School of Medicine, Tzu Chi University, Hualien, Taiwan.
Department of Medical Education, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan.
Sci Rep. 2020 Aug 7;10(1):13421. doi: 10.1038/s41598-020-70285-7.
Cataract is the primary cause of visual impairment and can be corrected by cataract surgery. We investigated the impact of cataract on the risk of depression along with the benefits of cataract surgery. Patients newly diagnosed with cataract by ophthalmologists between 2001 and 2015 were identified from the National Health Insurance Research Database (NHIRD) in Taiwan. Non-cataract individuals were recruited by 1:1 matching for age, sex and index year. After propensity score matching, 233,258 patients in total were included in our study: 116,629 in each of the cataract and non-cataract cohorts. The primary outcome was the new diagnosis of depression by psychiatrists. In a mean follow-up period of 7.8 years, cataract was significantly associated with increased risk of developing depression (adjusted hazard ratio [aHR] = 1.78, 95% confidence interval [CI] 1.70-1.87, p < 0.001). We further divided the cataract cohort into surgery and non-surgery groups. Notably, cataract surgery group was associated with a decreased risk of depression compared with non-surgery patients (aHR = 0.75, 95% CI 0.71-0.79, p < 0.001). Our results emphasise the importance of regular screening for depression among cataract patients and the beneficial effect of cataract surgery in reducing the risk of depression.
白内障是视力损害的主要原因,可以通过白内障手术来矫正。我们研究了白内障对抑郁症风险的影响,以及白内障手术的益处。在台湾的国家健康保险研究数据库(NHIRD)中,我们从 2001 年至 2015 年期间,由眼科医生诊断出患有白内障的患者。通过年龄、性别和索引年的 1:1 匹配,招募了非白内障个体。经过倾向评分匹配后,我们总共纳入了 233258 名患者:白内障组和非白内障组各 116629 名。主要结局是精神科医生新诊断的抑郁症。在平均 7.8 年的随访期间,白内障与发生抑郁症的风险增加显著相关(调整后的危险比[aHR] = 1.78,95%置信区间[CI]1.70-1.87,p < 0.001)。我们进一步将白内障组分为手术组和非手术组。值得注意的是,与非手术患者相比,白内障手术组发生抑郁症的风险降低(aHR = 0.75,95%CI 0.71-0.79,p < 0.001)。我们的研究结果强调了定期对白内障患者进行抑郁症筛查的重要性,以及白内障手术降低抑郁症风险的有益作用。