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Cited by 126Ophthalmology and Visual Impairment StudiesAging, Health, and DisabilityMental Health Treatment and Access

Association Between Visual Impairment and Depression in Patients Attending Eye Clinics: A Meta-analysis

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Parravano, Mariacristina, Petri, Davide, Maurutto, Erica, Lucenteforte, Ersilia, Menchini, Francesca, Lanzetta, Paolo, Varano, Monica, van Nispen, Ruth M. A. +1 more·2021·JAMA Ophthalmology
DOI 10.1001/jamaophthalmol.2021.1557PMC PMC8160932
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Abstract

IMPORTANCE: Given that depression is treatable and some ocular diseases that cause visual loss are reversible, early identification and treatment of patients with visual impairment who are most at risk of depression may have an important influence on the well-being of these patients. OBJECTIVE: To conduct a meta-analysis on the prevalence of depression in patients with visual impairment who regularly visit eye clinics and low vision rehabilitation services. DATA SOURCES: MEDLINE (inception to June 7, 2020) and Embase (inception to June 7, 2020) were searched. STUDY SELECTION: Studies that obtained data on the association between acquired visual impairment and depression among individuals aged 18 years or older were identified and included in this review. Exclusion criteria comprised inherited or congenital eye diseases, review studies, unpublished articles, abstracts, theses, dissertations, and book chapters. Four independent reviewers analyzed the results of the search and performed the selection and data extraction to ensure accuracy. DATA EXTRACTION AND SYNTHESIS: Meta-analyses of prevalence were conducted using random-intercept logistic regression models. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MAIN OUTCOMES AND MEASURES: Proportion of depression. RESULTS: A total of 27 studies were included in this review, and all but 2 included patients older than 65 years. Among 6992 total patients (mean [SD] age, 76 [13.9] years; 4195 women [60%]) with visual impairment, in 1687 patients with depression, the median proportion of depression was 0.30 (range, 0.03-0.54). The random-effects pooled estimate was 0.25 (95% CI, 0.19-0.33) with high heterogeneity (95% predictive interval, 0.05-0.70). No patient characteristic, measured at the study level, influenced the prevalence of depression, except for the inclusion of patients with cognitive impairment (0.33; 95% CI, 0.28-0.38 in 14 studies vs 0.18; 95% CI, 0.11-0.30 in 13 studies that excluded this with major comorbidities; P = .008). The prevalence of depression was high both in clinic-based studies (in 6 studies, 0.34; 95% CI, 0.23-0.47) and in rehabilitation services (in 18 studies, 0.25; 95% CI, 0.18-0.33 vs other settings in 3 studies, 0.15; 95% CI, 0.05-0.38; P = .17), and did not vary by visual impairment severity of mild (in 8 studies, 0.24; 95% CI, 0.14-0.38), moderate (in 10 studies, 0.29; 95% CI, 0.21-0.39), and severe (in 5 studies, 0.29; 95% CI, 0.12-0.56; P = .51). CONCLUSIONS AND RELEVANCE: The results of this meta-analysis suggest that depression in patients with visual impairment is a common problem that should be recognized and addressed by the health care professionals treating these patients.

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  • Non-ophthalmological health care resources were not consistently accounted for, thus potentially underestimating health care resource use and costs amongst patients prone to falls and depression.

    “Non-ophthalmological health care resources were not consistently accounted for, thus potentially underestimating health care resource use and costs amongst patients prone to falls and depression [64–66].”

    From The economic impact of retinal diseases for which gene therapy is emerging: a systematic literature review (2025) · cites this paper as [66]

    The Discussion reports that depression in adults with visual impairment is often overlooked, but it does not discuss accounting for non-ophthalmological health care resources. Searches for resource use, costs, falls, and underestimation found no passage assessing whether omitted resources led to underestimated use or costs. Page numbers were unavailable in the indexed copy. (LLM, conf=0.76)

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Research works printed but not linked: 1

  1. King E, Gilson S, Peveler R. Psychosocial needs o felderlyvisuallyimpairedpatients:pilotstudyofpatients' perspectives. Prim Care Ment Heal. 2006;4:185-197.

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Authors
Parravano, M., Petri, D., Maurutto, E., Lucenteforte, E., Menchini, F., Lanzetta, P., Varano, M., van Nispen, R. M. A., & Virgili, G.
Affiliations
  • Fondazione G.B. Bietti (IT)
  • University of Pisa (IT)
  • University of Udine (IT)
  • Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Ophthalmology, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
  • Queen's University Belfast (GB)
Corresponding author
Parravano, Mariacristina
ORCID
Venue
JAMA Ophthalmology
Publisher
American Medical Association (AMA)
Published
2021-07-01
Volume
139
Issue
7
Pages
753
ISSN
2168-6165 (ISSN-L)
DOI
10.1001/jamaophthalmol.2021.1557
PMC
PMC8160932
OpenAlex
W3164557379
Cited by
126
References
76
Citations by year
2026: 32 · 2025: 35 · 2024: 31 · 2023: 11 · 2022: 16 · 2021: 1
FWCI
2.25
Type
journal article
Language
en
Open access
Locations
  • JAMA Ophthalmology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion, other-oa)
  • Institutional Research Information System (University of Udine) (submittedVersion)
  • CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
  • Florence Research (University of Florence) (submittedVersion)
  • Research Portal (Queen's University Belfast) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Epidemiology › Ophthalmology and Visual Impairment Studies
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
depression, visual impairment, acquired visual impairment, eye clinic patients, low vision rehabilitation, depression prevalence, cognitive impairment, comorbidities, older adults, depression screening, early detection of depression, eye diseases, vision loss, patient well-being, quality of life, risk factors for depression
MeSH terms
Aged, Depression, Female, Humans, Male, Vision Disorders, Vision, Low, Comorbidity, Cognitive Dysfunction

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