TY - JOUR
T1 - Association between Visual Impairment and Depression in Patients Attending Eye Clinics: A Meta-analysis
T2 - A Meta-analysis
AU - Parravano, Mariacristina
AU - Petri, Davide
AU - Maurutto, Erica
AU - Lucenteforte, Ersilia
AU - Menchini, Francesca
AU - Lanzetta, Paolo
AU - Varano, Monica
AU - van Nispen, Ruth M. A.
AU - Virgili, Gianni
N1 - Funding Information: reported receiving personal fees from Allergan, Novartis, Bayer, and Zeiss outside the submitted work. Dr Varano reported receiving personal fees from Allergan, Novartis, Bayer, Biogen, and Sifi, all for work on the advisory board. Dr van Nispen reported receiving consultation fees from MeiraGTx UK II Ltd and grants from Bayer BV for investigator-initiated research outside the submitted work. Dr Menchini reported receiving personal fees from Novartis Pharma AG. Dr Lanzetta reported serving as a consultant to Allergan, Bayer, Centervue, Novartis, and Roche outside the submitted work. No other disclosures were reported. Funding Information: Funding/Support: This work was supported in part by the Italian Ministry of Health and Fondazione Roma under the Aging Network of Italian Research Hospitals. Publisher Copyright: © 2021 American Medical Association. All rights reserved. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/7
Y1 - 2021/7
N2 - Importance: Given that depression is treatable and some ocular diseases that cause visual loss are reversible, early identification and treatment of patients with visual impairment who are most at risk of depression may have an important influence on the well-being of these patients. Objective: To conduct a meta-analysis on the prevalence of depression in patients with visual impairment who regularly visit eye clinics and low vision rehabilitation services. Data Sources: MEDLINE (inception to June 7, 2020) and Embase (inception to June 7, 2020) were searched. Study Selection: Studies that obtained data on the association between acquired visual impairment and depression among individuals aged 18 years or older were identified and included in this review. Exclusion criteria comprised inherited or congenital eye diseases, review studies, unpublished articles, abstracts, theses, dissertations, and book chapters. Four independent reviewers analyzed the results of the search and performed the selection and data extraction to ensure accuracy. Data Extraction and Synthesis: Meta-analyses of prevalence were conducted using random-intercept logistic regression models. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Main Outcomes and Measures: Proportion of depression. Results: A total of 27 studies were included in this review, and all but 2 included patients older than 65 years. Among 6992 total patients (mean [SD] age, 76 [13.9] years; 4195 women [60%]) with visual impairment, in 1687 patients with depression, the median proportion of depression was 0.30 (range, 0.03-0.54). The random-effects pooled estimate was 0.25 (95% CI, 0.19-0.33) with high heterogeneity (95% predictive interval, 0.05-0.70). No patient characteristic, measured at the study level, influenced the prevalence of depression, except for the inclusion of patients with cognitive impairment (0.33; 95% CI, 0.28-0.38 in 14 studies vs 0.18; 95% CI, 0.11-0.30 in 13 studies that excluded this with major comorbidities; P =.008). The prevalence of depression was high both in clinic-based studies (in 6 studies, 0.34; 95% CI, 0.23-0.47) and in rehabilitation services (in 18 studies, 0.25; 95% CI, 0.18-0.33 vs other settings in 3 studies, 0.15; 95% CI, 0.05-0.38; P =.17), and did not vary by visual impairment severity of mild (in 8 studies, 0.24; 95% CI, 0.14-0.38), moderate (in 10 studies, 0.29; 95% CI, 0.21-0.39), and severe (in 5 studies, 0.29; 95% CI, 0.12-0.56; P =.51). Conclusions and Relevance: The results of this meta-analysis suggest that depression in patients with visual impairment is a common problem that should be recognized and addressed by the health care professionals treating these patients.
AB - Importance: Given that depression is treatable and some ocular diseases that cause visual loss are reversible, early identification and treatment of patients with visual impairment who are most at risk of depression may have an important influence on the well-being of these patients. Objective: To conduct a meta-analysis on the prevalence of depression in patients with visual impairment who regularly visit eye clinics and low vision rehabilitation services. Data Sources: MEDLINE (inception to June 7, 2020) and Embase (inception to June 7, 2020) were searched. Study Selection: Studies that obtained data on the association between acquired visual impairment and depression among individuals aged 18 years or older were identified and included in this review. Exclusion criteria comprised inherited or congenital eye diseases, review studies, unpublished articles, abstracts, theses, dissertations, and book chapters. Four independent reviewers analyzed the results of the search and performed the selection and data extraction to ensure accuracy. Data Extraction and Synthesis: Meta-analyses of prevalence were conducted using random-intercept logistic regression models. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Main Outcomes and Measures: Proportion of depression. Results: A total of 27 studies were included in this review, and all but 2 included patients older than 65 years. Among 6992 total patients (mean [SD] age, 76 [13.9] years; 4195 women [60%]) with visual impairment, in 1687 patients with depression, the median proportion of depression was 0.30 (range, 0.03-0.54). The random-effects pooled estimate was 0.25 (95% CI, 0.19-0.33) with high heterogeneity (95% predictive interval, 0.05-0.70). No patient characteristic, measured at the study level, influenced the prevalence of depression, except for the inclusion of patients with cognitive impairment (0.33; 95% CI, 0.28-0.38 in 14 studies vs 0.18; 95% CI, 0.11-0.30 in 13 studies that excluded this with major comorbidities; P =.008). The prevalence of depression was high both in clinic-based studies (in 6 studies, 0.34; 95% CI, 0.23-0.47) and in rehabilitation services (in 18 studies, 0.25; 95% CI, 0.18-0.33 vs other settings in 3 studies, 0.15; 95% CI, 0.05-0.38; P =.17), and did not vary by visual impairment severity of mild (in 8 studies, 0.24; 95% CI, 0.14-0.38), moderate (in 10 studies, 0.29; 95% CI, 0.21-0.39), and severe (in 5 studies, 0.29; 95% CI, 0.12-0.56; P =.51). Conclusions and Relevance: The results of this meta-analysis suggest that depression in patients with visual impairment is a common problem that should be recognized and addressed by the health care professionals treating these patients.
UR - http://www.scopus.com/inward/record.url?scp=85107378371&partnerID=8YFLogxK
U2 - https://doi.org/10.1001/jamaophthalmol.2021.1557
DO - https://doi.org/10.1001/jamaophthalmol.2021.1557
M3 - Review article
C2 - 34042966
SN - 2168-6165
VL - 139
SP - 753
EP - 761
JO - JAMA ophthalmology
JF - JAMA ophthalmology
IS - 7
ER -