Relationship between Retinopathy Severity, Visual Impairment and Depression in Persons with Long-term Type 1 Diabetes

Abstract

Purpose: Our aim was to investigate the proportion of individuals with depression and its association with diabetic retinopathy and visual impairment in a cohort with 25 or more years of type 1 diabetes.

Methods: This was a cross-sectional analysis at the 25-year follow-up of the population-based cohort of the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Examinations followed standardized protocols and included clinical and ophthalmic evaluations and questionnaires to assess current and past medical history, use of medications, and cigarette smoking. The Center for Epidemiologic Studies Depression Scale (CES-D) was administered to all participants. Depression was defined as use of antidepressant or CES-D score ≥16.

Results: A total of 484 individuals were included in the analysis. The proportion of depression was 37.8% (95% confidence interval 33.4-42.3%). A higher proportion of individuals with depression was observed among those with more severe diabetic retinopathy and visual impairment. However these associations were not statistically significant while controlling for other factors in the multivariable analyses.

Conclusions: Diabetic retinopathy severity and visual acuity in persons with long duration of type 1 diabetes were not cross-sectionally associated with depression in this cohort.

KEYWORDS::

• Diabetic retinopathy
• Visual impairment
• Depression
• Type 1 diabetes
• Epidemiology

ACKNOWLEDGMENTS

Financial Support: Supported by the National Institutes of Health (Bethesda, MD) Grant No. EY016379, (R Klein, BEK Klein) and, in part, by Research to Prevent Blindness (R. Klein and BEK Klein, Senior Scientific Investigator Awards), New York, NY. The National Eye Institute provided funding for the entire study including collection and analyses of data; RPB provided further additional support for data analyses. This research was also supported by the Mentor-based Post-doctoral Fellowship Award from the American Diabetes Association, Alexandria, VA (to RK).

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.