NAYMA
Research type
Research Study
Full title
Assessing the local prevalence of depressioN and AnxietY in patients diagnosed with neovascular age-related MAcular degeneration; a pilot study
IRAS ID
316338
Contact name
Antony Morland
Contact email
Sponsor organisation
University of York
Duration of Study in the UK
0 years, 5 months, 9 days
Research summary
Age-related macular degeneration (AMD) is a retinal disease primarily affecting the macular, the central part of the back of the eye. Late stage AMD, specifically neovascular AMD (nAMD), affects 12.2% of individuals aged over 80 years, with an estimated 40,000 newly diagnosed cases every year in the UK (1). nAMD usually manifests unilaterally (involving one eye only), although the onset of the disease in the fellow, unaffected eye occurs in 50% of patients within 3 years (2). nAMD predominantly affects the central visual field which is critical for reading, driving and recognising faces, often progressing beyond the central macular over time.
The progressive loss of vision associated with AMD has been shown to negatively affect an individual’s quality of life (QoL) (3–5) and unsurprisingly, QoL scores are worse as disease severity increases (6). Interestingly, recent research into the effects of anti-VEGF treatment for nAMD found a positive impact on QoL but only when patients experienced improvements in visual acuity (7–10).
Significant adverse effects on QoL have also been associated with comorbid mental health issues, with strong evidence of depression and anxiety in AMD patients due to limitations imposed by their vision loss (11–23). The prevalence of anxiety symptoms among AMD patients reportedly ranges between 9.6% and 30.1% whilst the prevalence of depression symptoms ranges between 15.7% and 44% (11). Depression has also been associated with worse disease severity (11), has been shown to correlate with visual acuity loss (17) and poor adaptation to vision loss (4), for example utilising low vision aids. It is therefore apparent that a vicious cycle exists between QoL and mental health in AMD. Although reports suggest a wide variability in the prevalence of depression and anxiety rates, possibly due to small sample sizes and different assessments used amongst studies (13), it has been highlighted that mental health issues often remain untreated in AMD (14).
Ophthalmology represents one of the busiest outpatient-based specialties and cancellation of routine services due to the COVID-19 pandemic affected thousands of eye patients (24). A UK study also revealed that approximately 50% of nvAMD patients failed to attend a scheduled hospital/clinical appointment, with 85% stating this was due to fear of contracting COVID-19 (25). COVID-19 lockdowns and quarantine have been shown to have a negative impact on the mental health of adults, children health workers and caregivers (26–28). Emerging data suggests that the mental health of individuals with moderate or severe visual impairment is also significantly affected by the COVID-19 lockdowns (24,29), with greater levels of loneliness experienced (30).REC name
North East - Tyne & Wear South Research Ethics Committee
REC reference
22/NE/0174
Date of REC Opinion
28 Oct 2022
REC opinion
Further Information Favourable Opinion