Minimal depression and vision function in age-related macular degeneration.

OBJECTIVE

To evaluate the impact of minimal depression on subjective and objective vision function measures in age-related macular degeneration (AMD).

DESIGN

Prospective cross-sectional study.

PARTICIPANTS

Two hundred six outpatients with newly diagnosed neovascular AMD in one eye and preexisting AMD in the fellow eye.

METHODS

Structured clinical evaluations of visual acuity (VA), contrast sensitivity, vision function, and depression.

MAIN OUTCOME MEASURES

The 17-item National Eye Institute Visual Function Questionnaire (NEI VFQ 17), Melbourne Low-Vision Index (MLVI), Chronic Disease Score, and Hamilton Depression Rating Scale.

RESULTS

Minimally depressed subjects had significantly worse vision function on both the NEI VFQ 17 and performance-based tasks of the MLVI than nondepressed subjects, independent of severity of VA, contrast sensitivity, and medical status.

CONCLUSIONS

Minimally depressed patients with AMD, who would not be considered depressed according to current diagnostic standards, suffer decrements in vision function that cannot be accounted for by the severity of their eye disease or general medical problems. These data emphasize the need to assess depressive symptoms in research studies that use vision function outcome measures and in clinical practice to identify excess vision-related disability in patients with AMD.