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Manners S, Meuleners LB, Ng JQ, Wood JM, Morgan B, Morlet N. Visual field loss and falls requiring hospitalisation: results from the eFOVID study. Age Ageing 2024; 53:afae191. [PMID: 39228096 PMCID: PMC11371543 DOI: 10.1093/ageing/afae191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND Visual fields are important for postural stability and ability to manoeuvre around objects. OBJECTIVE Examine the association between visual field loss and falls requiring hospitalisation in adults aged 50 +. METHODS Older adults aged 50+ with and without visual field loss were identified using a fields database obtained from a cross-section of ophthalmologists' practices in Western Australia (WA). Data were linked to the Hospital Morbidity Data Collection and WA Hospital Mortality System to identify participants who experienced falls-related hospitalisations between 1990 and 2019. A generalised linear negative binomial regression model examined the association between falls requiring hospitalisation for those with and without field loss, based on the better eye mean deviation (mild: -2 to -6 dB, moderate: -6.01 dB to -12 dB, severe < -12.01 dB) in the most contemporaneous visual field test (3 years prior or if not available, 2 years after the fall), after adjusting for potential confounders. RESULTS A total of 31 021 unique individuals of whom 6054 (19.5%) experienced 11 818 falls requiring hospitalisation during a median observation time of 14.1 years. Only mean deviation index of <-12.01 dB (severe) was significantly associated with an increased rate of falls requiring hospitalisations by 14% (adjusted IRR 1.14, 95% CI 1.0-1.25) compared with no field loss, after adjusting for potential confounders. Other factors included age, with those aged 80+ having an increased rate (IRR 29.16, 95% CI 21.39-39.84), other comorbid conditions (IRR 1.49, 95% CI 1.38-1.60) and diabetes (IRR 1.25, 95% CI 1.14-1.37). Previous cataract surgery was associated with a decreased rate of falls that required hospitalisations by 13% (IRR 0.87, 95% CI 0.81-0.95) compared with those who did not have cataract surgery. CONCLUSION The findings highlight the importance of continuous clinical monitoring of visual field loss and injury prevention strategies for older adults with visual field loss.
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Affiliation(s)
- Siobhan Manners
- School of Population and Global Health, The University of Western Australia, Clifton Street Building, Clifton Street, Nedlands 6009, Australia
| | - Lynn B Meuleners
- Western Australian Centre for Road Safety, School of Psychology, The University of Western Australia, Nedlands, Australia
| | - Jonathon Q Ng
- School of Population and Global Health, The University of Western Australia, Clifton Street Building, Clifton Street, Nedlands 6009, Australia
| | - Joanne M Wood
- School of Optometry and Vision Science, Queensland University of Technology, Nedlands, Australia
| | | | - Nigel Morlet
- School of Population and Global Health, The University of Western Australia, Clifton Street Building, Clifton Street, Nedlands 6009, Australia
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Dhawale KK, Tidake P. Cataract Surgery and Mental Health: A Comprehensive Review on Outcomes in the Elderly. Cureus 2024; 16:e65469. [PMID: 39188457 PMCID: PMC11346754 DOI: 10.7759/cureus.65469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Accepted: 07/26/2024] [Indexed: 08/28/2024] Open
Abstract
Cataract surgery is a widely performed and highly effective procedure that significantly improves vision in elderly patients. This narrative review examines the impact of cataract surgery on mental health outcomes in the elderly, focusing on conditions such as depression, anxiety, and cognitive decline. The review highlights the prevalence of cataracts in older adults and the importance of mental health in this demographic, emphasizing the interconnectedness of visual and mental health. Improved vision following cataract surgery has been associated with enhanced quality of life, increased independence, and better psychological well-being. Mechanisms linking visual improvement to mental health benefits include biological pathways, psychosocial factors, and overall health improvements. However, socioeconomic factors, access to healthcare, and patient education play crucial roles in achieving positive outcomes. This review also compares cataract surgery with other interventions, providing a cost-benefit analysis and discussing the long-term sustainability of mental health benefits. Practice recommendations include pre-surgical mental health screening, integrative care approaches, and guidelines for postoperative care focusing on mental health. The review concludes with suggestions for future research to further explore the relationship between cataract surgery and mental health in the elderly, aiming to enhance clinical practice and public health strategies.
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Affiliation(s)
- Kasturi K Dhawale
- Ophthalmology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pravin Tidake
- Ophthalmology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Wang S, Du Z, Lai C, Seth I, Wang Y, Huang Y, Fang Y, Liao H, Hu Y, Yu H, Zhang X. The association between cataract surgery and mental health in older adults: a review. Int J Surg 2024; 110:2300-2312. [PMID: 38668662 PMCID: PMC11020056 DOI: 10.1097/js9.0000000000001105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/08/2024] [Indexed: 04/29/2024]
Abstract
BACKGROUND Although cataract surgery has been proposed as a potentially modifiable protective factor for enhancing emotional well-being in cataract patients, studies examining the relationship between anxiety or depression and cataract surgery have yielded inconsistent findings. This review summarizes existing evidence to establish whether cataract surgery is associated with depression and anxiety in older adults. METHODS A literature search was conducted across PubMed, Medline, Web of Science, and Embase databases. An initial screening by abstracts and titles was performed, followed by a review and assessment of the methodological quality of the relevant full papers, and final inclusion of 44 studies were deemed eligible for inclusion in this review. RESULTS Among 44 included studies, 36 studies (81.8%) were observational studies concerning the association of cataract surgery or cataracts with anxiety or depression, four studies (9.1%) were interventional studies, and four studies (9.1%) were reviews. Cataract surgery notably enhances the mental health of individuals with impaired vision. However, the multifaceted nature of psychological well-being, influenced by various factors, suggests that cataract surgery may not address all aspects comprehensively. Additionally, preoperative anxiety and depression significantly impact cataract surgery outcomes. CONCLUSION Vision impairment in older adults is closely associated with increased symptoms of depression and anxiety. While surgical intervention for cataracts improves these symptoms, it might be less effective for mental disorders with multifactorial causes. Notably, anxiety or depression poses challenges to successful preoperative and intraoperative cataract surgeries.
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Affiliation(s)
- Shan Wang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Zijing Du
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Chunran Lai
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Ishith Seth
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia
| | - Yaxin Wang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Yu Huang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People’s Republic of China
| | - Ying Fang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Huiyi Liao
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Yijun Hu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
| | - Honghua Yu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
- Guangdong Provincial Key Laboratory of Artificial Intelligence in Image Analysis and Application, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences
| | - Xiayin Zhang
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, People’s Republic of China
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Widaeus M, Hertzberg D, Hallqvist L, Bell M. Risk factors for new antidepressant use after surgery in Sweden: a nationwide, observational cohort study. BJA OPEN 2023; 7:100218. [PMID: 37638080 PMCID: PMC10457487 DOI: 10.1016/j.bjao.2023.100218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 06/21/2023] [Indexed: 08/29/2023]
Abstract
Background Whilst somatic complications after major surgery are being increasingly investigated, the research field has scarce data on psychiatric outcomes such as postoperative depression. This study evaluates the impact of patient and surgical factors on the risk of depression after surgery using the proxy measure of prescribed and collected antidepressants. Methods An observational, registry-based, national multicentre cohort study of individuals ≥18 yr of age who underwent noncardiac surgery between 2007 and 2014. Exclusion criteria included history of antidepressant use defined by collection of a prescription within 5 yr before surgery. Participants were identified using a surgical database from 23 Swedish hospitals and data were linked to National Board of Health and Welfare registers for collection of prescribed antidepressants. Descriptive statistics were used for baseline data and logistic regression for predictive factors. Results Of 223 617 patients, 4.9% had a new prescription of antidepressants collected 31-365 days after surgery. Antidepressant prescription was associated with increasing age, female sex, and more comorbidities. The incidence of antidepressant prescription was highest after neurosurgery, vascular, and thoracic surgery. Affective and anxiety disorders were risk factors. In the whole cohort and within the aforementioned surgical subtypes, acute and cancer surgery increased the risk of antidepressant prescription. Conclusions This study brings novel insights to the epidemiology of postoperative antidepressant treatment in antidepressant-naive patients. One in 20 postoperative patients are prescribed antidepressants but with knowledge of risk factors, interventional strategies can be tested.
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Affiliation(s)
- Matilda Widaeus
- Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
| | - Daniel Hertzberg
- Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Linn Hallqvist
- Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Max Bell
- Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
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Karesvuo M, Kanclerz P, Hecht I, Achiron A, Tuuminen R. Association of clear vs blue-light filtering intraocular lenses with mental and behavioral disorders and diseases of the nervous system among patients receiving bilateral cataract surgery. J Cataract Refract Surg 2023; 49:679-685. [PMID: 36940191 PMCID: PMC10284132 DOI: 10.1097/j.jcrs.0000000000001184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 02/26/2023] [Accepted: 03/08/2023] [Indexed: 03/21/2023]
Abstract
PURPOSE To analyze new-onset mental and behavioral disorders and nervous system diseases in patients with cataract implanted with either non-blue-light filtering (BLF) or BLF intraocular lenses (IOLs) in both eyes. SETTING Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka, Finland. DESIGN A retrospective registry-based cohort study of patients operated between September 2007 and December 2018 who were followed until December 2021. We included 4986 patients who underwent bilateral cataract surgery. METHODS Patients were implanted with either non-BLF IOLs (N = 2609) or BLF IOLs (N = 2377) in both eyes. Follow-up before the first-eye surgery and between the first-eye and the second-eye surgery was performed to acknowledge the preexisting disorders and diseases. After the second-eye surgery, the groups were analyzed for the new-onset mental and behavioral disorders and diseases of the nervous system subcategorized by the International Classification of Diseases codes. RESULTS 1707 male and 3279 female patients, aged 73.2 ± 8.6 years at the first-eye surgery and 74.3 ± 8.8 years at the second-eye surgery, were identified. In univariate log-rank tests, the use of BLF IOLs showed no association in overall new-onset disorders or diseases over non-BLF IOLs, in any subtype diagnosis codes except for sleep disorders, which favored BLF IOLs ( P = .003). A multivariate analysis adjusted for age and sex identified no associations in any new-onset disorders or diseases. Multivariate analysis of sleep disorders showed a nonsignificant advantage for BLF-IOLs (hazard ratio 0.756, 95% CI 0.534-1.070, P = .114). CONCLUSIONS BLF IOLs were not associated with mental and behavioral disorders or diseases of the nervous system.
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Affiliation(s)
- Minna Karesvuo
- From the Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland (Karesvuo, Kanclerz, Hecht, Tuuminen); Health Services Dental Care, City of Helsinki, Helsinki, Finland (Karesvuo); Hygeia Clinic, Gdańsk, Poland (Kanclerz); Department of Ophthalmology, Shamir Medical Center, Tel Aviv, Israel (Hecht); Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (Hecht, Achiron); Tel Aviv Sourasky Medical Center, Tel Aviv, Israel (Achiron); Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka, Finland (Tuuminen)
| | - Piotr Kanclerz
- From the Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland (Karesvuo, Kanclerz, Hecht, Tuuminen); Health Services Dental Care, City of Helsinki, Helsinki, Finland (Karesvuo); Hygeia Clinic, Gdańsk, Poland (Kanclerz); Department of Ophthalmology, Shamir Medical Center, Tel Aviv, Israel (Hecht); Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (Hecht, Achiron); Tel Aviv Sourasky Medical Center, Tel Aviv, Israel (Achiron); Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka, Finland (Tuuminen)
| | - Idan Hecht
- From the Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland (Karesvuo, Kanclerz, Hecht, Tuuminen); Health Services Dental Care, City of Helsinki, Helsinki, Finland (Karesvuo); Hygeia Clinic, Gdańsk, Poland (Kanclerz); Department of Ophthalmology, Shamir Medical Center, Tel Aviv, Israel (Hecht); Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (Hecht, Achiron); Tel Aviv Sourasky Medical Center, Tel Aviv, Israel (Achiron); Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka, Finland (Tuuminen)
| | - Asaf Achiron
- From the Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland (Karesvuo, Kanclerz, Hecht, Tuuminen); Health Services Dental Care, City of Helsinki, Helsinki, Finland (Karesvuo); Hygeia Clinic, Gdańsk, Poland (Kanclerz); Department of Ophthalmology, Shamir Medical Center, Tel Aviv, Israel (Hecht); Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (Hecht, Achiron); Tel Aviv Sourasky Medical Center, Tel Aviv, Israel (Achiron); Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka, Finland (Tuuminen)
| | - Raimo Tuuminen
- From the Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland (Karesvuo, Kanclerz, Hecht, Tuuminen); Health Services Dental Care, City of Helsinki, Helsinki, Finland (Karesvuo); Hygeia Clinic, Gdańsk, Poland (Kanclerz); Department of Ophthalmology, Shamir Medical Center, Tel Aviv, Israel (Hecht); Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (Hecht, Achiron); Tel Aviv Sourasky Medical Center, Tel Aviv, Israel (Achiron); Department of Ophthalmology, Kymenlaakso Central Hospital, Kotka, Finland (Tuuminen)
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Zhao X, Wei K, Sun J, Chen J, Wang Y, Chen Y, Zhu X, Sun X, Li T, Zhou M. Association between previous cataract surgery and cognition among middle-aged and older Chinese: the China health and retirement longitudinal study (CHARLS). BMC Ophthalmol 2023; 23:243. [PMID: 37259095 DOI: 10.1186/s12886-023-02998-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 05/25/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Cataract is the primary cause of blindness globally, and surgery offers the only method by which to remove cataracts. We aimed to examine whether previous cataract surgery is associated with cognitive function. METHODS Our study included 13,824 participants. Data from the baseline of the China Health and Retirement Longitudinal Study (CHARLS) were used. The participants were categorized into two groups: with and without previous cataract surgery. Weighted multiple linear regression was used to obtain the β and 95% confidence intervals (CI). RESULTS The participants who had previous cataract surgery (n = 261) scored lower in cognition, including both memory and mental state, than those without previous cataract surgery. After adjusting for socioeconomic factors and metabolic measures, a negative association was evident between previous cataract surgery and cognition (β = -0.647, 95% CI: -1.244, - 0.049). Furthermore, the participants who were older and female demonstrated a decline in cognition, while living in cities and having higher levels education were associated with higher cognition. CONCLUSIONS Better cognitive function was associated with less previous cataract surgery or cataract occurrence. This suggests that a period of vision loss due to cataract leads to cognitive decline, however further studies are need to dissect the impact of vision loss and cataract surgery on cognitive decline.
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Affiliation(s)
- Xiaohuan Zhao
- Department of Ophthalmology, Shanghai General Hospital, Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
| | - Kunchen Wei
- Department of Plastic and Reconstructive Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Junran Sun
- Department of Ophthalmology, Shanghai General Hospital, Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
| | - Jieqiong Chen
- Department of Ophthalmology, Shanghai General Hospital, Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
| | - Yimin Wang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
| | - Yuhong Chen
- Department of Ophthalmology, Shanghai General Hospital, Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
| | - Xinyue Zhu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
| | - Xiaodong Sun
- Department of Ophthalmology, Shanghai General Hospital, Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
| | - Tong Li
- Department of Ophthalmology, Shanghai General Hospital, Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- National Clinical Research Center for Eye Diseases, Shanghai, China.
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China.
| | - Minwen Zhou
- Department of Ophthalmology, Shanghai General Hospital, Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- National Clinical Research Center for Eye Diseases, Shanghai, China.
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China.
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Mencucci R, Stefanini S, Favuzza E, Cennamo M, De Vitto C, Mossello E. Beyond vision:Cataract and health status in old age, a narrative review. Front Med (Lausanne) 2023; 10:1110383. [PMID: 37007780 PMCID: PMC10061098 DOI: 10.3389/fmed.2023.1110383] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/24/2023] [Indexed: 03/18/2023] Open
Abstract
Cataract is a leading cause of visual impairment in old age. Lens opacification is notoriously associated with several geriatric conditions, including frailty, fall risk, depression and cognitive impairment. The association is largely attributable to visual impairment, while other mechanisms, associated with extraocular comorbidity and lifestyle, might partly explain this correlation. Available literature suggests that cataract surgery may be effective in decreasing fall risk, improving depressive symptoms and limiting the risk of cognitive impairment and dementia incidence, although intervention studies on these outcomes are still limited. In this review we also emphasize the need to move from the concept of visual acuity to functional vision, especially in the context of the geriatric patient. Research is needed regarding the effect on the cited outcomes of different cataract treatment strategies, such as systematic bilateral versus monolateral surgery and use of different intraocular lenses.
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Affiliation(s)
- Rita Mencucci
- Eye Clinic, Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
- *Correspondence: Rita Mencucci,
| | - Simone Stefanini
- Eye Clinic, Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Eleonora Favuzza
- Eye Clinic, Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Michela Cennamo
- Eye Clinic, Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Chiara De Vitto
- Eye Clinic, Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | - Enrico Mossello
- Division of Geriatric and Intensive Care Medicine, Azienda Ospedaliero Universitaria Careggi, and Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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Wang YX, Kang GJ, Zhou J, Chen Y, Peng ZH. The Effect of Psychological Intervention on the Visual Quality of Patients with a Diffractive Multifocal Intraocular Lens Implant. Klin Monbl Augenheilkd 2023; 240:697-704. [PMID: 36216355 DOI: 10.1055/a-1957-8114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE This study aimed to investigate the effect of psychological intervention on the visual quality of patients with a diffractive multifocal intraocular lens implant and its possible mechanism. METHODS Eighty-nine patients undergoing age-related cataract surgery were enrolled in the study at the Affiliated Hospital of Southwest Medical University between December 2015 and July 2017. They were randomly divided into two groups: multiple focus M1 group (n = 45) and multiple focus M2 group (n = 40). The M1 group was only given routine preoperative health education, treatment, and evaluation, while the M2 group also received psychological intervention. RESULTS After treatment, there was no statistical difference in the uncorrected distance and near visual acuity, corrected distance and near visual acuity, or the vision and near removal rate in either of the two groups (p > 0.05). However, postoperative glare was lower in the M2 group (p < 0.05), and patient satisfaction was higher in the M2 group (p < 0.05). The M2 group had a more obvious improvement in the Symptom Checklist-90 score (p < 0.05), the serum interleukin-6 (IL-6) was lower, and the serum brain-derived neurotrophic factor (BDNF) was higher in the M2 group (p < 0.05). In addition, serum IL-6 had a negative correlation with the depression score, and serum BDNF also showed a negative correlation with the anxiety score (p < 0.05). CONCLUSIONS Psychological intervention improved the stress state of patients with age-related cataracts and diffractive multifocal intraocular lens implants, reduced the level of inflammatory factors in the body, improved the level of BDNF, reduced postoperative visual interference, and improved postoperative satisfaction.
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Affiliation(s)
- Yan-Xi Wang
- Ophthalmology, Affiliated Hospital of Southwest Medical University, Sichuan, China
| | - Gang-Jin Kang
- Ophthalmology, Affiliated Hospital of Southwest Medical University, Sichuan, China
| | - Juan Zhou
- Ophthalmology, Affiliated Hospital of Southwest Medical University, Sichuan, China
| | - Ying Chen
- Ophthalmology, Affiliated Hospital of Southwest Medical University, Sichuan, China
| | - Zheng-Hong Peng
- Physical Examination Center, Affiliated Hospital of Southwest Medical University, Sichuan, China
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9
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Day AC, Norridge CFE, Donachie PHJ, Barnes B, Sparrow JM. Royal College of Ophthalmologists' National Ophthalmology Database study of cataract surgery: report 8, cohort analysis of the relationship between intraoperative complications of cataract surgery and axial length. BMJ Open 2022; 12:e053560. [PMID: 35985773 PMCID: PMC9396167 DOI: 10.1136/bmjopen-2021-053560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To describe the relationships between axial length and intraoperative complications in patients undergoing cataract surgery. DESIGN Cohort analysis of the Royal College of Ophthalmologists' National Ophthalmology Database (RCOphth NOD). SETTING 110 National Health Service Trusts in England, Health Boards in Wales, Independent Sector Treatment Centres and Guernsey. PARTICIPANTS 820 354 patients, aged 18 years or older, undergoing cataract surgery. Eligible operations were those from centres with at least 50 operations with a recorded axial length measurement and age at surgery between 1 April 2010 and 31 August 2019. INTERVENTIONS Phacoemulsification where the primary intention was cataract surgery alone. OUTCOME MEASURES Posterior capsule rupture (PCR) and other recorded intraoperative complications. RESULTS 1 211 520 eligible operations were performed by 3210 surgeons. The baseline axial length was <21 mm (short eyes) for 17 170 (1.4%) eyes, 21-28 mm (medium eyes) for 1 182 513 (97.6%) eyes and >28 mm (long eyes) for 11 837 (1.0%) eyes. The median age at surgery was younger for patients with long eyes than those with short or medium eyes. The rate of any intraoperative complication was higher for short eyes than medium or long with complication rates of 4.5%, 2.9% and 3.3%, respectively (p<0.001). PCR occurred in 1.40% surgeries overall, and in 1.53%, 1.40% and 1.61% of short, medium and long eyes, respectively (p=0.043, not significant at the 1% level). CONCLUSIONS Overall PCR rates for cataract surgery in RCOphth NOD contributing centres are lower than previously reported and there is little change in PCR rates by axial length. Short eyes were more likely to have an intraoperative complication than medium or long eyes.
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Affiliation(s)
- Alexander C Day
- Institute of Ophthalmology, UCL, London, UK
- Cataract Service, Moorfields Eye Hospital City Road Campus, London, UK
| | - Charlotte F E Norridge
- College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, UK
- Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
| | - Paul H J Donachie
- Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
- Royal College of Ophthalmologists, London, UK
| | - Beth Barnes
- Royal College of Ophthalmologists, London, UK
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The Impact of Cataract Surgery on Vision-Related Quality of Life and Psychological Distress in Monocular Patients. J Ophthalmol 2022; 2021:4694577. [PMID: 34970451 PMCID: PMC8714322 DOI: 10.1155/2021/4694577] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 12/08/2021] [Indexed: 12/26/2022] Open
Abstract
Purpose To determine the changes in vision-related quality of life and psychological distress after cataract surgery in monocular patients and to compared these with a control group of age- and gender-matched binocular patients. Methods We enrolled 40 monocular patients and 40 binocular patients who underwent cataract surgery from August 2017 to December 2018. All participants undertook eye examinations and answered questionnaires (the National Eye Institute Visual Function Questionnaire, Self-rating Anxiety Scale, and Self-rating Depression Scale) before and after cataract surgery. Result The monocular patients had significantly worse mean CDVA than the binocular patients before and after surgery. However, there was no significant difference between the increases gained by the two groups. Mean composite VFQ-25 scores of the monocular group were significantly lower than those of the binocular group before and after surgery, but the improvement experienced by the monocular group was statistically larger than the binocular group (37.20 ± 12.84 vs. 19.11 ± 5.13, P < 0.001). Mean standard SAS scores of monocular patients were significantly higher than those of binocular controls before and after surgery, while monocular patients experienced a significant greater decline of SAS scores (−9.41 ± 5.39 VS −3.84 ± 1.61, P < 0.001). Mean standard SDS scores of the monocular group were significantly higher than those of the control group before and after surgery, but the monocular group experienced a significantly greater decline of SDS scores following cataract surgery (−11.91 ± 6.38 VS −4.78 ± 1.79, P < 0.001). There was a significant correlation between the preoperative logMAR CDVA and both the postoperative logMAR CDVA (r = 0.63, P < 0.001) and the changes in the logMAR CDVA (r = −0.881, P < 0.001) for monocular patients. Linear regression analyses suggested that higher postoperative VFQ-25 scores had significant associations with better preoperative CDVA and the absence of systemic comorbidity (both P < 0.05). Age and ocular comorbidity were significantly associated with postoperative SAS scores (both P < 0.05). Age and systemic comorbidity remained significant impact factors for SDS scores (both P < 0.05). Conclusion Monocular patients reported greater improvement in vision-related quality of life and greater decline in the level of anxiety and depression than binocular control subjects, despite having similar CDVA gains after cataract surgery. We argue that it is not a better choice for monocular patients to delay cataract surgery until the cataract is very advanced. A clear understanding of the impact of cataract surgery on vision-related quality of life and psychological distress in monocular patients is needed by ophthalmologists when making surgery decision.
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Hou CH, Chen KJ, Lee JS, Lin KK, Pu C. Effect of the time interval between cataract surgery for both eyes on mental health outcome: a cohort study of 585,422 patients. BMC Ophthalmol 2021; 21:110. [PMID: 33648477 PMCID: PMC7919071 DOI: 10.1186/s12886-021-01876-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cataract surgeries can improve mental health outcomes. However, previous studies have not investigated whether the time interval between cataract surgeries for 2 eyes affects mental health outcomes. METHODS We used the whole-population National Health Insurance (NHI) claims data from Taiwan to conduct a cohort study. Patients who received cataract surgeries for both eyes were identified (n = 585,422). The mental health inpatient and outpatient consultations received by these patients were analyzed, with different time intervals (< 3, 3 to 6, 6 to 12, and > 12 months) between the surgeries. Negative binominal regression was performed to estimate the interaction of the first eye surgery with the time interval. RESULTS The number of mental health consultations was lowest among patients with a time interval of < 3 months (1.783-1.743, P < .001), and a negative dose response effect was observed, such that a longer time interval corresponded to a lower reduction in the number of mental health consultations. For patients with a time interval of > 12 months, the predicted number of mental health consultations increased from 1.674 to 1.796 (P < .001). CONCLUSIONS Given a patient expected to receive surgeries for both eyes within 1 year, scheduling both surgeries within a short time interval may be beneficial for maximizing the effects of cataract surgery in reducing the number of mental health consultations.
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Affiliation(s)
- Chiun-Ho Hou
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.,Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, 155 Linong Street. Sec 2, Peitou, Taipei, Taiwan.,Department of Ophthalmology, Change Gung Memorial Hospital, Xiamen, People's Republic of China.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Ken-Jen Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Jiahn-Shing Lee
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Ken-Kuo Lin
- Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Christy Pu
- Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, 155 Linong Street. Sec 2, Peitou, Taipei, Taiwan.
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12
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Chen PW, Liu PPS, Lin SM, Wang JH, Huang HK, Loh CH. Cataract and the increased risk of depression in general population: a 16-year nationwide population-based longitudinal study. Sci Rep 2020; 10:13421. [PMID: 32770101 PMCID: PMC7414888 DOI: 10.1038/s41598-020-70285-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 07/22/2020] [Indexed: 11/10/2022] Open
Abstract
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.
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Affiliation(s)
- Po-Wei Chen
- School of Medicine, Tzu Chi University, Hualien, Taiwan.,Department of Medical Education, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Peter Pin-Sung Liu
- Center for Aging and Health, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Sec. 3, Chung Yang Rd., Hualien, 97002, Taiwan
| | - Shu-Man Lin
- School of Medicine, Tzu Chi University, Hualien, Taiwan.,Department of Physical Medicine and Rehabilitation, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Jen-Hung Wang
- Department of Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Huei-Kai Huang
- Department of Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan. .,Department of Family Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Sec. 3, Chung Yang Rd., Hualien, 97002, Taiwan.
| | - Ching-Hui Loh
- School of Medicine, Tzu Chi University, Hualien, Taiwan. .,Center for Aging and Health, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 707, Sec. 3, Chung Yang Rd., Hualien, 97002, Taiwan.
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13
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Liu ZH, Chen CZ, Gao C, Zhou DY. Prevalence and correlates of depressive symptoms among Chinese patients with cataracts treated in tertiary general hospitals. PeerJ 2020; 8:e9397. [PMID: 32587808 PMCID: PMC7304416 DOI: 10.7717/peerj.9397] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 05/30/2020] [Indexed: 12/28/2022] Open
Abstract
Background Previous studies recruited unrepresentative samples of Chinese patients with cataract and reported a wide range of prevalence of depressive symptoms in this patient population (18.0–89.7%). The present study determined the prevalence and correlates of depressive symptoms among a consecutive sample of Chinese patients with cataract treated in tertiary general hospitals. Methods A total of 339 patients with cataract were consecutively selected from ophthalmology departments of two large general hospitals in Wuhan, China. Depressive symptoms were assessed with the Chinese Hospital Anxiety and Depression Scale. Logistic regression was used to identify factors that were associated with depression. Results The prevalence of depressive symptoms was 23.9% (95% CI [19.4–28.4]%) among patients with cataract. Correlates for depressive symptoms include an education level of primary school and below (OR = 1.93, P = 0.038), marital status of “others” (OR =3.15, P < 0.001), poor family economic status (OR = 2.26, P = 0.010), nuclear cataract (OR =4.32, P < 0.001), and mixed cataract (OR = 2.76, P = 0.017). Conclusions Depressive symptoms are common among Chinese patients with cataract treated in large general hospitals. Patients who are poorly educated, have a marital status other than “married”, have poor family economic status, and suffer from nuclear and mixed cataracts are at greater risk for depressive symptoms.
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Affiliation(s)
- Zhong-Hua Liu
- Department of Ophthalmology, Wuhan Hankou Hospital, Wuhan, China
| | - Chang-Zheng Chen
- Department of Ophthalmology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Cong Gao
- Department of Ophthalmology, Wuhan Hankou Hospital, Wuhan, China
| | - De-Yi Zhou
- Department of Psychiatry, The Affiliated Wuxi Mental Health Center of Nanjing Medical University, Wuxi, China
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14
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Stanford P, Ewing J. Advanced ophthalmic nurse practitioners: the potential to improve outcomes for older people with cataracts. Nurs Older People 2020; 32:e1229. [PMID: 32548985 DOI: 10.7748/nop.2020.e1229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2020] [Indexed: 06/11/2023]
Abstract
An ageing population has led to a substantial increase in the prevalence of visual impairments, which can compromise lifestyle, health and general physical and psychological well-being. Age-related cataracts can have a negative effect on older people's quality of life but can be corrected by surgery. It is imperative that older people have access to cataract surgery and, given government objectives of NHS efficiency gains, advanced level nurse practitioners have the potential to increase capacity for and access to cataract surgery. This article outlines the aetiology of cataracts, developments in ophthalmic nursing and the broadened scope of practice of advanced ophthalmic nurse practitioners (AONPs). It explores how the AONP is well-placed to provide high quality care to the older person who requires cataract surgery. Professional drivers for role development are explored in relation to older people.
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Affiliation(s)
- Penelope Stanford
- Division of Nursing, Midwifery and Social Work, University of Manchester, Manchester, England
| | - Jordan Ewing
- ophthalmology, Aintree University Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool
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15
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Mylona I, Aletras V, Ziakas N, Tsinopoulos I. Successful Cataract Surgery Leads to an Improvement in Depressive Symptomatology. Ophthalmic Res 2020; 64:50-54. [PMID: 32454493 DOI: 10.1159/000508954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 05/20/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Cataract is the most common reversible cause of blindness worldwide, and the associated vision impairment has been associated with an adverse impact on health-related quality of life and mental health in particular. However, findings from studies on the mental health improvement of patients after cataract surgery remain inconclusive. The objective of this study is to ascertain whether the outcome on best-corrected visual acuity (BCVA) following cataract surgery is associated with depressive symptomatology. METHODS This is an observational prospective study of a cohort of 150 consecutive patients who underwent phacoemulsification surgery and who were evaluated for changes in depressive symptomatology with Beck's Depression Inventory-II (BDI-II). RESULTS The difference in BDI-II scores pre- and postoperatively correlated with the difference in BCVA pre- and postoperatively (p < 0.001). A paired-samples t test revealed a statistically significant difference in the preoperative and postoperative BDI-II scores (p < 0.001). A related-samples Wilcoxon signed-rank test revealed a statistically significant improvement of depression status among the patients (p = 0.004). A stepwise regression analysis concluded that the only statistically significant predictor in assessing the difference in total BDI-II score before and after the operation was the respective difference in visual acuity. DISCUSSION/CONCLUSION The success of phacoemulsification surgery for cataract as evaluated with the change in BCVA is related to the rate of improvement in depressive symptomatology.
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Affiliation(s)
- Ioanna Mylona
- 2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece,
| | - Vassilis Aletras
- Department of Business Administration, University of Macedonia, Thessaloniki, Greece
| | - Nikolaos Ziakas
- 2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
| | - Ioannis Tsinopoulos
- 2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece
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16
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Pellegrini M, Bernabei F, Schiavi C, Giannaccare G. Impact of cataract surgery on depression and cognitive function: Systematic review and meta‐analysis. Clin Exp Ophthalmol 2020; 48:593-601. [DOI: 10.1111/ceo.13754] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 02/26/2020] [Accepted: 03/19/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Marco Pellegrini
- Ophthalmology Unit, S.Orsola‐Malpighi University Hospital University of Bologna Bologna Italy
| | - Federico Bernabei
- Ophthalmology Unit, S.Orsola‐Malpighi University Hospital University of Bologna Bologna Italy
| | - Costantino Schiavi
- Ophthalmology Unit, S.Orsola‐Malpighi University Hospital University of Bologna Bologna Italy
| | - Giuseppe Giannaccare
- Department of Ophthalmology University Magna Græcia of Catanzaro Catanzaro Italy
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17
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Definition and clinical relevance of the concept of functional vision in cataract surgery ESCRS Position Statement on Intermediate Vision. J Cataract Refract Surg 2020; 46 Suppl 1:S1-S3. [DOI: 10.1097/j.jcrs.0000000000000096] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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Effects of self-reported hearing or vision impairment on depressive symptoms: a population-based longitudinal study. Epidemiol Psychiatr Sci 2019; 28:343-355. [PMID: 29415786 PMCID: PMC6998913 DOI: 10.1017/s2045796018000045] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AIMS The aims of this study were to investigate the effects of either hearing, vision or dual sensory impairment on depressive symptoms and to identify subgroups that are vulnerable and significantly affected. METHODS Data from the 2006-2014 Korean Longitudinal Study of Aging (KLoSA) were used and a total of 5832 individuals were included in this study. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression (CES-D10) scale. Sensory impairment was assessed according to the levels of self-reported hearing or vision, which were categorised as either good (excellent, very good or good) or poor (fair or poor). The changes in hearing or vision from records of previous survey were investigated. Changes from good to poor, which indicates new onset, were defined as hearing impairment or vision impairment. Interactions of changes in hearing and vision were considered in the analysis. Dual sensory impairment was indicated when hearing impairment and vision impairment both developed at the same time. Demographic, socioeconomic and health-related factors were considered as potential confounders and were adjusted for in the generalised estimating equation model. RESULTS Individuals with hearing impairment demonstrated significantly more severe depressive symptoms [β = 0.434, standard errors (s.e.) = 0.097, p < 0.001] than those who had good hearing. Those with vision impairment also showed significantly elevated depressive symptoms (β = 0.253, s.e. = 0.058, p < 0.001) than those with good vision. When the interactions between hearing and vision were considered, participants with dual sensory impairment showed significantly more severe depressive symptoms (β = 0.768, s.e. = 0.197, p < 0.001) than those with good hearing and vision. The effect of a single and dual sensory impairment on depressive symptoms was significant in both sexes and across age groups, except for vision impairment in male participants. CONCLUSIONS Hearing, vision and dual sensory impairment are significantly associated with depressive symptoms. Our results suggest that treatment or rehabilitation of either hearing or vision impairment would help prevent depression.
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19
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Illness uncertainty, anxiety and depression in Chinese patients with glaucoma or cataract. Sci Rep 2018; 8:11671. [PMID: 30076311 PMCID: PMC6076255 DOI: 10.1038/s41598-018-29489-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 06/08/2018] [Indexed: 12/15/2022] Open
Abstract
This study evaluated illness uncertainty, anxiety and depression among glaucoma patients and cataract patients in China. 263 patients with primary glaucoma and 100 patients with age-related cataract were recruited sequentially from Zhongshan Ophthalmic Center between October 2013 and March 2016. All the participants completed questionnaires for socio-demographic information, Mishel Uncertainty in Illness Scale (MUIS) and Hospital Anxiety and Depression Scale (HADS). 25 of the 263 glaucoma patients and 21 of the100 cataract patients finished two copies of the same questionnaires before and after surgery. Statistics were analyzed using SPSS17.0 software. We observed that glaucoma patients had higher MUIS and HADS score than did cataract patients. Multivariate logistic regression analysis indicated risk factors for illness uncertainty, anxiety and depression for glaucoma patients were high HADS score, poor visual acuity (VA) in the better eye and education level respectively. Risk factors for the same parameters of cataract patients were high HADS-A score, poor VA in the better eye and high illness uncertainty respectively. Scores of MUIS and HADS both decreased after surgery, but the change in HADS score among glaucoma patients was not significant. Clinical workers should take these factors into account to improve therapy, especially for glaucoma patients who undergo surgery.
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20
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Zheng L, Wu XH, Lin HT. The effect of cataract surgery on sleep quality: a systematic review and Meta-analysis. Int J Ophthalmol 2017; 10:1734-1741. [PMID: 29181319 DOI: 10.18240/ijo.2017.11.16] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 07/17/2017] [Indexed: 12/11/2022] Open
Abstract
AIM To evaluate the effect of cataract surgery on sleep quality and to compare the difference between ultraviolet-blocking clear intraocular lens (UVB-IOL) and blue-filtering intraocular lens (BF-IOL) implantation. METHODS Electronic search was performed of PubMed, MEDLINE, Embase and the Cochrane Library up to January 2016. Studies were eligible when they evaluated the sleep quality before and after cataract surgery by Pittsburgh sleep quality index (PSQI). A random/fixed-effects Meta-analysis was used for the pooled estimate. Heterogeneity was assessed with the I2 test. RESULTS Six studies were selected from 5623 references. Cataract surgery significantly reduced the PSQI scores at postoperative 0-3mo [mean difference (MD) =-0.62, 95%CI: -1.14 to -0.11, P=0.02, I2=66%] and 3-12mo (MD=-0.32, 95%CI: -0.62 to -0.02, P=0.04, I2=0), respectively. Considering different intraocular lens (IOL) implantations, relative post-operative PSQI reduction was found for both UVB-IOL and BF-IOL, but a significant reduction was detected only for UVB-IOL. No significant difference was found with the effect of BF-IOL vs UVB-IOL on sleep quality. CONCLUSION This study found that cataract surgery significantly improved the PSQI score-derived subjective sleep quality irrespective of the IOL type implanted. These findings highlight a substantial benefit of cataract surgery on systemic health with photoreceptive restoration in addition to visual acuity improvements.
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Affiliation(s)
- Ling Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China.,Jieyang People's Hospital, Jieyang Affiliated Hospital, Sun Yat-sen University, Jieyang 522000, Guangdong Province, China
| | - Xiao-Hang Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Hao-Tian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
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21
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Lin X, Chen Z, Jin L, Gao W, Qu B, Zuo Y, Liu R, Yu M. Rasch analysis of the hospital anxiety and depression scale among Chinese cataract patients. PLoS One 2017; 12:e0185287. [PMID: 28949992 PMCID: PMC5614566 DOI: 10.1371/journal.pone.0185287] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Accepted: 09/02/2017] [Indexed: 12/22/2022] Open
Abstract
Purpose To analyze the validity of the Hospital Anxiety and Depression Scale (HADS) among Chinese cataract population. Methods A total of 275 participants with unilateral or bilateral cataract were recruited to complete the Chinese version of HADS. The patients' demographic and ophthalmic characteristics were documented. Rasch analysis was conducted to examine the model fit statistics, the thresholds ordering of the polytomous items, targeting, person separation index and reliability, local dependency, unidimentionality, differential item functioning (DIF) and construct validity of the HADS individual and summary measures. Results Rasch analysis was performed on anxiety and depression subscales as well as HADS-Total score respectively. The items of original HADS-Anxiety, HADS-Depression and HADS-Total demonstrated evidence of misfit of the Rasch model. Removing items A7 for anxiety subscale and rescoring items D14 for depression subscale significantly improved Rasch model fit. A 12-item higher order total scale with further removal of D12 was found to fit the Rasch model. The modified items had ordered response thresholds. No uniform DIF was detected, whereas notable non-uniform DIF in high-ability group was found. The revised cut-off points were given for the modified anxiety and depression subscales. Conclusion The modified version of HADS with HADS-A and HADS-D as subscale and HADS-T as a higher-order measure is a reliable and valid instrument that may be useful for assessing anxiety and depression states in Chinese cataract population.
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Affiliation(s)
- Xianchai Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Ziyan Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Ling Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Wuyou Gao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Bo Qu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yajing Zuo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Rongjiao Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Minbin Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- * E-mail:
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22
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Luk S, Stroman L, Kang S, Natkunarajah M, Duguid G. Patient Perception and Emotional Disturbance in Out-of-Hour Ophthalmic Emergency Care. Semin Ophthalmol 2017; 32:559-563. [DOI: 10.3109/08820538.2015.1131834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Sheila Luk
- Accident and Emergency Department, Western Eye Hospital, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Luke Stroman
- Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Swan Kang
- Accident and Emergency Department, Western Eye Hospital, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Mythili Natkunarajah
- Accident and Emergency Department, Western Eye Hospital, Imperial College Healthcare NHS Foundation Trust, London, UK
| | - Graham Duguid
- Accident and Emergency Department, Western Eye Hospital, Imperial College Healthcare NHS Foundation Trust, London, UK
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23
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Berle D, Steel Z, Essue BM, Keay L, Jan S, Tan Phuc H, Hackett ML. Multisite prospective investigation of psychological outcomes following cataract surgery in Vietnam. BMJ Glob Health 2017; 2:e000162. [PMID: 28589001 PMCID: PMC5321390 DOI: 10.1136/bmjgh-2016-000162] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 11/25/2016] [Accepted: 12/11/2016] [Indexed: 11/13/2022] Open
Abstract
Background Cataract surgery is a low-cost and effective intervention. There is increasing evidence to suggest that cataract surgery is associated with improvements in mobility, overall functioning and reductions in psychological distress. Within low-income and middle-income countries, cataract surgery has also been documented to lead to reductions in psychological distress; however, differences in economic activity and engagement in paid and domestic work in these countries may moderate such reductions. We aimed to examine the psychological outcomes following cataract surgery among a diverse Vietnamese sample. Methods We report findings from the VISIONARY study, a 12-month multisite prospective study of cataract surgery outcomes conducted in Vietnam (N=462). Generalised estimating equations (GEEs) were used to identify the variables which were associated with reduced psychological distress. Results A high proportion of participants (56.6%) reported psychological distress before surgery and severity of psychological distress had decreased by 12 months following surgery (95% CI (4.13 to 4.95)). There were regional differences in the extent of improvement in psychological distress and change in paid and unpaid work. The extent of improvement in visual acuity, male gender, and increase in paid and unpaid work hours were significant predictors of reductions in psychological distress. Conclusions Cataract surgery appears to result in the greatest reductions in psychological distress in communities where work engagement is highest. Funding The VISIONARY study was funded by a grant provided by the Fred Hollows Foundation, Australia. During the course of this work, BME was in receipt of an Ian Potter Foundation Fellowship and a National Health and Medical Research Council (NHMRC) fellowship (1072148), SJ received an NHMRC Senior Research Fellowship, MLH was in receipt of a National Heart Foundation Future Leader Fellowship 100034.
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Affiliation(s)
- David Berle
- Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia.,School of Psychiatry, University of New South Wales (UNSW), Sydney, New South Wales, Australia
| | - Zachary Steel
- School of Psychiatry, University of New South Wales (UNSW), Sydney, New South Wales, Australia.,St John of God Health Care, Richmond Hospital, North Richmond, New South Wales, Australia
| | - Beverley M Essue
- The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Lisa Keay
- The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Stephen Jan
- The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Huynh Tan Phuc
- The Fred Hollows Foundation Vietnam, Da Nang City, Vietnam
| | - Maree L Hackett
- The George Institute for Global Health, The University of Sydney, Sydney, New South Wales, Australia
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Chen Y, Nondahl DM, Schubert CR, Klein BEK, Klein R, Cruickshanks KJ. The Relation between Sleep Disruption and Cataract in a Large Population-Based Study. Ophthalmic Epidemiol 2017; 24:111-115. [PMID: 28139160 DOI: 10.1080/09286586.2016.1259640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE To investigate the relation between sleep disruption and nuclear cataract, as well as the impact of cataract removal on sleep, in two discrete population-based cohorts. METHODS This is a cross-sectional study of 5070 participants from three large longitudinal epidemiologic studies of age-related eye disease, hearing, olfaction, and cognition. Slit-lamp photos of the lens were obtained to grade nuclear cataract using a standardized protocol. The quality of sleep was assessed using a modified Wisconsin Sleep Cohort Study questionnaire. Multiple linear regression analyses were used to assess the associations between levels of nuclear cataract/cataract extraction and the number of sleep problems. Systemic co-morbidity data were included as potential confounders, including diabetes mellitus, obesity, hypertension, cerebrovascular disease, thyroid disease, tobacco and alcohol use, and physical component summary score and mental component summary score. RESULTS The mean age of the cohort was 57.6 years (range 22-95 years). The majority of the cohort demonstrated nuclear cataract levels 2 or 3 (36.8% and 30.1%, respectively). A total of 8% of the cohort had an intraocular lens (IOL) in at least one eye. There was no statistically significant correlation between sleep problems with presence of either nuclear cataract or IOL implant (p > 0.05). CONCLUSION In this cross-sectional, population-based study, we found no significant association between nuclear cataract or presence of IOL with poor sleep quality after adjusting for potential confounders. Studies of the longitudinal impact of nuclear cataract and cataract removal on sleep are needed to elucidate the role of nuclear cataract and cataract removal on sleep.
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Affiliation(s)
- Yanjun Chen
- a Department of Ophthalmology & Visual Sciences , University of Wisconsin-Madison , Madison , WI , USA
| | - David M Nondahl
- a Department of Ophthalmology & Visual Sciences , University of Wisconsin-Madison , Madison , WI , USA
| | - Carla R Schubert
- a Department of Ophthalmology & Visual Sciences , University of Wisconsin-Madison , Madison , WI , USA
| | - Barbara E K Klein
- a Department of Ophthalmology & Visual Sciences , University of Wisconsin-Madison , Madison , WI , USA
| | - Ronald Klein
- a Department of Ophthalmology & Visual Sciences , University of Wisconsin-Madison , Madison , WI , USA
| | - Karen J Cruickshanks
- b Department of Ophthalmology & Visual Sciences and Population Health Sciences , University of Wisconsin-Madison , Madison , WI , USA
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Nakano T, Kawashima M, Hiratsuka Y, Tamura H, Ono K, Murakami A, Tsubota K, Yamada M. Assessment of quality of life in patients with visual impairments using a new visual function questionnaire: the VFQ-J11. Clin Ophthalmol 2016; 10:1939-1944. [PMID: 27784982 PMCID: PMC5063484 DOI: 10.2147/opth.s115159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The purpose of the present study was to assess the vision-related quality of life (QOL) of visually impaired patients using the Japanese 11-item National Eye Institute Visual Function Questionnaire (VFQ-J11). Comparisons with the 25-item version (VFQ-25) and the EuroQoL Index using a large group of patients with various degrees of impairments and various causative diseases were performed. Methods A total of 232 visually impaired Japanese patients were recruited from six ophthalmology departments in Japan. Information on ophthalmic findings and patient backgrounds was collected, and information on QOL and utility assessments was collected from the patients by means of survey questionnaires. Results The average age of patients was 69.6±14.3 years. Both the vision-related QOL scores (VFQ-25 composite and VFQ-J11) were significantly associated with better and worse visual acuity (VA) in visually impaired subjects (all P<0.01). VFQ-J11 was comparable to VFQ-25 regardless of causative diseases. VFQ-25 composite and the VFQ-J11 scores were concurrently associated with a range of systemic medical disorders. EuroQoL Index had a significant association with better eye VA (P<0.01), but not with worse eye VA, or any systemic disorders. Conclusion VFQ-J11 provides valid data on vision-related QOL and is less of a burden for patients with vision problems.
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Affiliation(s)
- Tadashi Nakano
- Department of Ophthalmology, Jikei University School of Medicine
| | | | - Yoshimune Hiratsuka
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo
| | - Hiroshi Tamura
- Department of Ophthalmology & Visual Sciences, Kyoto University; Division of Medical Information Technology & Administration Planning, Kyoto University Hospital, Kyoto
| | - Koichi Ono
- Department of Ophthalmology, Juntendo Tokyo Koto Geriatric Medical Center
| | - Akira Murakami
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine
| | - Masakazu Yamada
- National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center; Department of Ophthalmology, Kyorin University, Tokyo, Japan
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Kennedy GJ, Castro J, Chang M, Chauhan-James J, Fishman M. Psychiatric and Medical Comorbidity in the Primary Care Geriatric Patient-An Update. Curr Psychiatry Rep 2016; 18:62. [PMID: 27222136 DOI: 10.1007/s11920-016-0700-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The mental health needs of older primary care patients are now widely recognized if not widely addressed. The range of behavioral health approaches including co-locating psychiatrists and integrating mental health professionals as care managers into primary care sites is extensive and growing. Nonetheless the primary care provider remains the first line of defense against mental disorders, most commonly depression and anxiety that accompany and exacerbate common physical conditions. The excess, potentially avoidable disability that results from comorbidity makes it imperative that early recognition and evidence based intervention occur. Multi-morbidity and polypharmacy make intervention a challenge. Psychotherapy can help overcome comorbidity depression however the most accessible intervention would be an antidepressant FDA approved for both anxiety and depressive disorders. For all these reasons, a focus on physical conditions most commonly associated with mental disorders can foster early recognition before the older patient's care becomes overwhelmingly complicated.
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Affiliation(s)
- Gary J Kennedy
- Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center, 111 East 210th Street, Bronx, NY, 10467, USA. .,Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA.
| | - Jack Castro
- Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center, 111 East 210th Street, Bronx, NY, 10467, USA
| | - Mason Chang
- Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center, 111 East 210th Street, Bronx, NY, 10467, USA
| | - Jaimini Chauhan-James
- Department of Psychiatry and Behavioral Sciences, Montefiore Medical Center, 111 East 210th Street, Bronx, NY, 10467, USA
| | - Manuel Fishman
- Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA
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Clark A, Ng JQ, Morlet N, Semmens JB. Big data and ophthalmic research. Surv Ophthalmol 2016; 61:443-65. [DOI: 10.1016/j.survophthal.2016.01.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Revised: 01/16/2016] [Accepted: 01/25/2016] [Indexed: 02/07/2023]
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McCusker S, Koola MM. Association of Ophthalmologic Disorders and Depression in the Elderly: A Review of the Literature. Prim Care Companion CNS Disord 2015; 17:14r01731. [PMID: 26693037 DOI: 10.4088/pcc.14r01731] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 04/27/2015] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To review the prevalence of depression in common ophthalmologic disorders in the elderly and provide insight into treatment. DATA SOURCES PubMed, Google Scholar, and DynaMed were searched using the terms depression and ophthalmology in combination with depression, mood disorders, cataracts, vision loss, age-related macular degeneration, primary open-angle glaucoma, and Fuchs corneal dystrophy. Articles were limited to those published in the English language between 1993 and 2013. STUDY SELECTION AND DATA EXTRACTION Twenty-eight articles that studied the prevalence of depression in ophthalmologic disorders were screened and summarized. RESULTS The strongest association between ophthalmologic disorders and psychiatry is depression. In the future, primary care physicians and psychiatrists should play a significant role in the assessment and treatment of depression in visually impaired patients. CONCLUSION Greater recognition and treatment of depression in individuals with impaired vision is warranted.
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Affiliation(s)
- Scott McCusker
- Doctor of Medicine Program, Saba University School of Medicine, Saba, Dutch Caribbean (Dr McCusker); and Clinical Research Program, Sheppard Pratt Health System, Baltimore, Maryland (Dr Koola)
| | - Maju Mathew Koola
- Doctor of Medicine Program, Saba University School of Medicine, Saba, Dutch Caribbean (Dr McCusker); and Clinical Research Program, Sheppard Pratt Health System, Baltimore, Maryland (Dr Koola)
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Nishi T, Saeki K, Obayashi K, Miyata K, Tone N, Tsujinaka H, Yamashita M, Masuda N, Mizusawa Y, Okamoto M, Hasegawa T, Maruoka S, Ueda T, Kojima M, Matsuura T, Kurumatani N, Ogata N. The effect of blue-blocking intraocular lenses on circadian biological rhythm: protocol for a randomised controlled trial (CLOCK-IOL colour study). BMJ Open 2015; 5:e007930. [PMID: 25968007 PMCID: PMC4431140 DOI: 10.1136/bmjopen-2015-007930] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Blue light information plays an important role in synchronising internal biological rhythm within the external environment. Circadian misalignment is associated with the increased risk of sleep disturbance, obesity, diabetes mellitus, depression, ischaemic heart disease, stroke and cancer. Meanwhile, blue light causes photochemical damage to the retina, and may be associated with age-related macular degeneration (AMD). At present, clear intraocular lenses (IOLs) and blue-blocking IOLs are both widely used for cataract surgery; there is currently a lack of randomised controlled trials to determine whether clear or blue-blocking IOLs should be used. METHODS AND ANALYSIS This randomised controlled trial will recruit 1000 cataract patients and randomly allocate them to receive clear IOLs or blue-blocking IOLs in a ratio of 1:1. The primary outcomes are mortality and the incidence of cardiovascular disease, cancer and AMD. Secondary outcomes are fasting plasma glucose, triglycerides, cholesterol, glycated haemoglobin, sleep quality, daytime sleepiness depressive symptoms, light sensitivity, the circadian rhythm of physical activity, wrist skin temperature and urinary melatonin metabolite. Primary outcomes will be followed until 20 years after surgery, and secondary outcomes will be assessed at baseline and 1 year after surgery. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Institutional Review Board of Nara Medical University (No. 13-032). The findings of this study will be communicated to healthcare professionals, participants and the public through peer-reviewed publications, scientific conferences and the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) home page. TRIAL REGISTRATION NUMBER UMIN000014680.
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Affiliation(s)
- Tomo Nishi
- Department of Ophthalmology, Nara Medical University School of Medicine,Nara,Japan
| | - Keigo Saeki
- Department of Community Health and Epidemiology, Nara Medical University School of Medicine, Nara, Japan
| | - Kenji Obayashi
- Department of Community Health and Epidemiology, Nara Medical University School of Medicine, Nara, Japan
| | - Kimie Miyata
- Department of Ophthalmology, Nara Medical University School of Medicine,Nara,Japan
| | - Nobuhiro Tone
- Center for Academic Industrial and Governmental Relations, Nara Medical University School of Medicine, Nara, Japan
| | - Hiroki Tsujinaka
- Department of Ophthalmology, Nara Medical University School of Medicine,Nara,Japan
| | - Mariko Yamashita
- Department of Ophthalmology, Nara Medical University School of Medicine,Nara,Japan
| | - Naonori Masuda
- Department of Ophthalmology, Nara Medical University School of Medicine,Nara,Japan
| | - Yutarou Mizusawa
- Department of Ophthalmology, Nara Medical University School of Medicine,Nara,Japan
| | - Masahiro Okamoto
- Department of Ophthalmology, Nara Medical University School of Medicine,Nara,Japan
| | - Taiji Hasegawa
- Department of Ophthalmology, Nara Medical University School of Medicine,Nara,Japan
| | - Shinji Maruoka
- Department of Ophthalmology, Nara Medical University School of Medicine,Nara,Japan
| | - Tetsuo Ueda
- Department of Ophthalmology, Nara Medical University School of Medicine,Nara,Japan
| | - Masashi Kojima
- Department of Ophthalmology, Nara Medical University School of Medicine,Nara,Japan
| | - Toyoaki Matsuura
- Department of Ophthalmology, Nara Medical University School of Medicine,Nara,Japan
| | - Norio Kurumatani
- Department of Community Health and Epidemiology, Nara Medical University School of Medicine, Nara, Japan
| | - Nahoko Ogata
- Department of Ophthalmology, Nara Medical University School of Medicine,Nara,Japan
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Short-term influence of cataract surgery on circadian biological rhythm and related health outcomes (CLOCK-IOL trial): study protocol for a randomized controlled trial. Trials 2014; 15:514. [PMID: 25547247 PMCID: PMC4320588 DOI: 10.1186/1745-6215-15-514] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 12/10/2014] [Indexed: 12/11/2022] Open
Abstract
Background Light information is the most important cue of circadian rhythm which synchronizes biological rhythm with external environment. Circadian misalignment of biological rhythm and external environment is associated with increased risk of depression, insomnia, obesity, diabetes, cardiovascular disease, and cancer. Increased light transmission by cataract surgery may improve circadian misalignment and related health outcomes. Although some observational studies have shown improvement of depression and insomnia after cataract surgery, randomized controlled trials are lacking. We will conduct a parallel-group, assessor-blinded, simple randomized controlled study comparing a cataract surgery group at three months after surgery with a control group to determine whether cataract surgery improves depressive symptoms, sleep quality, body mass regulation, and glucose and lipid metabolism. Methods/Design We will recruit patients who are aged 60 years and over, scheduled to receive their first cataract surgery, and have grade 2 or higher nuclear opacification as defined by the lens opacities classification system III. Exclusion criteria will be patients with major depression, severe corneal opacity, severe glaucoma, vitreous haemorrhage, proliferative diabetic retinopathy, macular oedema, age-related macular degeneration, and patients needing immediate or combined cataract surgery. After baseline participants will be randomized to two groups. Outcomes will be measured at three months after surgery among the intervention group, and three months after baseline among the control group. We will assess depressive symptoms as a primary outcome, using the short version geriatric depression scale (GDS-15). Secondary outcomes will be subjective and actigraph-measured sleep quality, sleepiness, glycated haemoglobin, fasting plasma glucose and triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, body mass index, abdominal circumference, circadian rhythms of physical activity and wrist skin temperature, and urinary melatonin metabolite. Chronotype and visual function will be assessed using the ‘morningness-eveningness’ questionnaire, the Munich chronotype questionnaire, and the National Eye Institute Visual Function Questionnaire. Discussion Although there are potential limitations due to the difference in duration from baseline survey to outcome measurements between two groups, any seasonal effect on the outcome measurement will be balanced as a result of continuous inclusion of participants through the year, and outcomes will be adjusted for day length at outcome measurements at analysis. Trial registration UMIN000014559, UMIN Clinical Trials Registry, registered on 15 July 2014.
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Eramudugolla R, Wood J, Anstey KJ. Co-morbidity of depression and anxiety in common age-related eye diseases: a population-based study of 662 adults. Front Aging Neurosci 2013; 5:56. [PMID: 24106477 PMCID: PMC3788339 DOI: 10.3389/fnagi.2013.00056] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 09/09/2013] [Indexed: 12/16/2022] Open
Abstract
This study examined the prevalence of co-morbid age-related eye disease and symptoms of depression and anxiety in late life, and the relative roles of visual function and disease in explaining symptoms of depression and anxiety. A community-based sample of 662 individuals aged over 70 years was recruited through the electoral roll. Vision was measured using a battery of tests including high and low contrast visual acuity, contrast sensitivity, motion sensitivity, stereoacuity, Useful Field of View, and visual fields. Depression and anxiety symptoms were measured using the Goldberg scales. The prevalence of self-reported eye disease [cataract, glaucoma, or age-related macular degeneration (AMD)] in the sample was 43.4%, with 7.7% reporting more than one form of ocular pathology. Of those with no eye disease, 3.7% had clinically significant depressive symptoms. This rate was 6.7% among cataract patients, 4.3% among those with glaucoma, and 10.5% for AMD. Generalized linear models adjusting for demographics, general health, treatment, and disability examined self-reported eye disease and visual function as correlates of depression and anxiety. Depressive symptoms were associated with cataract only, AMD, comorbid eye diseases and reduced low contrast visual acuity. Anxiety was significantly associated with self-reported cataract, and reduced low contrast visual acuity, motion sensitivity and contrast sensitivity. We found no evidence for elevated rates of depressive or anxiety symptoms associated with self-reported glaucoma. The results support previous findings of high rates of depression and anxiety in cataract and AMD, and in addition show that mood and anxiety are associated with objective measures of visual function independently of self-reported eye disease. The findings have implications for the assessment and treatment of mental health in the context of late-life visual impairment.
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Affiliation(s)
- Ranmalee Eramudugolla
- Centre for Research on Ageing Health and Wellbeing, The Australian National University Canberra, ACT, Australia
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