumental variables were selected based on specific criteria, and statistical analyses were performed using the R programming language. Results After filtering and merging the datasets, a total of 60 Single Nucleotide Polymorphisms (SNPs) were obtained for analysis. Regression models were applied to assess the causal relationship between glaucoma and anxiety disorders. The results from all four methods indicated that glaucoma does not cause anxiety disorders (p > 0.05). Conclusion Through rigorous Mendelian Randomization analysis, our findings indicate that glaucoma is not a causative factor for anxiety, with minimal influence from confounding factors in this study. These findings enhance our understanding of the relationship between glaucoma and anxiety.
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Affiliation(s)
- Bin Lin
- Xiamen Eye Center and Eye Institute of Xiamen University, Xiamen, China
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Ophthalmology, Xiamen, Fujian, China
- Fujian Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
| | - Meng Xu
- Xiamen Eye Center and Eye Institute of Xiamen University, Xiamen, China
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Ophthalmology, Xiamen, Fujian, China
- Fujian Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
| | - Long-long Chen
- Xiamen Eye Center and Eye Institute of Xiamen University, Xiamen, China
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Ophthalmology, Xiamen, Fujian, China
- Fujian Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
| | - Dong-kan Li
- Xiamen Eye Center and Eye Institute of Xiamen University, Xiamen, China
- Xiamen Clinical Research Center for Eye Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Ophthalmology, Xiamen, Fujian, China
- Fujian Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Xiamen Key Laboratory of Corneal and Ocular Surface Diseases, Xiamen, Fujian, China
- Translational Medicine Institute of Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
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Klugah-Brown B, Bore MC, Liu X, Gan X, Biswal BB, Kendrick KM, Chang DHF, Zhou B, Becker B. The neurostructural consequences of glaucoma and their overlap with disorders exhibiting emotional dysregulations: A voxel-based meta-analysis and tripartite system model. J Affect Disord 2024; 358:487-499. [PMID: 38705527 DOI: 10.1016/j.jad.2024.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 04/23/2024] [Accepted: 05/02/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Glaucoma, a progressive neurodegenerative disorder leading to irreversible blindness, is associated with heightened rates of generalized anxiety and depression. This study aims to comprehensively investigate brain morphological changes in glaucoma patients, extending beyond visual processing areas, and explores overlaps with morphological alterations observed in anxiety and depression. METHODS A comparative meta-analysis was conducted, using case-control studies of brain structural integrity in glaucoma patients. We aimed to identify regions with gray matter volume (GMV) changes, examine their role within distinct large-scale networks, and assess overlap with alterations in generalized anxiety disorder (GAD) and major depressive disorder (MDD). RESULTS Glaucoma patients exhibited significant GMV reductions in visual processing regions (lingual gyrus, thalamus). Notably, volumetric reductions extended beyond visual systems, encompassing the left putamen and insula. Behavioral and functional network decoding revealed distinct large-scale networks, implicating visual, motivational, and affective domains. The insular region, linked to pain and affective processes, displayed reductions overlapping with alterations observed in GAD. LIMITATIONS While the study identified significant morphological alterations, the number of studies from both the glaucoma and GAD cohorts remains limited due to the lack of independent studies meeting our inclusion criteria. CONCLUSION The study proposes a tripartite brain model for glaucoma, with visual processing changes related to the lingual gyrus and additional alterations in the putamen and insular regions tied to emotional or motivational functions. These neuroanatomical changes extend beyond the visual system, implying broader implications for brain structure and potential pathological developments, providing insights into the overall neurological consequences of glaucoma.
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Affiliation(s)
- Benjamin Klugah-Brown
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Mercy C Bore
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiqin Liu
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Xianyang Gan
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Bharat B Biswal
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China; Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, USA
| | - Keith M Kendrick
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Dorita H F Chang
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China; Department of Psychology, The University of Hong Kong, Hong Kong, China
| | - Bo Zhou
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
| | - Benjamin Becker
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China; State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China; Department of Psychology, The University of Hong Kong, Hong Kong, China.
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Petriti B, Rabiolo A, Chau KY, Williams PA, Montesano G, Lascaratos G, Garway-Heath DF. Peripheral blood mononuclear cell respiratory function is associated with progressive glaucomatous vision loss. Nat Med 2024; 30:2362-2370. [PMID: 38886621 PMCID: PMC11333286 DOI: 10.1038/s41591-024-03068-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 05/14/2024] [Indexed: 06/20/2024]
Abstract
Intraocular pressure (IOP) is currently the only modifiable risk factor for glaucoma and all licensed treatments lower IOP. However, many patients continue to lose vision despite IOP-lowering treatment. Identifying biomarkers for progressive vision loss would have considerable clinical utility. We demonstrate that lower peripheral blood mononuclear cell (PBMC) oxygen consumption rate (OCR) is strongly associated with faster visual field (VF) progression in patients treated by lowering IOP (P < 0.001, 229 eyes of 139 participants), explaining 13% of variance in the rate of progression. In a separate reference cohort of untreated patients with glaucoma (213 eyes of 213 participants), IOP explained 16% of VF progression variance. OCR is lower in patients with glaucoma (n = 168) than in controls (n = 50; P < 0.001) and is lower in patients with low baseline IOP (n = 99) than those with high baseline IOP (n = 69; P < 0.01). PBMC nicotinamide adenine dinucleotide (NAD) levels are lower in patients with glaucoma (n = 29) compared to controls (n = 25; P < 0.001) and strongly associated with OCR (P < 0.001). Our results support PBMC OCR and NAD levels as new biomarkers for progressive glaucoma.
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Affiliation(s)
- Bledi Petriti
- NIHR Biomedical Research Centre, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
- Department of Clinical and Movement Neurosciences, UCL Queens Square Institute of Neurology, London, UK
| | - Alessandro Rabiolo
- Department of Health Sciences, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy
| | - Kai-Yin Chau
- Department of Clinical and Movement Neurosciences, UCL Queens Square Institute of Neurology, London, UK
| | - Pete A Williams
- Department of Clinical Neuroscience, Division of Eye and Vision, St. Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Giovanni Montesano
- NIHR Biomedical Research Centre, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
| | | | - David F Garway-Heath
- NIHR Biomedical Research Centre, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK.
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Jia S, Mei X, Chen L, Chan LH, Tsang C, Suen V, Li T, Zaw MW, Liu A, Thompson B, Sabel B, Woo G, Leung CKS, Yip SP, Chang DHF, Cheong AMY. Glaucoma Rehabilitation using ElectricAI Transcranial Stimulation (GREAT)-study protocol for randomized controlled trial using combined perceptual learning and transcranial electrical stimulation for vision enhancement. Trials 2024; 25:501. [PMID: 39039582 PMCID: PMC11264395 DOI: 10.1186/s13063-024-08314-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 07/03/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Glaucoma patients with irreversible visual field loss often experience decreased quality of life, impaired mobility, and mental health challenges. Perceptual learning (PL) and transcranial electrical stimulation (tES) have emerged as promising interventions for vision rehabilitation, showing potential in restoring residual visual functions. The Glaucoma Rehabilitation using ElectricAI Transcranial stimulation (GREAT) project aims to investigate whether combining PL and tES is more effective than using either method alone in maximizing the visual function of glaucoma patients. Additionally, the study will assess the impact of these interventions on brain neural activity, blood biomarkers, mobility, mental health, quality of life, and fear of falling. METHODS The study employs a three-arm, double-blind, randomized, superiority-controlled design. Participants are randomly allocated in a 1:1:1 ratio to one of three groups receiving: (1) real PL and real tES, (2) real PL and sham tES, and (3) placebo PL and sham tES. Each participant undergoes 10 sessions per block (~ 1 h each), with a total of three blocks. Assessments are conducted at six time points: baseline, interim 1, interim 2, post-intervention, 1-month post-intervention, and 2-month post-intervention. The primary outcome is the mean deviation of the 24-2 visual field measured by the Humphrey visual field analyzer. Secondary outcomes include detection rate in the suprathreshold visual field, balance and gait functions, and electrophysiological and biological responses. This study also investigates changes in neurotransmitter metabolism, biomarkers, self-perceived quality of life, and psychological status before and after the intervention. DISCUSSION The GREAT project is the first study to assess the effectiveness of PL and tES in the rehabilitation of glaucoma. Our findings will offer comprehensive assessments of the impact of these treatments on a wide range of brain and vision-related metrics including visual field, neural activity, biomarkers, mobility, mental health, fear of falling, and quality of life. TRIAL REGISTRATION ClinicalTrials.gov NCT05874258 . Registered on May 15, 2023.
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Affiliation(s)
- Shuwen Jia
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Xiaolin Mei
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Lilin Chen
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Lok Hin Chan
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Celia Tsang
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Venus Suen
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Tingni Li
- Centre for Eye and Vision Research Limited, Hong Kong Science Park, Hong Kong Special Administrative Region, China
| | - Myo Win Zaw
- Centre for Eye and Vision Research Limited, Hong Kong Science Park, Hong Kong Special Administrative Region, China
| | - Amanda Liu
- Centre for Eye and Vision Research Limited, Hong Kong Science Park, Hong Kong Special Administrative Region, China
| | - Ben Thompson
- Centre for Eye and Vision Research Limited, Hong Kong Science Park, Hong Kong Special Administrative Region, China
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Canada
| | - Bernhard Sabel
- Institute of Medical Psychology, University of Magdeburg, Magdeburg, Germany
| | - George Woo
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Christopher K S Leung
- Department of Ophthalmology, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Shea-Ping Yip
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China
| | - Dorita H F Chang
- Department of Psychology, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Allen M Y Cheong
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China.
- Centre for Eye and Vision Research Limited, Hong Kong Science Park, Hong Kong Special Administrative Region, China.
- Research Centre for SHARP Vision, The Hong Kong Polytechnic University, Hong Kong Special Administrative Region, China.
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11
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Barak Özer A, Eröz P. Evaluation of Depression Levels in Patients With Primary Open-Angle Glaucoma Using the Geriatric Depression Scale. Cureus 2024; 16:e64162. [PMID: 39119439 PMCID: PMC11309073 DOI: 10.7759/cureus.64162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2024] [Indexed: 08/10/2024] Open
Abstract
Introduction Glaucoma is a chronic disease that can lead to severe visual impairment and blindness. Methods The study included 91 primary open-angle glaucoma patients aged 60 years and older (group 1) and 83 healthy controls (group 2) with similar age and gender distribution. The duration of the disease, the number of anti-glaucomatous drops used daily, and visual field parameters were recorded. All participants then underwent a comprehensive mental status examination by a psychiatrist and were administered the Geriatric Depression Scale (GDS). Results In Group 1, the mean duration of glaucoma was 10.2±6.0 years, and the mean number of drops used per day was 2.91±1.47 drops/day. According to visual field (24-2) data, the mean mean deviation (MD) was -7.76±4.78 dB and the mean pattern standard deviation (PSD) was 5.14±2.60 dB. According to the classification based on MD, 33 (36.3%) patients were in the early stage, 36 (39.5%) in the intermediate stage, and 22 (24.2%) in the advanced stage. The mean best-corrected visual acuity (BCVA) was 0.85±0.38 logMAR in group 1 and 0.34±0.19 logMAR in group 2. The mean GDS scores were 13.7±7.23 points in group 1 and 3.61±1.71 points in group 2. There were statistically significant differences between the groups in terms of BCVA and GDS scores (p=0.039 and p<0.001, respectively). Conclusion In conclusion, it is important that ophthalmologists provide adequate information about glaucoma to prevent the development of depression in patients with glaucoma. This information may protect patients from uncertainty. A multidisciplinary approach in the management of glaucoma, a chronic and vision-threatening disease, can positively affect patients' compliance with follow-up and treatment, increase the quality of healthcare, and improve treatment responses.
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Affiliation(s)
- Ayşegül Barak Özer
- Psychiatry, Niğde Ömer Halisdemir University Training and Research Hospital, Niğde, TUR
| | - Pınar Eröz
- Ophthalmology, Tarsus State Hospital, Mersin, TUR
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12
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Ramesh PV, Morya AK, Azad A, Pannerselvam P, Devadas AK, Gopalakrishnan ST, Ramesh SV, Aradhya AK. Navigating the intersection of psychiatry and ophthalmology: A comprehensive review of depression and anxiety management in glaucoma patients. World J Psychiatry 2024; 14:362-369. [PMID: 38617979 PMCID: PMC11008383 DOI: 10.5498/wjp.v14.i3.362] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/28/2024] [Accepted: 02/29/2024] [Indexed: 03/19/2024] Open
Abstract
Glaucoma, a prevalent and debilitating eye disease, has long been associated with vision impairment and blindness. However, recent research has shed light on the often-underestimated psychological dimensions of this condition. Anxiety and depression, two pervasive psychiatric comorbidities, have been increasingly recognized among glaucoma patients. This comprehensive review aims to explore the intricate relationship between psychiatry and ophthalmology, in the context of managing depression and anxiety in glaucoma patients. By meticulously examining peer-reviewed literature, we synthesize current knowledge on the prevalence, risk factors, and underlying mechanisms of anxiety and depression in glaucoma. The evidence reveals that glaucoma patients face an elevated risk of experiencing these mood disorders. Factors such as progressive vision loss, complex medication regimens, and the fear of further visual deterioration contribute to their vulnerability. Moreover, we delve into the bidirectional relationship between glaucoma and mood disorders, shedding light on the complex interplay between ocular and emotional health. Our review investigates the implications of anxiety and depression on glaucoma management, including their potential impact on treatment adherence, disease progression, and overall quality of life. We also explore the neurobiological pathways linking glaucoma and mood disorders, providing a foundation for future research and potential therapeutic interventions. In conclusion, recognizing the psychological burden carried by glaucoma patients is essential for holistic and patient-centered care. This review underscores the pressing need for integrated approaches that bring together ophthalmological and psychiatric expertise to optimize the well-being of individuals facing the challenges of glaucoma. By addressing anxiety and depression in glaucoma care, healthcare providers can enhance the overall quality of life for these patients, ultimately leading to improved outcomes and a brighter future for those affected by this condition. This review offers valuable insight for healthcare practitioners and researchers, providing a concise overview of key topics and research in the field of managing depression and anxiety in glaucoma patients.
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Affiliation(s)
- Prasanna Venkatesh Ramesh
- Department of Glaucoma and Research, Mahathma Eye Hospital Private Limited, Trichy 620017, Tamil Nadu, India
| | - Arvind Kumar Morya
- Department of Ophthalmology, All India Institute of Medical Sciences, Hyderabad 508126, Telangana, India
| | - Ashik Azad
- Department of Optometry and Visual Science, Mahathma Eye Hospital Private Limited, Trichy 620017, Tamil Nadu, India
| | - Pavithra Pannerselvam
- Junior Resident, Mahathma Eye Hospital Private Limited, Trichy 620017, Tamil Nadu, India
| | - Aji Kunnath Devadas
- Department of Optometry and Visual Science, Mahathma Eye Hospital Private Limited, Trichy 620017, Tamil Nadu, India
| | | | - Shruthy Vaishali Ramesh
- Department of Cataract and Refractive Surgery, Mahathma Eye Hospital Private Limited, Trichy 620017, Tamil Nadu, India
| | - Ajanya K Aradhya
- Department of Optometry and Visual Science, Mahathma Eye Hospital Private Limited, Trichy 620017, Tamil Nadu, India
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13
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Yamanishi R, Yotsukura E, Hanyuda A, Uchino M, Yuki K, Negishi K, Yasuda N, Saito I, Kato T, Arima K, Aoyagi K, Tanno K, Yamagishi K, Muraki I, Yamaji T, Iwasaki M, Inoue M, Tsugane S, Sawada N. Relation between a history of glaucoma and subjective happiness: the JPHC-Next study. BMJ Open Ophthalmol 2024; 9:e001553. [PMID: 38373803 PMCID: PMC10882359 DOI: 10.1136/bmjophth-2023-001553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 01/31/2024] [Indexed: 02/21/2024] Open
Abstract
OBJECTIVE This population-based, cross-sectional study was performed to investigate the relationship between a history of glaucoma and subjective happiness. METHODS AND ANALYSIS We conducted a cross-sectional questionnaire-based survey of 92 397 Japanese men and women aged 40-74 who participated in the Japan Public Health Center-based Prospective Study for the Next Generation study. A multivariable logistic regression model was used to estimate the ORs of glaucoma associated with subjective happiness and their two-sided 95% CIs. RESULTS Among 40 727 men and 51 670 women, 1733 participants (635 men, 1098 women) had a history of glaucoma. The odds of unhappiness in male participants with a history of glaucoma were higher (OR 1.26; 95% CI 1.05 to 1.51) than in female participants (OR 1.05; 95% CI 0.90 to 1.23). In a subgroup analysis stratified by age, among participants with a history of glaucoma, males in the younger group (40-59 years) showed the most robust association with unhappiness (OR 1.40; 95% CI 1.04 to 1.88). CONCLUSIONS These findings suggest that a history of glaucoma is related with subjective unhappiness, especially in men.
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Affiliation(s)
- Ryutaro Yamanishi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Erisa Yotsukura
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Akiko Hanyuda
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Miki Uchino
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kenya Yuki
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Nobufumi Yasuda
- Department of Public Health, Kochi University Medical School, Kochi, Japan
| | - Isao Saito
- Department of Public Health and Epidemiology, Faculty of Medicine, Oita University, Oita, Japan
| | - Tadahiro Kato
- Center for Education and Educational Research, Faculty of Education, Ehime University, Matsuyama, Japan
| | - Kazuhiko Arima
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kiyoshi Aoyagi
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kozo Tanno
- Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Insitute of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
- Ibaraki Western Medical Center, Chikusei, Japan
| | - Isao Muraki
- Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Taiki Yamaji
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Motoki Iwasaki
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Division of Epidemiology, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Manami Inoue
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Shoichiro Tsugane
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Norie Sawada
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
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14
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Hashemi A, Hashemi H, Jamali A, Ghasemi H, Ghazizadeh Hashemi F, Khabazkhoob M. The association between visual impairment and mental disorders. Sci Rep 2024; 14:2301. [PMID: 38280884 PMCID: PMC10821922 DOI: 10.1038/s41598-024-52389-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/18/2024] [Indexed: 01/29/2024] Open
Abstract
To determine the association between visual impairment (VI) and some mental disorders using the general health questionnaire (GHQ) in individuals aged 60 years and above in Tehran, Iran. The present population-based cross-sectional study was conducted on people aged 60 and older in Tehran, Iran using multi-stage cluster sampling. After selecting the samples, examinations including visual acuity measurement, refraction, and slit-lamp biomicroscopy were performed for all participants. The GHQ was used to examine mental disorders. Simple and multiple linear regressions were used to investigate the association between VI and mental disorders. Of the 3740 invitees, 3310 participated in the study (response rate: 88.50%). After applying the exclusion criteria, 2789 individuals were analyzed for this report. Mean score of physical, anxiety, social and depression disorders in people with and without VI was 3.74 ± 2.03, 5.81 ± 2.79, 7.56 ± 1.91, 1.32 ± 1.90, and 3.14 ± 1.76, 4.93 ± 2.71, 8.09 ± 1.99, 0.91 ± 1.38, respectively. The total score of GHQ in participants with and without VI was 18.43 ± 4.75 and 17.07 ± 4.19, respectively. The association between GHQ subscales and total GHQ score with VI by multiple linear regression showed that VI had a statistically significant direct association with physical symptoms (β = 0.37; 95% CI 0.12 to 0.62) and anxiety (β = 0.48; 95% CI 0.16 to 0.81). Nevertheless, depression had a borderline association with VI (β = 0.21; 95% CI - 0.03 to 0.45) and social dysfunction did not have a statistically significant association with VI in the final linear regression model and did not remain in the model. Total GHQ score had a statistically significant association with VI (β = 1.02; 95% CI 0.39 to 1.64) in the presence of covariates. Regarding the association between VI and GHQ components, the physical symptoms had the highest R2 (R2 = 0.159). Patients with VI suffer more from anxiety, depression, and physical symptoms regardless of age, sex, education, and other effective variables. The coincidence of aging with VI and the association of VI with mental disorders emphasizes the importance of a broader view of the elderly and the aging process.
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Affiliation(s)
- Alireza Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Hassan Hashemi
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Alireza Jamali
- Rehabilitation Research Center, Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hamed Ghasemi
- Eye Research CenterFarabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Fatemeh Ghazizadeh Hashemi
- Psychiatry and Psychology Research CenterRoozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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15
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Andualem F, Ali D, Tinsae T, Nakie G, Gedef GM, Demilew D, Begashaw TD, Tegegn LF, Seid J. Psychological Distress Associated With Suicidal Ideation Among Glaucoma Patients Attending at Tertiary Eye Care Clinic, Gondar, Ethiopia. SAGE Open Nurs 2024; 10:23779608241297299. [PMID: 39584154 PMCID: PMC11583269 DOI: 10.1177/23779608241297299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 10/09/2024] [Accepted: 10/11/2024] [Indexed: 11/26/2024] Open
Abstract
Introduction Suicide is defined as the deliberate taking of one's own life with either implicit or explicit proof; however, it can also refer to the contemplation or actualization of suicide. Suicide is a mental illness with several contributing factors. It is frequently linked to sex, age, health problems, substance misuse, and traumatic life experiences. Objective The purpose of this study was to evaluate the prevalence of suicide thought and attempts among glaucoma patients and its contributing factors in Gondar, Ethiopia, 2022. Methods An observational cross-sectional study was conducted on 422 glaucoma patients at the Tertiary Eye Care Clinic, University of Gondar Comprehensive and Specialized Hospital. Suicidal ideation and attempts were assessed using the suicidality module of the World Mental Health Survey Initiative version of the World Health Organization's Composite International Diagnostic Interview. Bivariate and multivariate logistic regressions were conducted to identify factors associated with suicidal ideation and attempts. The variables with a p-value less than 0.05 and a 95% CI were considered statistically significant. Results The overall prevalence of suicidal ideation and attempt was 6.4% with a 95% CI of 4.3-9.2% and 2.4% with a 95% CI of 1.1-4.3%, respectively. In multivariate analysis, severe psychological distress, moderate psychological distress, mild psychological distress, and current substance use were identified as risk factors for suicidal ideation, whereas living alone, co-morbid chronic medical disease, and ever-present substance use were identified as risk factors for suicidal attempts. Conclusion Based on this study finding, the prevalence of suicidal ideation and attempts was high among glaucoma patients. This study may provide further information to pay much attention to the physical health care of patients with glaucoma. More representative samples, or rather, a cross-sectional study design, should be used in future studies aiming for more precise data.
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Affiliation(s)
- Fantahun Andualem
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Dawed Ali
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Techilo Tinsae
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Girum Nakie
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Getachew Muluye Gedef
- Department of General Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Demeke Demilew
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Tesfaye Derbie Begashaw
- Department of Psychiatry, College of Medicine and Health Science, Axum University, Axum, Ethiopia
| | - Lidiya Fasil Tegegn
- Department of Nursing, College of Medicine and Health Science, Arsi University, Arsi, Ethiopia
| | - Jemal Seid
- Department of Psychiatry, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
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16
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Delavar A, Bu JJ, Radha Saseendrakumar B, Weinreb RN, Baxter SL. Gender Disparities in Depression, Stress, and Social Support Among Glaucoma Patients. Transl Vis Sci Technol 2023; 12:23. [PMID: 38149963 PMCID: PMC10755593 DOI: 10.1167/tvst.12.12.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 12/14/2023] [Indexed: 12/28/2023] Open
Abstract
Purpose To understand differences in measures of depression, stress, and social support by gender among those diagnosed with glaucoma. Methods We obtained a cohort of glaucoma patients (any type) ages 18 years and over who answered the COVID-19 Participant Experience (COPE) survey of the NIH All of Us Research Program. We analyzed several measures of depression, stress, and social support by gender. Logistic regression was used to evaluate the association among reported stress associated with social distancing, depression (using Patient Health Questionnaire-9 [PHQ-9] scores), and measures of social support by self-reported gender, with men as the reference group. Multivariable models were adjusted for age, race and ethnicity, health insurance status, education, and income. Results Of 3633 glaucoma patients, 56.8% were women. Many patients had a PHQ-9 score > 4 (33.3%), indicating mild, moderate, or severe depression. In multivariable models, women were significantly more likely to report a PHQ-9 score > 4 (odds ratio [OR] = 1.40; 95% confidence interval [CI], 1.20-1.62; P < 0.001) and some or a lot of stress (OR = 1.34; 95% CI, 1.14-1.57; P < 0.001) compared with men. Further, women were significantly less likely to report having help all or most of the time if they needed someone to prepare meals (OR = 0.78; 95% CI, 0.67-0.92; P = 0.002) or perform daily chores (OR = 0.79; 95% CI, 0.67-0.91; P = 0.003) than men. Conclusions Women with glaucoma were more likely to experience depression and stress and were less likely to have social support on some measures than men. Translational Relevance The disproportionate burden of psychosocial factors among women may complicate glaucoma management.
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Affiliation(s)
- Arash Delavar
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA, USA
- Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, TX, USA
| | - Jennifer J. Bu
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
| | - Bharanidharan Radha Saseendrakumar
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Robert N. Weinreb
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
| | - Sally L. Baxter
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA, USA
- Hamilton Glaucoma Center, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, CA, USA
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Fu J, Yang J, Li Q, Huang D, Yang H, Xie X, Xu H, Zhang M, Zheng C. What can we learn from a Chinese social media used by glaucoma patients? BMC Ophthalmol 2023; 23:470. [PMID: 37986061 PMCID: PMC10661764 DOI: 10.1186/s12886-023-03208-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 11/07/2023] [Indexed: 11/22/2023] Open
Abstract
PURPOSE Our study aims to discuss glaucoma patients' needs and Internet habits using big data analysis and Natural Language Processing (NLP) based on deep learning (DL). METHODS In this retrospective study, we used web crawler technology to crawl glaucoma-related topic posts from the glaucoma bar of Baidu Tieba, China. According to the contents of topic posts, we classified them into posts with seeking medical advice and without seeking medical advice (social support, expressing emotions, sharing knowledge, and others). Word Cloud and frequency statistics were used to analyze the contents and visualize the keywords of topic posts. Two DL models, Bidirectional Long Short-Term Memory (Bi-LSTM) and Bidirectional Encoder Representations from Transformers (BERT), were trained to identify the posts seeking medical advice. The evaluation matrices included: accuracy, F1 value, and the area under the ROC curve (AUC). RESULTS A total of 10,892 topic posts were included, among them, most were seeking medical advice (N = 7071, 64.91%), and seeking advice regarding symptoms or examination (N = 4913, 45.11%) dominated the majority. The following were searching for social support (N = 2362, 21.69%), expressing emotions (N = 497, 4.56%), and sharing knowledge (N = 527, 4.84%) in sequence. The word cloud analysis results showed that ocular pressure, visual field, examination, and operation were the most frequent words. The accuracy, F1 score, and AUC were 0.891, 0.891, and 0.931 for the BERT model, 0.82, 0.821, and 0.890 for the Bi-LSTM model. CONCLUSION Social media can help enhance the patient-doctor relationship by providing patients' concerns and cognition about glaucoma in China. NLP can be a powerful tool to reflect patients' focus on diseases. DL models performed well in classifying Chinese medical-related texts, which could play an important role in public health monitoring.
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Affiliation(s)
- Junxia Fu
- Department of Ophthalmology, School of Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University, 200092, Shanghai, China
- Institute of Hospital Development Strategy, China Hospital Development Institute, Shanghai Jiao Tong University, 200092, Shanghai, China
| | - Junrui Yang
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou University Medical College, Shantou, Guangdong, China
- Department of Ophthalmology, The 74th Army Group Hospital, Guangzhou, Guangdong, China
| | - Qiuman Li
- Department of Pediatric Cardiology, Guangzhou Women and Children's Medical Center, Guangzhou, Guangdong, China
| | - Danqing Huang
- Institute of Hospital Development Strategy, China Hospital Development Institute, Shanghai Jiao Tong University, 200092, Shanghai, China
| | - Hongyang Yang
- Institute of Hospital Development Strategy, China Hospital Development Institute, Shanghai Jiao Tong University, 200092, Shanghai, China
| | - Xiaoling Xie
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou University Medical College, Shantou, Guangdong, China
| | - Huaxin Xu
- The Faculty of Science, University of Technology Sydney, Sydney, Australia
| | - Mingzhi Zhang
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou University Medical College, Shantou, Guangdong, China.
| | - Ce Zheng
- Department of Ophthalmology, School of Medicine, Xinhua Hospital Affiliated to Shanghai Jiao Tong University, 200092, Shanghai, China.
- Institute of Hospital Development Strategy, China Hospital Development Institute, Shanghai Jiao Tong University, 200092, Shanghai, China.
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18
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Song D, Fan S, Zhou Q, Yang X, Li S, Lohfeld L, Zhou W, Congdon N, Liang Y, Wang N. Impact of primary glaucoma on health-related quality of life in China: the handan eye study. BMC Ophthalmol 2023; 23:377. [PMID: 37710186 PMCID: PMC10503180 DOI: 10.1186/s12886-023-03106-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 08/17/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND We assessed health-related quality of life (HRQOL) and its determinants among rural glaucoma participants compared to age-matched normal controls in the population-based Handan Eye Study (HES), in rural Yongnian County, northern China. METHODS We enrolled 99 adults with glaucoma (mean age 63.0 ± 11.0 years), including primary open-angle glaucoma (POAG, n = 67) and primary angle-closure glaucoma (PACG, n = 32) and 102 controls (mean age 58.5 ± 5.3 years) with normal visual acuity and visual field and no history of glaucoma. Results of ophthalmic examinations and socioeconomic data were recorded. HRQOL was measured using the EQ-5D (converted to utility valves, UVs), and visual function (VF) and vision-related quality of life (VRQOL) were evaluated using the visual function-quality of life (VF-QOL) instrument. PRIMARY AND SECONDARY OUTCOME MEASURES EQ-5D and VF-QOL scores. RESULTS The mean UVs, VF, and VRQOL scores for glaucoma cases were 0.98 ± 0.04, 87.9 ± 15.2, and 95.5 ± 12.8, respectively, significantly worse than VF (94.4 ± 4.4) and VRQOL (100.0 ± 0.0) among controls, even after adjusting for age, gender, educational level, and family income (P = 0.015, P = 0.033). UVs were significantly lower among glaucoma participants with impaired VRQOL (55.4 ± 11.5) compared to those with normal VRQOL scores (99.1 ± 2.8) (UVs: 0.92 ± 0.08 vs. 0.99 ± 0.03, P = 0.036), also after adjustment for age and family income (P = 0.006). Participants with PACG had significantly lower VF and VRQOL scores compared to POAG (77.8 ± 21.4 vs. 92.9 ± 6.8, P < 0.001; 89.0 ± 18.1 vs. 98.7 ± 7.5, P < 0.001). CONCLUSION Participants with glaucoma have worse visual function and related quality of life compared to age-matched normal population controls. Participants with PACG have lower VF and VRQOL compared to those with POAG. UVs can be used for cost-effectiveness research and to support public health strategies for glaucoma in rural China.
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Affiliation(s)
- Di Song
- National Clinical Research Center for Eye Diseases, The Eye Hospital, School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China
- The First People's Hospital of Huzhou, The First Affiliated Hospital of Huzhou Teacher College, Huzhou, Zhejiang, China
| | - Sujie Fan
- Handan Eye Hospital, Handan, Hebei, China
| | - Qiang Zhou
- Beijing Chaoyang Hospital, Beijing, China
| | - Xiaohui Yang
- Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Sizhen Li
- Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Lynne Lohfeld
- Centre for Public Health, Queen's University, Belfast, UK
| | - Weihe Zhou
- National Clinical Research Center for Eye Diseases, The Eye Hospital, School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Glaucoma Institute, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Nathan Congdon
- Centre for Public Health, Queen's University, Belfast, UK
- Orbis International, New York, NY, USA
| | - Yuanbo Liang
- National Clinical Research Center for Eye Diseases, The Eye Hospital, School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China.
- Glaucoma Institute, Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Ningli Wang
- Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Guo Y, Wu D, Jin Y, Tian Y, Li X. Prevalence and risk factors for depression and anxiety in patients with nasolacrimal duct obstruction. Front Psychiatry 2023; 14:1174404. [PMID: 37614647 PMCID: PMC10442548 DOI: 10.3389/fpsyt.2023.1174404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 07/25/2023] [Indexed: 08/25/2023] Open
Abstract
Objective To investigate the prevalence and risk factors for depression and anxiety in patients with nasolacrimal duct obstruction (NLDO). Methods We conducted a telephone-based survey of patients with NLDO who underwent dacryocystorhinostomy (DCR) at the Department of Ophthalmology of Peking University Third Hospital in China between January 2016 and January 2021. Depression and anxiety were assessed with the PHQ-9 (range 0-25) and STAI (range 20-80) scales. PHQ-9 ≥ 5 and STAI ≥ 55 were considered clinically significant. Logistic regression and linear regression were performed to determine the factors related to depression and anxiety. Results Of 565 patients approached, 344 (60.9%) completed the survey. A total of 13.1% of patients had mild-severe depression and 63.4% had severe anxiety. Univariate logistic regression revealed that hypertension, dry eye, and cataract were associated with mild to severe depression (P = 0.018, 0.045, 0.035, respectively). Dry eye was associated with severe anxiety (P = 0.007). Univariate linear regression revealed that male and income levels were significantly negatively correlated with PHQ-9 scores (P = 0.011, 0.010, respectively). Hypertension and dry eye were significantly positively correlated with PHQ-9 scores (P = 0.030, P < 0.001, respectively). Male, income levels, and educational levels were significantly negatively correlated with STAI scores (P = 0.022, P < 0.001, P = 0.005, respectively). Dry eye was significantly positively correlated with STAI scores (P < 0.001). Conclusion Prevalence of depression and anxiety disorders was relatively high among NLDO patients. Our results demonstrate the importance of depression and anxiety screening and psychosocial support for patients with NLDO, which can improve their quality of life and compliance with medical appointments.
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Affiliation(s)
- Yining Guo
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Defu Wu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Yu Jin
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Yanjie Tian
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Xuemin Li
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
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Groff ML, Choi B, Lin T, Mcllraith I, Hutnik C, Malvankar-Mehta MS. Anxiety, depression, and sleep-related outcomes of glaucoma patients: systematic review and meta-analysis. CANADIAN JOURNAL OF OPHTHALMOLOGY 2023; 58:346-355. [PMID: 35305959 DOI: 10.1016/j.jcjo.2022.02.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 02/07/2022] [Accepted: 02/12/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This study aims to synthesize data quantifying the prevalence and severity of common psychological conditions in patients with glaucoma. DESIGN Systematic review and meta-analysis. METHODS Databases including Ovid MEDLINE, CINAHL, EMBASE, PsycINFO, Cochrane Library, Web of Science, Open Grey, and ProQuest Theses and dissertations were searched. Two reviewers independently assessed and screened all studies, followed by quality assessment of included studies using the modified Downs and Black checklist. Data were pooled using fixed-effect and random-effects models. RESULTS Of 2067 studies identified by the search strategy, 57 passed full-text screening, and 45 studies (4 995 538 subjects) were eligible for analysis. Overall, the prevalence of depression (effect size [ES] = 0.19, 95% CI 0.16-0.23; n = 31), anxiety (ES = 0.25, 95% CI 0.21-0.30; n = 18), and sleep disorders (ES = 0.47, 95% CI 0.26-0.68; n = 7) were high in patients with glaucoma. Similarly, symptomatic measurements of depression (standardized mean difference [SMD] = 0.46, 95% CI 0.19-0.73), anxiety (SMD = 0.44, 95% CI 0.08-0.81), and sleep quality (SMD = 0.72, 95% CI 0.22-1.21) were significant in glaucoma patients. CONCLUSIONS A higher prevalence and severity of depression, anxiety, and sleep disorders was experienced in patients with glaucoma compared with patients without glaucoma. Caregivers as well as health care providers may need to be aware of unique psychological and social stressors placed on glaucoma patients.
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Affiliation(s)
- Michael Lee Groff
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON
| | - Bohmyi Choi
- Faculty of Medicine, University of Ottawa, Ottawa, ON
| | - Tony Lin
- Department of Ophthalmology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON
| | - Ian Mcllraith
- Department of Ophthalmology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON
| | - Cindy Hutnik
- Department of Ophthalmology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON
| | - Monali S Malvankar-Mehta
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON; Department of Ophthalmology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON.
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21
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Qian C, Soh ZD, Thakur S, Yan W, Shao X, Zhong H, Wang K. Assessment of anxiety and depression in patients with Posner-Schlossman syndrome. BMC Ophthalmol 2023; 23:287. [PMID: 37353735 DOI: 10.1186/s12886-023-03047-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/15/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND To assess the anxiety and depression levels in patients with Posner-Schlossman syndrome (PSS) and to determine the potential risk factors. METHODS In this cross-sectional study, a total of 195 participants, including 93 PSS patients and 102 healthy controls were recruited. Sociodemographic and clinical information were collected for all participants. Hospital Anxiety and Depression scale (HADS) was administered to evaluate the anxiety and depression levels. Visual function (VF) and quality-of-life (QOL) questionnaires were administered to assess variables potentially associated with anxiety and depression. RESULTS Increased anxiety level was observed in 22 (23.7%) PSS patients as compared to 10 (9.8%) of controls (P = 0.009). While the frequency of depression between the two groups was not significantly different (P = 0.349). The mean anxiety and depression scores were 6.98 ± 4.20 and 6.44 ± 3.66 in PSS patients as compared to 6.67 ± 3.21 (P = 0.564) and 5.96 ± 2.93 (P = 0.311) in controls. Logistic regression analysis showed mental well-being was significantly associated with anxiety (odds ratio [OR] = 0.920, 95% confidence interval [CI] = 0.881-0.962, P < 0.001) and depression (OR = 0.959, CI = 0.926-0.994, P = 0.023) in PSS patients. CONCLUSION More patients with PSS may experience anxiety as compared to healthy controls. Mental well-being is an independent risk factor for anxiety and depression. It is important for ophthalmologists to be aware of these factors and should pay more attention on mental health when PSS is managed in clinic.
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Affiliation(s)
- Chaoxu Qian
- Shanghai Aier Eye Hospital, Shanghai Aier Eye Institute, Shanghai, China
| | - Zhi Da Soh
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Sahil Thakur
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Wen Yan
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xian Shao
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Hua Zhong
- Department of Ophthalmology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Kaidi Wang
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Rd, 200031, Shanghai, China.
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22
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Delavar A, Bu JJ, Radha Saseendrakumar B, Weinreb RN, Baxter SL. Mental health and social support among glaucoma patients enrolled in the NIH All of Us COVID-19 Participant Experience (COPE) survey. BMC Ophthalmol 2023; 23:63. [PMID: 36782129 PMCID: PMC9923653 DOI: 10.1186/s12886-023-02771-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 01/04/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic created many challenges for our society. In this study, we explore how measures of mental health, coping strategies, and social support during the pandemic varied by glaucoma status. METHODS A cohort of patients aged 40 and over enrolled in the NIH All of Us Research Program, a nationwide longitudinal cohort, who answered the COVID-19 Participant Experience (COPE) survey was obtained. We analyzed several measures of mental health, coping strategies, and social support used during the early stages of the COVID-19 pandemic. Surveys were recurring and answered from May 2020 to February 2021. Demographics and the most recently answered survey responses were obtained and stratified by glaucoma status. Pearson's Chi-squared tests and multivariable logistic regressions adjusting for age, gender, race, ethnicity, and income were used to generate p-values, odds ratios (ORs) and 95% confidence intervals (CIs) between outcome measures and glaucoma status. RESULTS Of 42,484 patients who responded to All of Us COPE survey items, 2912 (6.9%) had a diagnosis of glaucoma. On Pearson's Chi-squared tests glaucoma patients were less likely to report drinking alcohol (P = 0.003), eating more food than usual (P = 0.004), and using marijuana (P = 0.006) to cope with social distancing than those without a diagnosis of glaucoma. Further, glaucoma patients had lower rates of probable mild, moderate, or severe depression as calculated by Patient Health Questionnaire-9 (PHQ-9) scores (P < 0.001) and had lower rates of reporting some or a lot of stress from social distancing (P < 0.001). However, glaucoma patients were less likely to report having someone to help prepare meals (P = 0.005) or help with daily chores (P = 0.003) if they became sick with COVID-19. In multivariable logistic regression analyses adjusting for confounding factors, no differences were found for measures of mental health or social support. CONCLUSIONS Glaucoma patients did not fare worse on many measures of mental health and coping strategies during the early stages of the COVID-19 pandemic compared those without glaucoma. However, a substantial proportion of glaucoma patients still endorsed stress, social isolation, and probable depression, representing challenges for disease management.
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Affiliation(s)
- Arash Delavar
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA, USA
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive MC 0946, La Jolla, CA, 92093, USA
| | - Jennifer J Bu
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive MC 0946, La Jolla, CA, 92093, USA
| | - Bharanidharan Radha Saseendrakumar
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA, USA
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive MC 0946, La Jolla, CA, 92093, USA
| | - Robert N Weinreb
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Sally L Baxter
- Division of Biomedical Informatics, Department of Medicine, University of California San Diego, La Jolla, CA, USA.
- Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive MC 0946, La Jolla, CA, 92093, USA.
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Klauke S, Sondocie C, Fine I. The impact of low vision on social function: The potential importance of lost visual social cues. JOURNAL OF OPTOMETRY 2023; 16:3-11. [PMID: 35568628 PMCID: PMC9811370 DOI: 10.1016/j.optom.2022.03.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 01/09/2022] [Accepted: 03/06/2022] [Indexed: 05/06/2023]
Abstract
Visual cues usually play a vital role in social interaction. As well as being the primary cue for identifying other people, visual cues also provide crucial non-verbal social information via both facial expressions and body language. One consequence of vision loss is the need to rely on non-visual cues during social interaction. Although verbal cues can carry a significant amount of information, this information is often not available to an untrained listener. Here, we review the current literature examining potential ways that the loss of social information due to vision loss might impact social functioning. A large number of studies suggest that low vision and blindness is a risk factor for anxiety and depression. This relationship has been attributed to multiple factors, including anxiety about disease progression, and impairments to quality of life that include difficulties reading, and a lack of access to work and social activities. However, our review suggests a potential additional contributing factor to reduced quality of life that has been hitherto overlooked: blindness may make it more difficult to effectively engage in social interactions, due to a loss of visual information. The current literature suggests it might be worth considering training in voice discrimination and/or recognition when carrying out rehabilitative training in late blind individuals.
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Affiliation(s)
| | - Chloe Sondocie
- Department of Psychology, University of Washington, Seattle, USA
| | - Ione Fine
- Department of Psychology, University of Washington, Seattle, USA.
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24
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Zhou W, Lin H, Ren Y, Lin H, Liang Y, Chen Y, Zhang S. Mental health and self-management in glaucoma patients during the COVID-19 pandemic: a cross-sectional study in China. BMC Ophthalmol 2022; 22:474. [PMID: 36474185 PMCID: PMC9727872 DOI: 10.1186/s12886-022-02695-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To investigate mental health and self-management in glaucoma patients during the COVID-19 pandemic in China and to describe the correlation between anxiety, depression, glaucoma, and self-management. METHODS This cross-sectional study included glaucoma patients who enrolled in the case management platform and completed an online survey. The survey included the Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), and Glaucoma Self-Management Questionnaire (GSMQ). RESULTS Among 109 glaucoma patients enrolled in this study, the proportions of patients suffering from depression and anxiety during the COVID-19 pandemic were 26.6% and 20.2%, respectively. A statistical association was found between depression and self-management behaviour in these glaucoma patients (r = -0.247, P = 0.010). The self-management scores in patients less than 35 years were lower than those in patients aged 35-60 years (P = 0.046). The scores of body function promotion in men were lower than those in women (P = 0.048). Patients with primary school education and below had lower scores in the medical management of disease than those with either middle school education (P = 0.032) or community college education or higher (P = 0.022). CONCLUSION A high proportion of anxiety and depression was found in glaucoma patients during the COVID-19 pandemic. Better self-management behaviour was associated with stronger mental health regulation. It is important to help glaucoma patients improve their self-management behaviours, especially for young men with low educational levels.
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Affiliation(s)
- Wenzhe Zhou
- grid.268099.c0000 0001 0348 3990The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China
| | - Haishuang Lin
- grid.268099.c0000 0001 0348 3990The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China ,grid.268099.c0000 0001 0348 3990Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China
| | - Yanhan Ren
- grid.168645.80000 0001 0742 0364University of Massachusetts Medical School, Worcester, USA
| | - Hao Lin
- grid.268099.c0000 0001 0348 3990The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China
| | - Youping Liang
- grid.268099.c0000 0001 0348 3990The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China
| | - Yanyan Chen
- grid.268099.c0000 0001 0348 3990The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China
| | - Shaodan Zhang
- grid.268099.c0000 0001 0348 3990The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, 325027 Zhejiang Province China
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Rasheed HA, Cohenmehr J, Chen ST. Electroconvulsive Therapy With Titanium-Based Uveoscleral Stents. J ECT 2022; 38:262-263. [PMID: 35700965 DOI: 10.1097/yct.0000000000000871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Fu J, Yang J, Li Q, Huang D, Yang H, Xie X, Xu H, Zhang M, Zheng C. Glaucoma-related posts from a Chinese social media: An exploratory study.. [DOI: 10.21203/rs.3.rs-2312218/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Abstract
Purpose: Our study aims to discuss glaucoma patients' needs and Internet habits using big data analysis and Natural Language Processing (NLP) based on deep learning (DL). We also developed and validated DL models to recognize social media data.
Methods: In this retrospective study, we used web crawler technology to crawl glaucoma-related topic posts from the glaucoma bar of Baidu Tieba. According to the contents of topic posts, we classified them into posts with or without seeking medical advice. Word Cloud and frequency statistics were used to analyze the contents and visualize the keywords. Two DL models, Bidirectional Long Short-Term Memory (Bi-LSTM) and Bidirectional Encoder Representations from Transformers (BERT), were trained to identify the posts seeking medical advice. The evaluation matrices included: accuracy, F1 value, and the area under the ROC curve (AUC).
Results: A total of 10,892 topic posts were included, among them, most were seeking medical advice (N=7071, 64.91%), and seeking advice regarding symptoms or examination (N=4913, 45.11%) dominated the majority, followed by searching for social support , expressing emotions, and sharing knowledge. The word cloud analysis showed that ocular pressure, visual field, examination, and operation were the most frequent words. The accuracy, F1 score, and AUC were 0.891, 0.891, and 0.931 for BERT model, 0.82, 0.821, and 0.890 for Bi-LSTM model.
Conclusion: Social media can help enhance the patient-doctor relationship by providing patients’ concerns and cognition about glaucoma. DL models performed well in classifying Chinese medical-related texts, which could play an important role in public health monitoring.
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Affiliation(s)
| | - Junrui Yang
- Joint Shantou International Eye Center of Shantou University, Chinese University of Hong Kong, Shantou University Medical College
| | - Qiuman Li
- Guangzhou Women and Children’s Medical Center
| | | | | | - Xiaoling Xie
- Joint Shantou International Eye Center of Shantou University, Chinese University of Hong Kong, Shantou University Medical College
| | | | - Mingzhi Zhang
- Joint Shantou International Eye Center of Shantou University, Chinese University of Hong Kong, Shantou University Medical College
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Berchuck SI, Jammal AA, Page D, Somers TJ, Medeiros FA. A Framework for Automating Psychiatric Distress Screening in Ophthalmology Clinics Using an EHR-Derived AI Algorithm. Transl Vis Sci Technol 2022; 11:6. [PMID: 36180026 PMCID: PMC9547354 DOI: 10.1167/tvst.11.10.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/14/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose In patients with ophthalmic disorders, psychosocial risk factors play an important role in morbidity and mortality. Proper and early psychiatric screening can result in prompt intervention and mitigate its impact. Because screening is resource intensive, we developed a framework for automating screening using an electronic health record (EHR)-derived artificial intelligence (AI) algorithm. Methods Subjects came from the Duke Ophthalmic Registry, a retrospective EHR database for the Duke Eye Center. Inclusion criteria included at least two encounters and a minimum of 1 year of follow-up. Presence of distress was defined at the encounter level using a computable phenotype. Risk factors included available EHR history. At each encounter, risk factors were used to discriminate psychiatric status. Model performance was evaluated using area under the receiver operating characteristic (ROC) curve and area under the precision-recall curve (PR AUC). Variable importance was presented using odds ratios (ORs). Results Our cohort included 358,135 encounters from 40,326 patients with an average of nine encounters per patient over 4 years. The ROC and PR AUC were 0.91 and 0.55, respectively. Of the top 25 predictors, the majority were related to existing distress, but some indicated stressful conditions, including chemotherapy (OR = 1.36), esophageal disorders (OR = 1.31), central pain syndrome (OR = 1.25), and headaches (OR = 1.24). Conclusions Psychiatric distress in ophthalmology patients can be monitored passively using an AI algorithm trained on existing EHR data. Translational Relevance When paired with an effective referral and treatment program, such algorithms may improve health outcomes in ophthalmology.
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Affiliation(s)
| | - Alessandro A. Jammal
- Duke Eye Center and Department of Ophthalmology, Duke University, Durham, NC, USA
| | - David Page
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | - Tamara J. Somers
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Felipe A. Medeiros
- Duke Eye Center and Department of Ophthalmology, Duke University, Durham, NC, USA
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
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Duong AT, Van Tassel SH. Depression and Glaucoma: A Review and Considerations for Researchers and Providers. Int Ophthalmol Clin 2022; 62:39-44. [PMID: 36170220 DOI: 10.1097/iio.0000000000000441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Meer EA, Lee YH, Repka MX, Borlik MF, Velez FG, Perez C, Yu F, Coleman AL, Pineles SL. Association of Mood Disorders, Substance Abuse, and Anxiety Disorders in Children and Teens With Serious Structural Eye Diseases. Am J Ophthalmol 2022; 240:135-142. [PMID: 35314189 DOI: 10.1016/j.ajo.2022.03.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 03/06/2022] [Accepted: 03/06/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE We sought to evaluate the association between 5 eye diseases (including glaucoma, cataract, congenital optic nerve disease, congenital retinal disease, and blindness/low vision) and mental illness in a pediatric population. DESIGN Cross-sectional study. METHODS A de-identified commercial insurance claims database, OptumLabs Data Warehouse, between January 1, 2007, and December 31, 2018, was used. Children and teens less than 19 years of age at the time of eye diagnosis were included. Demographics and mental illness claims were compared, looking at the association of mental illness and eye disease claims. RESULTS A total of 11,832,850 children and teens were included in this study with mean age of 8.04 ± 5.94 years at the first claim. Of the patients with at least 1 of the 5 eye diseases (n = 180,297), 30.5% had glaucoma (n = 54,954), 9.5% had cataract (n = 17,214), 21.4% had congenital optic nerve disease (n = 38,555), 26.9% had congenital retinal disease (n = 48,562), and 25.9% had blindness or low vision (n = 46,778). There was a statistically significant association, after adjusting for confounding variables, between at least 1 of the 5 eye diseases and schizophrenia disorder (OR = 1.54, 95% CI = 1.48-1.61, P < .001), anxiety disorder (OR = 1.45, 95% CI = 1.43-1.48, P < .001), depressive disorder (OR = 1.27, 95% CI = 1.25-1.29, P < .001), and bipolar disorder (OR = 1.27, 95% CI = 1.21-1.31, P < .001), but a reversed association with substance use disorder (OR = 0.88, 95% CI = 0.86-0.90, P < .001). CONCLUSIONS We found associations between eye disease in children and teens and mental illness. Understanding these relationships may improve mental illness screening and treatment in the pediatric population.
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Affiliation(s)
- Elana A Meer
- From the Perelman School of Medicine (E.A.M), University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yoon H Lee
- Department of Ophthalmology (Y.H.L., F.Y., A.L.C., S.L.P.), Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA
| | - Michael X Repka
- Department of Ophthalmology (M.X.R.), Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Marcy F Borlik
- Department of Psychiatry and Biobehavioral Sciences (M.F.B.), David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Federico G Velez
- Department of Ophthalmology (F.G.V.), Doheny Eye Institute, University of California Los Angeles, Los Angeles, California; USA; Department of Ophthalmology (F.G.V.), Duke University School of Medicine, Durham, North Carolina, USA
| | - Claudia Perez
- Department of Medicine Statistics Core (C.P.), David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | - Fei Yu
- Department of Ophthalmology (Y.H.L., F.Y., A.L.C., S.L.P.), Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA; Department of Biostatistics (F.Y.), University of California Los Angeles Fielding School of Public Health, Los Angeles, California, USA
| | - Anne L Coleman
- Department of Ophthalmology (Y.H.L., F.Y., A.L.C., S.L.P.), Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA; Department of Epidemiology (A.L.C.), University of California Los Angeles Fielding School of Public Health, Los Angeles, California, USA
| | - Stacy L Pineles
- Department of Ophthalmology (Y.H.L., F.Y., A.L.C., S.L.P.), Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA
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Guedes RAP, Souza CP, Dias LLDS, Murta L, Gravina DM, Chaoubah A. A Brazilian cost-utility analysis of trabecular micro-bypass with iStent inject® for the treatment of open-angle glaucoma. REVISTA BRASILEIRA DE OFTALMOLOGIA 2022. [DOI: 10.37039/1982.8551.20220049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abu EK, Antiri EO, Ocansey S, Ntodie M, Abokyi S, Abraham CH. Associations between personality traits and adherence to treatment in patients with primary open–angle glaucoma in an African population. Clin Exp Optom 2022:1-7. [DOI: 10.1080/08164622.2022.2075253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Emmanuel K Abu
- Department of Optometry and Vision Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Ebenezer O Antiri
- Department of Optometry and Vision Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Stephen Ocansey
- Department of Optometry and Vision Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Michael Ntodie
- Department of Optometry and Vision Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Samuel Abokyi
- Department of Optometry and Vision Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Carl Halladay Abraham
- Department of Optometry and Vision Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
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Halawa OA, Roldan AM, Meshkin RS, Zebardast N, Fenwick EK, Lamoureux EL, Friedman DS. Factors associated with glaucoma-specific quality of life in a US glaucoma clinic in a pilot implementation of an online computerised adaptive test (GlauCAT). Br J Ophthalmol 2022:bjophthalmol-2022-321145. [PMID: 35551060 DOI: 10.1136/bjophthalmol-2022-321145] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 04/25/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Measure quality of life (QoL) outcomes using a novel computerised adaptive test in a clinical setting, and determine the social and demographic factors associated with specific QoL domains in patients with glaucoma. DESIGN Cross-sectional study between July 2020 and April 2021. PARTICIPANTS English-speaking adults presenting to glaucoma clinic. Patients with cognitive impairment on a six-item cognitive impairment screen or with intraocular surgery within 90 days prior to presentation were excluded. RESULTS Of 206 patients surveyed, mean age was 64.8 years (SD 15.2), 122 (56.7%) were female and 159 (74.7%) were white. On multivariable regression, visual acuity was associated with greater activity limitation (β=-2.8 points, 95% CI -3.8 to -1.8, p<0.001) and worse mobility (β=-2.1 points, 95% CI -3.2 to -0.9, p<0.001), while poorer visual field (VF) mean deviation was associated with lower scores on the emotional well-being domain (β=-2.4 points, 95% CI -4.6 to -0.3, p=0.03). Glaucoma suspects and those with early VF defects had higher QoL scores than those with severe glaucoma in the following domains: activity limitation (88.5±14.6 vs 74.3±21.9, respectively, p<0.001), mobility (91.0±12.5 vs 80.0±25.3, respectively, p=0.005) and concerns domains (82.2±13.9 vs 72.5 5±18.9, respectively, p=0.01). CONCLUSIONS In a busy glaucoma clinic where QoL was measured with online adaptive tests for glaucoma, we found that several demographic and clinical variables are associated with lower domain scores, suggesting that patients with predisposing demographic and clinical factors are at a higher risk of worse QoL.
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Affiliation(s)
- Omar A Halawa
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Ana M Roldan
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Ryan S Meshkin
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Nazlee Zebardast
- Harvard Medical School, Boston, Massachusetts, USA.,Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Eva K Fenwick
- Singapore Eye Research Institute, Singapore.,Duke-NUS Medical School, Singapore
| | - Ecosse Luc Lamoureux
- HSSR, Duke-NUS Medical School, Singapore.,Population Health, Singapore Eye Research Institute, Singapore
| | - David S Friedman
- Glaucoma Center of Excellence, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
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Glaucoma – risk factors and current challenges in the diagnosis of a leading cause of visual impairment. Maturitas 2022; 163:15-22. [DOI: 10.1016/j.maturitas.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/01/2022] [Accepted: 05/09/2022] [Indexed: 11/21/2022]
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Anatomical Evidence for the Neural Connection from the Emotional Brain to Autonomic Innervation in the Anterior Chamber Structures of the Eye. Curr Med Sci 2022; 42:417-425. [PMID: 35366148 DOI: 10.1007/s11596-022-2571-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 02/09/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Previous studies have shown that the autonomic nervous system (ANS), which can be affected by emotions, is important in the occurrence or progression of glaucoma. The autonomic innervation distributed in the anterior chamber (AC) structures might play an efferent role in the neural regulation of intraocular pressure (IOP). This study aimed to investigate the anatomic neural connection from the emotional brain to autonomic innervation in the AC. METHODS A retrograde trans-multisynaptic pseudorabies virus encoded with an enhanced green fluorescent protein (PRV531) and non-trans-synaptic tracer FAST Dil were injected into the right eye of mice, respectively. Fluorescent localization in the emotional brain and preganglionic nuclei was studied. Five and a half days after PRV531 injection into the right AC, fluorescent signals were observed in several emotional brain regions, including the amygdala, agranular insular cortex, lateral septal nuclei, periaqueductal gray, and hypothalamus. Autonomic preganglionic nuclei, including Edinger-Westphal nucleus, superior salivatory nucleus, and intermediolateral nucleus, were labeled using PRV531. RESULTS The sensory trigeminal nuclei were not labeled using PRV531. The fluorescence signals in the nuclei mentioned above showed bilateral distribution, primarily on the ipsilateral side. Seven days after injecting FAST Dil into the AC, we observed no FAST Dil-labeled neurons in the central nervous system. CONCLUSION Our results indicate a neural connection from the emotional brain to autonomic innervation in the AC, which provides anatomical support for the emotional influence of IOP via the ANS.
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Wu N, Kong X, Sun X. Anxiety and depression in Chinese patients with glaucoma and its correlations with vision-related quality of life and visual function indices: a cross-sectional study. BMJ Open 2022; 12:e046194. [PMID: 35190403 PMCID: PMC8860023 DOI: 10.1136/bmjopen-2020-046194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To investigate anxiety and depression in patients with glaucoma and its correlations with vision-related quality of life (VR-QoL) and visual function indices. DESIGN A hospital-based, cross-sectional study. SETTING Shanghai, China PARTICIPANTS: The Hospital Anxiety and Depression Scale and the 25-item National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) were administered to 446 Chinese patients with glaucoma to assess their psychological disorders, namely anxiety and depression, and VR-QoL, respectively. OUTCOME MEASURES Sociodemographic and clinical data were collected at the same time. Multivariate linear regression analysis was carried out to investigate the associations between VR-QoL, visual function indices and psychological disorders. Standardised partial regression analysis was used to identify the variable mostly indicative in evaluating psychological burdens. RESULTS The prevalence of anxiety and depression in Chinese patients with glaucoma was 12.11% and 25.78%, respectively. Most of the subscales and the composite score of NEI VFQ-25 were negatively associated with each parameter of anxiety and depression after adjusting for sociodemographic and clinical variables. For visual function indices, only the best-corrected visual acuity of both eyes was correlated with anxiety after adjustment. Standardised partial regression analysis further showed VR-QoL, but not the objective visual function indices, was mostly relevant to psychological disturbances. CONCLUSIONS Anxiety and depression were common in Chinese patients with glaucoma. Self-reported VR-QoL was beneficial in assessing psychological status of patients with glaucoma, while objective visual function indices provide little hint on it.
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Affiliation(s)
- Na Wu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Xiangmei Kong
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Xinghuai Sun
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
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Ulhaq ZS, Soraya GV, Dewi NA, Wulandari LR. The prevalence of anxiety symptoms and disorders among ophthalmic disease patients. Ther Adv Ophthalmol 2022; 14:25158414221090100. [PMID: 35464342 PMCID: PMC9021519 DOI: 10.1177/25158414221090100] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/09/2022] [Indexed: 12/26/2022] Open
Abstract
Background: Progressive and irreversible vision loss has been shown to place a patient at risk of mental health problems such as anxiety. However, the reported prevalence of anxiety symptoms and disorders among eye disease patients vary across studies. Thus, this study aims to clarify the estimated prevalence of anxiety symptoms and disorders among ophthalmic disease patients. Methods: Relevant studies on the prevalence of anxiety symptoms and disorders among eye disease patients were collected through international databases, PubMed, Scopus, and Web of Science. A random-effects model was used to determine the pooled prevalence of anxiety symptoms and disorders among ophthalmic disease patients. Results: The 95 included studies yielded a pooled prevalence of 31.2% patients with anxiety symptoms and 19.0% with anxiety disorders among subjects with ophthalmic disease. Pediatric patients were more anxious (58.6%) than adults (29%). Anxiety symptoms were most prevalent in uveitis (53.5%), followed by dry eye disease (DED, 37.2%), retinitis pigmentosa (RP, 36.5%), diabetic retinopathy (DR, 31.3%), glaucoma (30.7%), myopia (24.7%), age-related macular degeneration (AMD, 21.6%), and cataract (21.2%) patients. Anxiety disorders were most prevalent in thyroid eye disease (TED, 28.9%), followed by glaucoma (22.2%) and DED (11.4%). When compared with healthy controls, there was a twofold increase on the prevalence of anxiety symptoms (OR = 1.912, 95% CI 1.463–2.5, p < 0.001) and anxiety disorders (OR = 2.281, 95% CI 1.168–4.454, p = 0.016). Conclusion: Anxiety symptoms and disorders are common problems associated with ophthalmic disease patients. Thus, comprehensive and appropriate treatments are necessary for treating anxiety symptoms and disorders among ophthalmic disease patients.
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Affiliation(s)
- Zulvikar Syambani Ulhaq
- Research Center for Pre-Clinical and Clinical Medicine, National Research and Innovation Agency Republic of Indonesia, Cibinong, Indonesia
| | - Gita Vita Soraya
- Department of Biochemistry, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Nadia Artha Dewi
- Department of Ophthalmology, Faculty of Medicine, Brawijaya University, Malang, Indonesia
| | - Lely Retno Wulandari
- Department of Ophthalmology, Faculty of Medicine, Brawijaya University, Malang, Indonesia
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Dayal A, Sodimalla KVK, Chelerkar V, Deshpande M. Prevalence of Anxiety and Depression in Patients With Primary Glaucoma in Western India. J Glaucoma 2022; 31:37-40. [PMID: 34474423 DOI: 10.1097/ijg.0000000000001935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 08/14/2021] [Indexed: 11/25/2022]
Abstract
PRCIS Glaucoma can cause disturbance in psychological and emotional functioning of patients, leading to anxiety and depression, even early in the disease. Identification and management of these problems should be included as a part of the holistic approach for patient care. PURPOSE The purpose of this study was to assess the prevalence of anxiety and depression in patients with primary glaucoma using a standard validated questionnaire. METHODOLOGY A cross-sectional prevalence study was carried out on 200 patients attending the glaucoma outpatient clinic at a tertiary care eye hospital in Pune, India. After obtaining written consent, all patients underwent a thorough ophthalmic examination. Those with primary glaucoma were included in the study and classified on the basis of the Hodapp-Parrish-Anderson criteria. Participants were asked to respond to the Hospital Anxiety and Depression Scale (HADS) questionnaire, and responses were analyzed statistically. RESULTS The mean HADS-Anxiety score was 4.5 (SD=3.4), while HADS-Depression was 4.1 (SD=3.8). The severity of the disease was associated with significantly higher HADS scores. Mean HADS-Anxiety scores were 3.1 (SD=2.9) for mild glaucoma, 4.4 (SD=2.6) for moderate, and 7.7 (SD=3.0) for advanced disease (P<0.001). Similarly, mean HADS-Depression scores were 2.0 (SD=2.6), 4.2 (SD=3.0), and 8.3 (SD=3.3), respectively for mild, moderate, and severe glaucoma (P<0.001). Based on HADS scores, a third of patients (34.5%) were symptomatic for anxiety or depression, out of which 25 (12.5%) could be classified as definite cases. Duration of treatment had no association with HADS scores. CONCLUSIONS An association exists between the amount of visual loss among patients with glaucoma and symptoms of anxiety and depression, irrespective of disease duration. This information may help to choose treatment approaches most likely to be beneficial to the patients.
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Affiliation(s)
- Ashutosh Dayal
- Department of Glaucoma, PBMA's H.V. Desai Eye Hospital, Pune, Maharashtra, India
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Berchuck SI, Jammal AA, Mukherjee S, Somers TJ, Medeiros FA. Impact of anxiety and depression on progression to glaucoma among glaucoma suspects. Br J Ophthalmol 2021; 105:1244-1249. [PMID: 32862132 PMCID: PMC9924953 DOI: 10.1136/bjophthalmol-2020-316617] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/24/2020] [Accepted: 08/01/2020] [Indexed: 01/12/2023]
Abstract
AIMS To assess the impact of anxiety and depression in the risk of converting to glaucoma in a cohort of glaucoma suspects followed over time. METHODS The study included a retrospective cohort of subjects with diagnosis of glaucoma suspect at baseline, extracted from the Duke Glaucoma Registry. The presence of anxiety and depression was defined based on electronic health records billing codes, medical history and problem list. Univariable and multivariable Cox proportional hazards models were used to obtain HRs for the risk of converting to glaucoma over time. Multivariable models were adjusted for age, gender, race, intraocular pressure measurements over time and disease severity at baseline. RESULTS A total of 3259 glaucoma suspects followed for an average of 3.60 (2.05) years were included in our cohort, of which 911 (28%) were diagnosed with glaucoma during follow-up. Prevalence of anxiety and depression were 32% and 33%, respectively. Diagnoses of anxiety, or concomitant anxiety and depression were significantly associated with risk of converting to glaucoma over time, with adjusted HRs (95% CI) of 1.16 (1.01, 1.33) and 1.27 (1.07, 1.50), respectively. CONCLUSION A history of anxiety or both anxiety and depression in glaucoma suspects was associated with developing glaucoma during follow-up.
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Affiliation(s)
- Samuel I. Berchuck
- Department of Statistical Science and Forge, Duke University, Durham, North Carolina, USA,Duke Eye Center and Department of Ophthalmology, Duke University, Durham, North Carolina, USA
| | - Alessandro A. Jammal
- Duke Eye Center and Department of Ophthalmology, Duke University, Durham, North Carolina, USA
| | - Sayan Mukherjee
- Departments of Statistical Science, Mathematics, Computer Science, Biostatistics & Bioinformatics, Duke University, Durham, North Carolina, USA
| | - Tamara J. Somers
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
| | - Felipe A. Medeiros
- Duke Eye Center and Department of Ophthalmology, Duke University, Durham, North Carolina, USA
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Loughman J, Loskutova E, Butler JS, Siah WF, O’Brien C. Macular Pigment Response to Lutein, Zeaxanthin, and Meso-zeaxanthin Supplementation in Open-Angle Glaucoma. OPHTHALMOLOGY SCIENCE 2021; 1:100039. [PMID: 36247822 PMCID: PMC9562333 DOI: 10.1016/j.xops.2021.100039] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/28/2021] [Accepted: 07/01/2021] [Indexed: 01/30/2023]
Abstract
Purpose To evaluate macular pigment response to carotenoid supplementation in glaucomatous eyes. Design Double-masked, randomized, placebo-controlled clinical trial, the European Nutrition in Glaucoma Management Study (ClinicalTrials.gov identifier, NCT04460365). Participants Sixty-two participants (38 men, 24 women) with a diagnosis of open-angle glaucoma were enrolled. Forty-two were randomized to receive the active supplement, 20 participants were allocated to placebo. Methods Macular pigment optical density (MPOD) was measured by autofluorescence using the Heidelberg Spectralis scanning laser ophthalmoscope. Macular pigment optical density volume within the central 6° of retinal eccentricity as well as MPOD at 0.23°, 0.51°, 0.74°, and 1.02° were recorded at baseline and at 6-month intervals over 18 months. Visual function was assessed using visual acuity, mesopic and photopic contrast sensitivity under glare conditions, photo stress recovery time, microperimetry, and Glaucoma Activities Limitation 9 questionnaire. Advanced glaucoma module scans of retinal nerve fiber layer thickness and ganglion cell complex thickness over the central 6° of retinal eccentricity also were completed at each study visit. Main Outcome Measures Change in MPOD after supplementation with 10 mg lutein, 2 mg zeaxanthin, and 10 mg meso-zeaxanthin or placebo over 18 months. Results A mixed-model repeated measures analysis of variance revealed a statistically significant increase in MPOD volume (significant time effect: F(3,111) = 89.31, mean square error (MSE) = 1656.9; P < 0.01). Post hoc t tests revealed a significant difference in MPOD volume at each study visit for the treatment group (P < 0.01 for all), but no change in the placebo group (P > 0.05 for all). A statistically significant increase in mesopic contrast sensitivity under glare conditions was noted at 18 months in the treatment group, but not placebo. No other structural or functional changes were observed. No serious adverse events were noted during the trial. Conclusions Macular pigment can be augmented in glaucomatous eyes by supplementation with a formulation containing the carotenoids lutein, zeaxanthin, and meso-zeaxanthin. The greatest relative benefit was observed in those with the lowest baseline levels, but increases were noted across all participants and each retinal eccentricity. The potential benefits of MP augmentation for macular health in glaucoma merit further long-term evaluation.
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Dar S, De Moraes CG, Karani R, Khan S, Chen R, Blumberg D, Harizman N, Krawitz B, Valenzuela IA, Aliancy J, Tezel T, Horowitz J, Bearelly S, Coleman DJ, Chang S, Cioffi GA, Liebmann JM. Patient Concerns Regarding Suspended Ophthalmic Care Due to COVID-19. J Glaucoma 2021; 30:750-757. [PMID: 33979109 PMCID: PMC8366515 DOI: 10.1097/ijg.0000000000001877] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 04/14/2021] [Indexed: 12/22/2022]
Abstract
PURPOSE The temporary cessation and profound changes in ophthalmic care delivery that occurred as a result of the coronavirus disease 2019 (COVID-19) pandemic have yet to be fully understood. Our objective is to assess patients' self-reported impact of health care lockdown measures on their fears and anxieties during the crisis period of the COVID-19 pandemic in New York City. METHODS We conducted a digital, self-reported, patient care survey distributed by an e-mail at Columbia University's Department of Ophthalmology outpatient faculty practice. Inclusion criteria were age greater than or equal to 18 years, a diagnosis of either retinal disease or glaucoma, and a canceled or rescheduled ophthalmology established patient appointment during the acute phase of the COVID-19 pandemic in New York City. Patients without an e-mail address listed in their electronic medical records were excluded. The survey occurred between March 2, 2020, to May 30, 2020. Primary measures were survey responses to assess key areas of patient anxiety or concern during the pandemic including the safety of care delivery in a COVID pandemic, difficulties contacting or being seen by their ophthalmologist, concern of vision loss or disease progression, and concern over missed or access to treatments. Secondary measures were correlating survey response to factors such as visual acuity, intraocular pressure, diagnosis, disease severity, follow-up urgency, recent treatments, and diagnostic testing data. RESULTS Of the 2594 surveys sent out, 510 (19.66%) were completed. Over 95% of patients were at least as concerned as in normal circumstances about their ocular health during the peak of the pandemic. Overall, 76% of respondents were more concerned than normal that they could not be seen by their ophthalmologist soon enough. Increased concern over ocular health, disease progression, and access to care all showed positive correlations (P<0.05) with worse disease severity as measured with testing such as visual fields and optical coherence tomography. In addition, 55% of patients were afraid of contracting COVID-19 during an office visit. CONCLUSION AND RELEVANCE We found a majority of our patients were concerned about limitations in access to ophthalmic care and were fearful of disease progression. In addition, we found a number of demographic and clinical factors that correlated with increased anxiety in our patients.
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Østergaard Madsen H, Hageman I, Kolko M, Lund-Andersen H, Martiny K, Ba-Ali S. Seasonal variation in neurohormones, mood and sleep in patients with primary open angle glaucoma - implications of the ipRGC-system. Chronobiol Int 2021; 38:1421-1431. [PMID: 34112046 DOI: 10.1080/07420528.2021.1931275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Primary open angle glaucoma is associated with an increased risk of mood and sleep disorders. These adversities have been suggested to relate to a disrupted function of the intrinsically photosensitive retinal ganglion cells (ipRGCs). The ipRGCs are key components in the nonvisual photoreceptive system that mediates light effects on mood, sleep and circadian rhythm. We assessed the diurnal hormone levels, pupillary responses and mood and sleep under seasons with different photoperiods in 24 patients with glaucoma and 24 age- and sex-matched healthy controls to investigate responses to naturalistic seasonal changes in daylight. The patients had moderate-to-advanced glaucoma with substantial visual field defects and reductions in the ipRGC-mediated pupillary responses (p < .001). In winter, compared with summer, patients with glaucoma had higher daytime melatonin concentration (p < .001) and lower nighttime cortisol (p = .002). In winter, the daytime melatonin level was inversely correlated with the ipRGC-mediated pupillary responses in the control group (p = .04). In the control group, there were no significant changes in hormone levels between seasons or any correlations between neurohormone levels and the ipRGC-mediated responses. The two groups showed a similar response to season with lower depression scores in summer compared with winter. In between-group comparison, the nocturnal melatonin level (area under curve from 20:00 h to 08:00 h) in summer was lower in glaucoma compared with controls (p = .03). In winter, nocturnal cortisol (at 04:00 h) was lower (p = .004) and daytime cortisol (12:00 h and 16:00 h) was higher (p = .007) in glaucoma compared with controls. In conclusion, we found that patients with glaucoma displayed a seasonal variation in diurnal hormone levels that was not present in healthy controls. Such neurohormonal changes may contribute to the increased risk of mood and sleep disorders seen in patients with glaucoma.
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Affiliation(s)
| | - Ida Hageman
- Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Miriam Kolko
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark.,Department of Ophthalmology, Rigshospitalet-Glostrup Hospital, Copenhagen, Denmark
| | - Henrik Lund-Andersen
- Department of Ophthalmology, Rigshospitalet-Glostrup Hospital, Copenhagen, Denmark
| | - Klaus Martiny
- Mental Health Center Copenhagen, Copenhagen, Denmark
| | - Shakoor Ba-Ali
- Department of Ophthalmology, Rigshospitalet-Glostrup Hospital, Copenhagen, Denmark
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Tilahun MM, Yibekal BT, Kerebih H, Ayele FA. Prevalence of common mental disorders and associated factors among adults with Glaucoma attending University of Gondar comprehensive specialized hospital tertiary eye care and training center, Northwest, Ethiopia 2020. PLoS One 2021; 16:e0252064. [PMID: 34015012 PMCID: PMC8136648 DOI: 10.1371/journal.pone.0252064] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 05/07/2021] [Indexed: 11/18/2022] Open
Abstract
PURPOSE This study aimed to assess the prevalence of common mental disorders and associated factors among adults with glaucoma at Gondar university comprehensive specialized hospital tertiary eye care and training center. Glaucoma predisposes patients to common mental problems and leads to wasteful, costly and inefficient use of medical services and complications of the diagnoses. So, determining the level and factors associated with common mental disorders among glaucoma patient would help to improve and integrate comprehensive ophthalmic services which address common mental disorder in a follow-up visit. METHODS An institution-based cross-sectional study was conducted on 495 glaucoma patients selected by using systematic random sampling. Data were collected through face-to-face interview and chart review. Self-reported questionnaire (SRQ-20) was used to assess the presence of common mental disorders. Binary logistic regression analysis was done to identify factors associated with common mental disorders. Variables with P<0.05 were considered as factors significantly associated with common mental disorders. RESULT Four hundred sixty-eight patients were included in this study with a response rate of 94.54%. The mean age of the participant was 58 ± 14.11 years. The prevalence of common mental disorders was found to be 29.5% (95% CI 25.4-33.3). Female sex (AOR = 3.79, 95% CI: 1.66-8.62) (p-value = 0.001), average monthly income of less than 1200 birr (AOR = 6.05 95% CI: 2.26-16.22) (p-value = 0.001), poor level of social support (AOR = 17.39 95% CI: 7.79-38.82) (p-value = 0.001), moderate and high risk of alcohol use (AOR = 10.42 95%CI: 2.74-39.54) (p-value = 0.001), presence of chronic medical illness (AOR = 3.85 95% CI: 2.07-7.16) (p-value = 0.001), receiving both drug and surgical treatment (AOR = 2.50, 95%CI: 1.30-4.83) (p-value = 0.006) and presence of systemic carbonic anhydrase inhibitors use (AOR = 3.16, 95%CI: 1.65-6.06) (p-value = 0.001) were significantly associated with increased level of common mental disorders. CONCLUSION Significant numbers of glaucoma patients have CMD and found significantly associated with socio-economic, ocular and systemic clinical factors. Therefore, the integration of psychosocial care into the current treatment of patients with glaucoma would have a significant advantage to help these patients.
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Affiliation(s)
- Mikias Mered Tilahun
- Department of Optometry, School of Medicine, College of Medicine and Health Science, University of Gondar Comprehensive specialized hospital, Gondar Town, Ethiopia
| | - Betelhem Temesgen Yibekal
- Department of Optometry, School of Medicine, College of Medicine and Health Science, University of Gondar Comprehensive specialized hospital, Gondar Town, Ethiopia
| | - Habtamu Kerebih
- Department of Psychiatry, School of Medicine, College of Medicine and Health Science, University of Gondar Comprehensive Specialized Hospital, Gondar Town, Ethiopia
| | - Fisseha Ademassu Ayele
- Department of Ophthalmology, School of Medicine, College of Medicine and Health Science, University of Gondar Comprehensive Specialized Hospital, Gondar Town, Ethiopia
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Şahin ŞK, Aslan E, Elboga G, Altındağ A, Çiloğlu E. Effective and Safe Use of Vortioxetine in a Patient with Anxious Depression and Comorbid Glaucoma. Psychiatr Ann 2021. [DOI: 10.3928/00485713-20210412-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Tharmathurai S, Muhammad-Ikmal MK, Razak AA, Che-Hamzah J, Azhany Y, Fazilawati Q, Liza-Sharmini AT. Depression and Severity of Glaucoma Among Older Adults in Urban and Suburban Areas. J Glaucoma 2021; 30:e205-e212. [PMID: 33710066 DOI: 10.1097/ijg.0000000000001830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 02/25/2021] [Indexed: 11/26/2022]
Abstract
PRCIS Depression increases with severity of visual field defect in older adults with primary open-angle glaucoma (POAG). PURPOSE This study aimed to determine the prevalence of depression among patients with POAG and examine the relationship between depression and the severity of POAG in older adults. MATERIALS AND METHODS Three hundred and sixty patients with POAG aged 60 years or above were recruited from 2 tertiary centers located in an urban and suburban area. The participants were stratified according to the severity of their glaucoma based on the scores from the modified Advanced Glaucoma Intervention Study (AGIS) to mild, moderate, severe, and end stage. Face-to-face interviews were performed using the Malay Version Geriatric Depression Scale 14 (mGDS-14) questionnaire. Depression is diagnosed when the score is ≥8. One-way analysis of variance was used to compare the subscores between the groups. Multifactorial analysis of variance was also applied with relevant confounding factors. RESULTS Depression was detected in 16% of older adults with POAG; a higher percentage of depression was seen in those with end stage disease. There was a significant increase in the mean score of mGDS-14 according to the severity of POAG. There was evidence of an association between depression and severity of visual field defect (P<0.001). There was a significant difference in mGDS-14 score between the pairing of severity of POAG [mild-severe (P=0.003), mild-end stage (P<0.001), moderate-severe (P<0.001), and moderate-end stage (P<0.001)] after adjustment to living conditions, systemic disease, and visual acuity. CONCLUSION Ophthalmologists should be aware that older adults with advanced visual field defects in POAG may have depression. The detection of depression is important to ensure adherence and persistence to the treatment of glaucoma.
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Affiliation(s)
- Sangeetha Tharmathurai
- Departments of Ophthalmology
- Eye Clinic, Hospital USM, Health Campus, USM, Kubang Kerian, Kelantan
- Department of Ophthalmology, Hospital Selayang, Batu Caves, Selangor
| | - Mohamad K Muhammad-Ikmal
- Departments of Ophthalmology
- Eye Clinic, Hospital USM, Health Campus, USM, Kubang Kerian, Kelantan
- Department of Surgical Based Discipline, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah
| | | | - Jemaima Che-Hamzah
- Department of Ophthalmology, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Yaakub Azhany
- Departments of Ophthalmology
- Eye Clinic, Hospital USM, Health Campus, USM, Kubang Kerian, Kelantan
| | | | - Ahmad T Liza-Sharmini
- Departments of Ophthalmology
- Eye Clinic, Hospital USM, Health Campus, USM, Kubang Kerian, Kelantan
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Naufal F, Gajwani P, Medina R, Dutson M, Mariotti SP, West SK. Knowledge of patient emotional health status: impact on clinical care in glaucoma and retinal services. BMJ Open Ophthalmol 2021; 6:e000640. [PMID: 33981855 PMCID: PMC8061815 DOI: 10.1136/bmjophth-2020-000640] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 03/08/2021] [Accepted: 03/31/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Knowledge of a patient's emotional health status and using patient-centred communication may be key to providing early intervention and referral to appropriate treatment/support services for ophthalmology patients. This study aims to determine if and how ophthalmologists use anxiety and depression scores to determine clinical care of patients with chronic eye disease. METHODS AND ANALYSIS This cross-sectional study included 10 ophthalmologists and a convenience sample of 100 of their patients (>18 years). The Patient Health Questionnaire (PHQ-9) for depression and the Generalised Anxiety Disorder (GAD-7) tool were administered to patients. Scores from these instruments were provided to ophthalmologists just prior to the clinic visit. After the visit, ophthalmologists were given a questionnaire to assess self-reported change in clinical practice and whether knowledge of scores impacted their communication style, treatment plan and follow-up protocol. RESULTS Of these patients (mean age=63), 27% reported mild-moderate anxiety or depression as their worst score, while 2% reported suicidal thoughts; 20% reported neither anxiety nor depression. Ophthalmologists' response to patients with mild or worse anxiety or depression was to change clinical approach (28%) and communication style (31%), both metrics increasing with severity of symptoms (Fisher's exact p<0.05). None reported changing their choice of treatment or modifying follow-up protocols; referral to social work/psychiatry services was 60%, 3.7% and 0% for patients with moderately severe or worse, mild-to-moderate, or minimal scores, respectively. CONCLUSION Providing ophthalmologists with knowledge of the emotional health of their patients may change the clinical approach and referral pattern.
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Affiliation(s)
- Fahd Naufal
- Dana Center for Preventive Ophthalmology, Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland, USA
| | - Prateek Gajwani
- Dana Center for Preventive Ophthalmology, Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland, USA
| | - Robert Medina
- Dana Center for Preventive Ophthalmology, Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland, USA
| | - Madison Dutson
- Dana Center for Preventive Ophthalmology, Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland, USA
| | | | - Sheila K West
- Dana Center for Preventive Ophthalmology, Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland, USA
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Patel PA, Gopali R, Reddy A, Patel KK. The Readability of Ophthalmological Patient Education Materials Provided by Major Academic Hospitals. Semin Ophthalmol 2021; 37:71-76. [PMID: 33852375 DOI: 10.1080/08820538.2021.1915341] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The internet is an increasingly important resource for patients seeking health-related information. Because of this trend, the American Medical Association (AMA) and National Institutes of Health (NIH) recommend that online patient education materials (PEMs) be written between a third and seventh grade level. The present study evaluates the readability levels of ophthalmological PEMs provided by five major academic hospitals, quantifies the availability of accompanying videos and graphics, and examines the extent to which readability may be increased. METHODS In March 2021, 397 PEMs from five major academic hospitals were extracted for subsequent analysis by seven validated readability assessments. The presence of an accompanying video or graphic was noted. Statistical significance was assessed using the Kruskal-Wallis test with Dunn's multiple comparisons test and the chi-square test. RESULTS Nearly all articles were written above the recommended reading level of 7th grade. After averaging the scales for each article, the median grade level was 11.7 (interquartile range [IQR], 10.7-12.7). The PEMs with the highest median reading level were provided by the Johns Hopkins University Wilmer Institute (12.6, IQR, 11.3 - 13.6). Only 13.6% and 13.1% of articles had an accompanying video and graphic, respectively. Reduction of sentence length beneath 15 words resulted in an improvement of readability by 2.7 grade levels. CONCLUSIONS The readability of online patient resources provided by major academic hospitals were above the literacy guidelines recommended by the NIH and AMA. Furthermore, most articles did not include a video or graphic, both of which could potentially improve patient understandability of educational materials. By altering these PEMs, as demonstrated here, institutions could increase the value these articles provide for patients and therefore the quality of the patient-physician relationship.
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Affiliation(s)
- Parth A Patel
- Department of Ophthalmology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Rhea Gopali
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA
| | - Anvith Reddy
- Department of Biological Sciences, University of Georgia, Athens, GA, USA
| | - Kajol K Patel
- Department of Ophthalmology, Medical College of Georgia, Augusta University, Augusta, GA, USA
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Stamatiou ME, Kazantzis D, Theodossiadis P, Chatziralli I. Depression in glaucoma patients: A review of the literature. Semin Ophthalmol 2021; 37:29-35. [PMID: 33822676 DOI: 10.1080/08820538.2021.1903945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Purpose: The purpose of this review was to evaluate the association between glaucoma and depression and to identify possible risk factors for depressive symptoms in glaucoma patients.Methods: A total of 587 abstracts were screened and 32 studies were deemed eligible for inclusion in this review.Results: An association of glaucoma and depression was found, while advanced disease stage, older age, female sex and faster visual loss progression were recognized as potential risk factors for depression in patients with glaucoma.Conclusions: Our findings may have important clinical significance, such as alerting ophthalmologists to implement a multidisciplinary approach in patients with glaucoma. Further research is needed to examine this association in different types of glaucoma and try to investigate the underlying pathophysiological mechanisms to establish a causal inference between glaucoma and depression.
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Ikeda MC, Hamada KU, Bando AH, Nakamura VPL, Prata TS, Tatham AJ, Paranhos A, Gracitelli CPB. Interventions to Improve Reading Performance in Glaucoma. Ophthalmol Glaucoma 2021; 4:624-631. [PMID: 33813064 DOI: 10.1016/j.ogla.2021.03.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 03/24/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To evaluate whether changes to contrast, line spacing, or font size can improve reading performance in patients with glaucoma. DESIGN Cross-sectional study. PARTICIPANTS Thirty-five patients with glaucoma and 32 healthy control participants. METHODS A comprehensive ophthalmologic examination was performed followed by reading speed assessment using the Minnesota Low Vision Reading (MNREAD) test under a range of contrasts (10%, 20%, 30%, 40%, and 50%), line spacings (1.0, 1.5, 2.0, 2.5, and 3.0 lines), and font sizes (0.8, 0.9, 1.0, 1.1, and 1.2 logarithm of the minimum angle of resolution), for a total of 15 tests. Regression analyses were performed to examine the effect of varying test conditions on reading speed (measured in words per minute [wpm]). RESULTS Participants' mean age was 63.0 ± 12.6 years. Patients with glaucoma showed a visual field mean deviation in the better eye of -6.29 ± 6.35 dB. Reading speeds were significantly slower in patients with glaucoma versus control participants for 14 of the 15 MNREAD tests, despite no significant differences in age, gender, or education between groups. Increased contrast (from 10% to 50%) was associated with faster reading speed in patients with glaucoma (10.6-wpm increase per 10% increase in contrast; 95% confidence interval, 7.4-13.8 wpm; P < 0.001; R2 = 0.211). No significant improvement was found in reading speed with increase in font size or line spacing. CONCLUSIONS Patients with glaucoma showed significantly slower reading speeds than similarly aged control participants. Reading speed was improved by increasing contrast, but not by increases in line spacing or font size.
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Affiliation(s)
- Mariana C Ikeda
- Department of Ophthalmology and Visual Science, Glaucoma Service, Federal University of São Paulo, São Paulo, Brazil
| | - Koiti U Hamada
- Department of Ophthalmology and Visual Science, Glaucoma Service, Federal University of São Paulo, São Paulo, Brazil
| | - Andre H Bando
- Department of Ophthalmology and Visual Science, Glaucoma Service, Federal University of São Paulo, São Paulo, Brazil
| | - Vinicius P L Nakamura
- Department of Ophthalmology and Visual Science, Glaucoma Service, Federal University of São Paulo, São Paulo, Brazil
| | - Tiago S Prata
- Department of Ophthalmology and Visual Science, Glaucoma Service, Federal University of São Paulo, São Paulo, Brazil; Glaucoma Unit, Hospital Medicina dos Olhos, Osasco, Brazil; Department of Ophthalmology, Mayo Clinic, Jacksonville, Florida; Department of Ophthalmology, Glaucoma Service, Hospital Oftalmológico de Sorocaba-BOS, Sorocaba, Brazil
| | - Andrew J Tatham
- Princess Alexandra Eye Pavilion and Department of Ophthalmology, University of Edinburgh, Edinburgh, United Kingdom
| | - Augusto Paranhos
- Department of Ophthalmology and Visual Science, Glaucoma Service, Federal University of São Paulo, São Paulo, Brazil
| | - Carolina P B Gracitelli
- Department of Ophthalmology and Visual Science, Glaucoma Service, Federal University of São Paulo, São Paulo, Brazil; Centro de Estudos Alcides Hirai, Ver Mais Oftalmologia, Vinhedo, São Paulo, Brazil.
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Effect of depressive symptom and depressive disorder on glaucoma incidence in elderly. Sci Rep 2021; 11:5888. [PMID: 33723349 PMCID: PMC7961135 DOI: 10.1038/s41598-021-85380-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 02/18/2021] [Indexed: 12/27/2022] Open
Abstract
Although depression and glaucoma share several common pathophysiology, the risk of glaucoma in patients with depression has not been reported. Thus, we investigated the effect of depressive symptom and depressive disorder on glaucoma incidence. In this nationwide population-based cohort study, all subjects receiving the National Screening Program at the age of 66 during 2009-2014 were included. These subjects were divided into depression group and no depression group based on subjective depressive symptoms and clinically diagnosed depressive disorder and were tracked until 2017 for development of glaucoma. Of the 922,769 subjects included in the study, 191,636 (20.77%) subjects were categorized as depression group. Subjects with depression showed increased hazard of developing glaucoma (adjusted HR = 1.12[95% confidence interval (CI), 1.09-1.15]) than those without depression. The risk of glaucoma increased sequentially from those with no depression to those with subjective depressive symptom (adjusted HR = 1.09[95% CI, 1.06-1.13]), those with clinically diagnosed depressive disorder (adjusted HR = 1.23[95% CI, 1.14-1.32]), and those with both subjective depressive symptom and clinically diagnosed depressive disorder (adjusted HR = 1.36[95% CI, 1.22-1.52]). Our analyses suggest that individuals with depression had a greater risk of developing glaucoma than those without depression. Subjective depressive symptoms and clinically diagnosed depressive disorder independently and synergistically increased the risk of glaucoma incidence.
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The Effect of Glaucoma on the Quality of Patient’s Life. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2021. [DOI: 10.2478/sjecr-2020-0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Glaucoma is a chronic, progressive opticopathy with morphological optic disc changes and visual field disturbances. Visual field disturbances change the patient’s life habits. Medical as well as surgical treatments also disturb patients` activities of daily living. According to this, glaucoma is the disease which affects quality of patient’s life (QQL). Visual field (VF) evaluation is very important in glaucoma disease diagnostic process. Location of the VF defects also have an impact on the QOL. Patient`s daily activities, such as walking, low light condition adaptation, peripheral seeing of the objects, can be affected by glaucoma progression and with VF defects. All social, religious, cultural and traveling events are more difficult for the severe glaucomatous patients (MD<-12dB) in comparison with mild glaucomatous, defined as patients with MD > −6 dB. Every day usage of the local antuglaucomatous therapy disturbs patients’ QOL. The side effects of the eye drops can produce burning sensation, bronchospasm, bradycardia, increased iris pigmentation, increased eyelash length. Also, locally applied therapy provokes ocular surface disease. Benzalkonium chloride provokes destruction of the epithelial cells junction with development of the epitheliopathy and ocular surface disease. Surgically treated glaucoma patients can have disturbed QOL due to ocular surface disease symptoms (foreign body sensation, eye pain, redness, and increased tearing). These symptoms are caused by trabeculectomy and they are correlated with filtering bleb existence.To achieve QOL of the glaucomatous patients, different founded instruments are used. They are classified in: general health, vision specific, and glaucoma specific.
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