Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea.
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Ophthalmology. 2023 Jun;130(6):615-623. doi: 10.1016/j.ophtha.2023.01.014. Epub 2023 Jan 27.
To evaluate the prospective association of age-related macular degeneration (AMD) and related visual disability (VD) with the risk of depression.
This nationwide population-based cohort study used authorized clinical data provided by the Korean National Health Insurance Service.
A total of 3 599 589 individuals older than 50 years participated in the Korean National Health Screening Program in 2009.
Age-related macular degeneration diagnosis and the presence of accompanying VD were verified using diagnostic codes and disability registration data. Data on covariates, including age, sex, income level, residential area, systemic comorbidities, and behavioral factors, were collected from health screening results and claims data. Patients were followed up until December 2019, and incident cases of depression were identified using registered diagnostic codes. The prospective association of AMD and related VD with new-onset depression was investigated using the multivariable-adjusted Cox proportional hazard model.
Hazard ratios and 95% confidence intervals (CIs) for depression development according to the presence of AMD and VD.
During an average follow-up period of 8.52 years, 1 037 088 patients received new diagnoses of depression. Patients with previous diagnoses of AMD showed a greater risk of new-onset depression, with a hazard ratio of 1.15 (95% CI, 1.13-1.17) compared with the control group in the fully adjusted model. Patients with AMD and accompanying VD showed a further increased risk of depression, with a hazard ratio of 1.23 (95% CI, 1.16-1.30).
Individuals with a diagnosis of AMD have a higher risk of depression developing in the future. The risk of depression is increased further in patients with AMD who demonstrate VD.
FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
评估年龄相关性黄斑变性（AMD）和相关视力障碍（VD）与抑郁症风险的前瞻性关联。
这是一项全国性基于人群的队列研究，使用韩国国家健康保险服务提供的授权临床数据。
共有 3599589 名 50 岁以上的人参加了 2009 年的韩国国家健康筛查计划。
使用诊断代码和残疾登记数据验证 AMD 的诊断和是否存在伴随的 VD。从健康筛查结果和索赔数据中收集了包括年龄、性别、收入水平、居住区域、系统性合并症和行为因素在内的协变量数据。对患者进行了随访，直至 2019 年 12 月，使用登记的诊断代码确定新发抑郁症病例。使用多变量调整的 Cox 比例风险模型调查 AMD 和相关 VD 与新发抑郁症之间的前瞻性关联。
根据 AMD 和 VD 的存在，抑郁症发展的风险比和 95%置信区间（CI）。
在平均 8.52 年的随访期间，有 1037088 名患者被新诊断为抑郁症。与对照组相比，在完全调整模型中，有既往 AMD 诊断的患者新发抑郁症的风险更高，风险比为 1.15（95%CI，1.13-1.17）。患有 AMD 和伴随 VD 的患者，抑郁症的风险进一步增加，风险比为 1.23（95%CI，1.16-1.30）。
患有 AMD 的个体未来患抑郁症的风险较高。在患有 AMD 且表现出 VD 的患者中，患抑郁症的风险进一步增加。
