October 2014

 

RETINA

 

Depression common in AMD patients

 
   

According to the National Institutes of Health (NIH, Bethesda, Md.), depression is a common risk for people whove lost vision from age-related macular degeneration (AMD); up to 25% of people with bilateral AMD develop clinical depression. However, behavior activation can cut this depression risk in half, NIH said.

Barry Rovner, MD, and colleagues at Thomas Jefferson University (Philadelphia) recruited 188 participants with bilateral AMD into an NIH-funded study on behavior activation. Participants were 84 years of age on average, and 70% were women. Half of the participants lived alone. All had a best corrected vision of less than 20/70. Each had mild depressive symptoms and was considered at risk for developing clinical depression.

Optometrists first evaluated the participants and prescribed low vision devices such as handheld magnifiers. Participants were then randomly split into 2 groups. One received behavior activation. Occupational therapists helped them use the low vision devices, make changes around the home (such as using brighter lights and highlighting objects with high-contrast tape), increase social activities, and set and achieve personal goals by breaking them down into manageable steps. People in the second group met with a support therapist to talk about their vision loss and disability.

Both groups had 6 hour-long therapy sessions in their homes over a 2-month period. They were allowed to take antidepressants, but fewer than 10% did so. By 4 months, 18 in the control group (23.4%) and 11 in the behavior activation group (12.6%) developed clinical depression. Behavior activation had the most benefit for participants with the worst vision (less than 20/100), reducing the risk of depression by about 60% compared to controls. Overall, the researchers estimate that behavior activation reduced the risk of clinical depression by 50% compared to control treatment.

Depression common in AMD patients Depression common in AMD patients
Ophthalmology News - EyeWorld Magazine
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