Patients with AMD are at heightened risk of developing depression.

Patients with AMD are at heightened risk of developing depression. Photo: National Eye Institute. Click image to enlarge.

In an effort to evaluate the prospective association of age-related macular degeneration (AMD) and related visual disability with the risk of depression, a recently published study in Ophthalmology found that individuals diagnosed with AMD have a higher risk of developing depression, further amplified if visual disability is involved.

This nationwide population-based cohort study used authorized clinical data provided by the Korean National Health Insurance Service. A total of 3,599,589 individuals over 50 years of age participated in the Korean National Health Screening Program in 2009. AMD diagnosis and the presence of accompanying visual disability were verified using diagnostic codes and disability registration data. Data on covariates, including age, sex, income level, residential area, systemic comorbidities and behavioral factors, were collected from health screening results and claims data. Patients were followed until December 2019, and incident cases of depression were identified using registered diagnostic codes. The prospective association of AMD and related visual disability with new-onset depression was investigated using the multivariable-adjusted Cox proportional hazard model.

During an average follow-up period of 8.52 years, 1,037,088 patients were newly diagnosed with depression. Patients previously diagnosed with AMD had a greater risk of new-onset depression, with a hazard ratio of 1.15 compared with the control group in the fully adjusted model. Patients with AMD and accompanying visual disability had a further increased risk of depression with a hazard ratio of 1.23.

“This nationwide population-based study revealed that AMD diagnosis is an independent risk factor for the future development of depression, and the risk further increases when accompanied by visual disability,” the study authors wrote in their paper. “This study suggests that clinicians should be wary of depressive symptoms when dealing with patients with AMD and visual impairment.”

Hwang S, Kang SW, Kim SJ, et al. Impact of age-related macular degeneration and related visual disability on the risk of depression: a nationwide cohort study. Ophthalmology. January 27, 2023. [Epub ahead of print].