Update on depression and age-related macular degeneration

Abstract

Introduction This review updates the literature on depression in age-related macular degeneration. Purpose of review Treatment for AMD has been revolutionized since the 2004 review of depression and AMD. New data describing the prevalence of depression in AMD, as well as novel interventions for managing depression in AMD, are discussed. Recent findings Depression continues to be prevalent in AMD and new information is available on the pathways by which impaired vision leads to depression. Strategies for the treatment of depression in patients with impaired vision have evolved. Summary AMD is still a major risk factor for depression and people with activity restriction due to vision loss are at greatest risk. An integrated approach to depression management in older adults with impaired vision may be the best course of action.

Understanding the patient’s lived experience of neovascular age-related macular degeneration: a qualitative study

“…16,26 A fear of blindness Living with neovascular ARMD: the patient's story C McCloud and S Lake was pervasive in this study population, and more than one participant felt that death would be preferable to living with the limitations of blindness, which was a finding that resonated with suicide ideation following vision loss described by Casten and Rovner in 2008. 18 Ongoing lifestyle limitations described by the participants of this study were similar to findings of other studies of people with significant vision loss. 27,28 The experience of the anti-VEGF injections for neovascular ARMD had not been studied in detail in the past, and this study has shed light on the burden and anxieties associated with the rigorous and ongoing treatment regime for what is now a chronic lifelong disease.…”

“…In the past qualitative explorations of people's experience of ARMD, generally reported on people with end-stage ARMD, often after significant vision has been lost. 16,17,18 Such studies predated the widespread use of anti-VEGF treatments for neovascular ARMD and were unable to elucidate experiences of people for whom vision loss could be avoided or limited.…”

Experience of Anti-VEGF Treatment and Clinical Levels of Depression and Anxiety in Patients With Wet Age-Related Macular Degeneration

“…However, this finding should be confirmed in further studies conducted on a larger sample size, as our group 1 sample was small and the correlation coefficient we found was significant but weak. Previous literature on this topic is very limited and inconclusive about the frequency of depression in patients at different anti-VEGF treatment stages (9,22,28,34). One possible hypothesis to explain why depression is higher in patients at early stages of treatment is the fact of AMD is 10 often seen as a threatening condition that entails further blindness (50).…”

Depression and experience of vision loss in group of adults in rehabilitation setting: Mixed-methods pilot study

“…Since patients who reported higher levels of depression also had a mean CES-D score of 24, they fulfilled the CES criteria for clinical depression. According to previous research [20][21], depression following vision loss often represents an additional source of disability or barrier to functioning. Therefore, patients' extended rehabilitation time may possibly be explained by the negative effect that depression can have on patients' functioning levels and rehabilitation outcomes.…”

“…Unfortunately, depression following irreversible vision loss in elderly individuals is associated with poor general functioning [11][12][13][14], long-term emotional distress [1,3], problems with well-being [15][16], poor quality of life [17][18], and problems in health and social participation [19]. In fact, some studies have reported that depression following vision loss represents a secondary source of disability [20][21].…”