Association Between Anxiety, Depression, and Severity of Diabetic Retinopathy

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D. Olson, A. Zhang, Ophthalmology, University of North Carolina, Chapel Hill, North Carolina, UNITED STATES|P. Le, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, UNITED STATES|T. Vu, University of North Carolina, Chapel Hill, North Carolina, UNITED STATES|E. Van Buren, F. Lin, Biostatistics, University of North Carolina, Chapel Hill, North Carolina, UNITED STATES|

Tag(s) 2020 Annual Meeting, CL: Clinical / Epidemiologic Research, Scientific presentation

Association Between Anxiety, Depression, and Severity of Diabetic Retinopathy

Description

Purpose:
Associations between diabetic retinopathy and presence of anxiety and depression are inconsistent and controversial in the literature. The aim of this retrospective cohort study is to determine associations between diabetic retinopathy severity and psychological comorbidities of anxiety and depression.
Methods:
A retrospective study including 95,575 subjects age 18 and older with eye exams on record was performed. Subjects were identified with diagnoses of diabetic retinopathy, anxiety, depression, and any combination of these diseases between July 2008-July 2017 using ICD-9 and ICD-10 codes. Subjects were stratified by gender and age. Odds ratios (OR) were calculated for subjects with anxiety and/or depression in subjects with diabetic retinopathy while adjusting for age. Subjects were then stratified by disease severity. Sub-analysis was performed comparing the prevalence of anxiety and/or depression in subjects with diabetic retinopathy with and without cystoid macular edema.
Results:
Of the 95,575 subjects reviewed, 54,617 (57.1%) were female and 22,454 (23.5%) were diagnosed with diabetes mellitus, 17,972 (18.8%) with anxiety, 20,052 (21.0%) with depression, and 4,315 (4.5%) with diabetic retinopathy. Of the subjects with diabetic retinopathy, 1,334 (30.9%) were documented to have diabetic macular edema. ORs were calculated for subjects with anxiety and mild NPDR (OR 1.381; CI 1.171,1.628; p<0.001), moderate NPDR (OR 0.898, CI 0.664, 1.215; p<0.001), severe NPDR (OR 1.399, CI 0.860, 2.273; p<0.001), and PDR (OR 0.956, CI 0.830, 1.101; p<0.001), respectively. OR were also calculated for subjects with depression and mild NPDR (OR 1.840, CI 1.585, 2.136; p<0.001), moderate NPDR (OR 1.452, CI 1.128, 1.870; p<0.001), severe NPDR (OR 1.984, CI 1.281, 3.074; p<0.001), and PDR (OR 1.410, CI 1.249, 1.591; p<0.001).
Conclusions:
In this study, patients with all levels of diabetic retinopathy are more likely to have depression although there was no linear correlation between the severity of disease and presence of depression. There was no significant correlation between severity of diabetic retinopathy and anxiety. Male patients with diabetic retinopathy are more likely to have depression, and younger patients were more likely to have anxiety, depression or both.

Daniel Olson: Commercial Relationship: Code N (No Commercial Relationship) | Patrick Le: Commercial Relationship: Code N (No Commercial Relationship) | Thoai Vu: Commercial Relationship: Code N (No Commercial Relationship) | Eric Van Buren: Commercial Relationship: Code N (No Commercial Relationship) | Feng-Chang Lin: Commercial Relationship: Code N (No Commercial Relationship) | Alice Zhang: Commercial Relationship: Code N (No Commercial Relationship)