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Prevalence and Predictors of Depression Among Participants With Glaucoma in a Nationally Representative Population Sample

      Purpose

      To investigate the prevalence of and risk factors for depression among participants with glaucoma and the predictive value of glaucoma for depression.

      Design

      Cross-sectional study.

      Methods

      This study included 6760 participants in the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2008, aged ≥40 years, who reported a presence or absence of glaucoma. Demographic and disease-related information was obtained by interview. Self-reported measures of vision were ascertained via items from the Visual Function Questionnaire (VFQ-25). Participants underwent visual acuity examination, fundus photography, and visual field testing with screening frequency-doubling technology (FDT N-30-5). The main outcome was presence of depression, as determined by a score ≥10 on the Patient Health Questionnaire-9 (PHQ-9).

      Results

      Prevalence of depression among participants with and without glaucoma was 10.9% (SEM 2.2%) and 6.9% (SEM 0.62%), respectively. While the presence of glaucoma was significantly associated with depression after adjustment for demographic factors (OR 1.80, 95% CI 1.16–2.79), this association was not significant after adjustment for self-reported general health condition (OR 1.35, 95% CI 0.822–2.23). Among participants with glaucoma, objective measures of glaucoma severity were not significant predictors for depression. However, several self-reported measures of visual function were significantly associated with depression.

      Conclusions

      Glaucoma is a significant predictor of depression after adjustment for demographic factors and multiple comorbidities, but not after adjustment for self-reported general health condition. Among participants with glaucoma, self-reported measures of vision were significant risk factors for depression, whereas objective measures of vision were not.
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      Biography

      Shan Lin is Professor and Co-Director of Glaucoma Service at the University of California, San Francisco and Director of Glaucoma Service at San Francisco General Hospital. His research interests include angle closure glaucoma and glaucoma among Asians. His leadership positions include Chair of the Glaucoma Section of the Ophthalmic Technology Assessment Committee and Chair of the American Glaucoma Society Documents Subcommittee. His special honors include the American Glaucoma Society and The Glaucoma Foundation's Clinician-Scientist Awards.

      Biography

      Sophia Wang is currently a Clinical and Translational Research Fellow at the University of California, San Francisco (UCSF). She is a trainee in the Advanced Training in Clinical Research program at the UCSF Department of Epidemiology and Biostatistics. She earned her A.B. in Biochemistry from Harvard University, and will complete her medical degree at UCSF. Her research interests include modifiable risk factors for ophthalmologic illness, including glaucoma, and health disparities research.