Glaucoma Facility, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, New Delhi, India.
Ophthalmologica. 2011;226(3):157-60. doi: 10.1159/000328585. Epub 2011 Aug 10.
It was the aim of this study to evaluate the prevalence of major depressive disorder (MDD) in chronic glaucoma patients on a topical β-blocker (timolol).
An observational case control study was performed.
The subjects recruited were divided into 3 groups. Group I included 98 patients with chronic glaucoma on topical β-blocker therapy, group II included 64 chronic glaucoma patients on prostaglandin analogues, and group III included 150 normal controls. All subjects were screened for MDD by the self-administered questionnaire Prime-MD Today (Primary Care Evaluation of Mental Disorders, New York, N.Y., USA).
The control group had a significantly higher age (p < 0.001) compared to the glaucoma patients on timolol or prostaglandin analogues; 9/98 patients (9.2%) on timolol, 1/64 patients (1.5%) on prostaglandins and 3/150 (2%) control subjects were screened positive for MDD. The odds ratios adjusted for age, sex and duration of glaucoma showed that patients on β-blocker therapy were 6.4 and 4.9 times more likely to have depression compared to those on prostaglandin analogues and control subjects, respectively.
Glaucoma patients on topical timolol should be screened for depression and referred for appropriate psychiatric consultation and treatment if indicated.
本研究旨在评估慢性青光眼患者在使用局部β受体阻滞剂（噻吗洛尔）治疗时出现重度抑郁症（MDD）的患病率。
本研究采用观察性病例对照研究。
招募的受试者被分为 3 组。第 I 组包括 98 例接受局部β受体阻滞剂治疗的慢性青光眼患者，第 II 组包括 64 例接受前列腺素类似物治疗的慢性青光眼患者，第 III 组包括 150 例正常对照者。所有受试者均通过自我管理问卷 Prime-MD Today（纽约州纽约市初级保健评估精神障碍，Primary Care Evaluation of Mental Disorders, New York, N.Y., USA）进行 MDD 筛查。
对照组的年龄明显高于噻吗洛尔或前列腺素类似物组的青光眼患者（p < 0.001）；9/98 例（9.2%）使用噻吗洛尔的患者、1/64 例（1.5%）使用前列腺素的患者和 3/150 例（2%）对照组受试者的 MDD 筛查呈阳性。调整年龄、性别和青光眼持续时间后的优势比表明，使用β受体阻滞剂治疗的患者与使用前列腺素类似物和对照组患者相比，发生抑郁的可能性分别增加了 6.4 倍和 4.9 倍。
应筛查使用局部噻吗洛尔的青光眼患者是否患有抑郁，并在必要时转介给适当的精神科会诊和治疗。
