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01-12-2024 | Mood Disorders | Original Paper

The association of symptomatic vitreous floaters with depression and anxiety

Authors: Nikolaos Gouliopoulos, Dimitra Oikonomou, Foteini Karygianni, Alexandros Rouvas, Stylianos Kympouropoulos, Marilita M. Moschos

Published in: International Ophthalmology | Issue 1/2024

Abstract

Purpose

To evaluate the levels of anxiety and depression in patients with symptomatic vitreous floaters and to determine the possible correlations of psychological implications with the symptoms duration and possible improvement, the degree of posterior vitreous detachment, and the discomfort severity.

Methods

Ninety patients complaining for floaters and fifty-seven age- and gender-matched healthy-control subjects were recruited. Every participant underwent a complete ophthalmological examination, including funduscopy and optical coherence tomography scans, while clinical and demographic data were also gathered. The Patient Health Questionnaire-9 (PHQ-9), the Zung Depression Inventory-Self-Rating Depression Scale (Zung SDS), and the Hospital Anxiety and Depression Scale (HADS) were completed by everyone.

Results

Between the studied groups, no significant differences were detected regarding the clinical and demographic data (p > 0.05). The patients with floaters had significantly higher scores of PHQ-9, Zung SDS, HADS Anxiety, and HADS Depression (p < 0.001). After adjustment for several confounders, PHQ-9 (p = 0.041), Zung SDS (p = 0.003), and HADS Anxiety (p = 0.036) values remained significantly impaired. Among the patients, PHQ-9 and Zung SDS scores were significantly elevated in the patients with floaters duration less than 4 weeks (p < 0.05). Finally, anxiety and depression were significantly correlated with the symptoms duration and intensity, with the floater-associated discomfort, and with the stage of posterior vitreous detachment.

Conclusion

Vitreous floaters have a negative impact on patients’ psychological status, by the terms of enhanced depressive and anxiety levels. To the best of our knowledge, our study is the first in the literature to elaborate the aforementioned association, by assessing three different questionnaires simultaneously.

Milston R, Madigan MC, Sebag J (2016) Vitreous floaters: Etiology, diagnostics, and management. Surv Ophthalmol 61:211–227. https://doi.org/10.1016/j.survophthal.2015.11.008CrossRefPubMed

Wagle AM, Lim WY, Yap TP, Neelam K, Au Eong KG (2011) Utility values associated with vitreous floaters. Am J Ophthalmol 152:60-65.e1. https://doi.org/10.1016/j.ajo.2011.01.026CrossRefPubMed

Gishti O, van den Nieuwenhof R, Verhoekx J, van Overdam K (2019) Symptoms related to posterior vitreous detachment and the risk of developing retinal tears: a systematic review. Acta Ophthalmol 97:347–352. https://doi.org/10.1111/aos.14012CrossRefPubMed

Roufail ED, Polkinghorne P (2006) Vitreous floaters. Compr Ophthalmol Update 7:171–177PubMed

Sebag J (2011) Floaters and the quality of life. Am J Ophthalmol 152:3-4.e1. https://doi.org/10.1016/j.ajo.2011.02.015CrossRefPubMed

Byer NE (1994) Natural history of posterior vitreous detachment with early management as the premier line of defense against retinal detachment. Ophthalmology 101:1503–1514. https://doi.org/10.1016/s0161-6420(94)31141-9CrossRefPubMed

Garcia GA, Khoshnevis M, Yee KMP, Nguyen-Cuu J, Nguyen JH, Sebag J (2016) Degradation of Contrast Sensitivity Function Following Posterior Vitreous Detachment. Am J Ophthalmol 172:7–12. https://doi.org/10.1016/j.ajo.2016.09.005CrossRefPubMed

Khoshnevis M, Nguyen-Cuu J, Sebag J (2016) Floaters and reduced contrast sensitivity after successful pharmacologic vitreolysis with ocriplasmin. Am J Ophthalmol Case Rep 4:54–56. https://doi.org/10.1016/j.ajoc.2016.08.005CrossRefPubMed

Kim YK, Moon SY, Yim KM, Seong SJ, Hwang JY, Park SP (2017) Psychological Distress in Patients with Symptomatic Vitreous Floaters. J Ophthalmol 2017:3191576. https://doi.org/10.1155/2017/3191576CrossRefPubMed

10.

Senra H, Ali Z, Aslam T, Patton N (2022) Psychological implications of vitreous opacities - A systematic review. J Psychosom Res 154:110729. https://doi.org/10.1016/j.jpsychores.2022.110729CrossRefPubMed

11.

Moschos MM, Gouliopoulos NS, Kalogeropoulos C, Androudi S, Kitsos G, Ladas D, Tsatsos M, Chatziralli I (2018) Psychological Aspects and Depression in Patients with Symptomatic Keratoconus. J Ophthalmol 2018:7314308. https://doi.org/10.1155/2018/7314308CrossRefPubMedPubMedCentral

12.

Hu Y, Deng F, Zhang L, Hu K, Liu S, Zhong S, Yang J, Zeng X, Peng X (2022) Depression and Quality of Life in Patients with Gliomas: A Narrative Review. J Clin Med 11:4811. https://doi.org/10.3390/jcm11164811CrossRefPubMedPubMedCentral

13.

Del Piccolo L, Saltini A, Zimmermann C (1998) Which patients talk about stressful life events and social problems to the general practitioner? Psychol Med 28:1289–1299. https://doi.org/10.1017/s0033291798007478CrossRefPubMed

14.

Mitchell AJ, Vaze A, Rao S (2009) Clinical diagnosis of depression in primary care: a meta-analysis. Lancet 374:609–619. https://doi.org/10.1016/S0140-6736(09)60879-5CrossRefPubMed

15.

Williams JW Jr, Kerber CA, Mulrow CD, Medina A, Aguilar C (1995) Depressive disorders in primary care: prevalence, functional disability, and identification. J Gen Intern Med 10:7–12. https://doi.org/10.1007/BF02599568CrossRefPubMed

16.

Penninx BW, Pine DS, Holmes EA, Reif A (2021) Anxiety disorders. Lancet 397:914–927. https://doi.org/10.1016/S0140-6736(21)00359-7CrossRefPubMed

17.

Stern AF (2014) The hospital anxiety and depression scale. Occup Med (Lond) 64:393–394. https://doi.org/10.1093/occmed/kqu024CrossRefPubMed

18.

García BG, Orduna Magán C, Alvarez-Peregrina C, Villa-Collar C, Sánchez-Tena MÁ (2021) Nd:YAG laser vitreolysis and health-related quality of life in patients with symptomatic vitreous floaters. Eur J Ophthalmol. https://doi.org/10.1177/11206721211008036CrossRefPubMed

19.

Wu RH, Jiang JH, Gu YF, Moonasar N, Lin Z (2020) Pars plana vitrectomy relieves the depression in patients with symptomatic vitreous floaters. Int J Ophthalmol 13:412–416. https://doi.org/10.18240/ijo.2020.03.07CrossRefPubMedPubMedCentral

20.

Kroenke K, Spitzer RL, Williams JB (2001) The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 16:606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.xCrossRefPubMedPubMedCentral

21.

Zung WW (1965) A self-rating depression scale. Arch Gen Psychiatry 12:63–70. https://doi.org/10.1001/archpsyc.1965.01720310065008CrossRefPubMed

22.

Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.xCrossRefPubMed

23.

Gouliopoulos N, Siasos G, Moschos MM, Oikonomou E, Rouvas A, Bletsa E, Stampouloglou P, Siasou G, Paraskevopoulos T, Vlasis K, Marinos G, Tousoulis D (2020) Endothelial dysfunction and impaired arterial wall properties in patients with retinal vein occlusion. Vasc Med 25:302–308. https://doi.org/10.1177/1358863X20913609CrossRefPubMed

24.

Spitzer RL, Kroenke K, Williams JB (1999) Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary care evaluation of mental disorders. Patient Health Questionnaire JAMA 282:1737–1744. https://doi.org/10.1001/jama.282.18.1737CrossRefPubMed

25.

Spitzer RL, Williams JB, Kroenke K, Hornyak R, McMurray J (2000) Validity and utility of the PRIME-MD patient health questionnaire in assessment of 3000 obstetric-gynecologic patients: the PRIME-MD patient health questionnaire obstetrics-gynecology study. Am J Obstet Gynecol 183:759–769. https://doi.org/10.1067/mob.2000.106580CrossRefPubMed

26.

Kroenke K, Spitzer RL, Williams JB, Löwe B (2010) The patient health questionnaire somatic, anxiety, and depressive symptom scales: a systematic review. Gen Hosp Psychiatry 32:345–359. https://doi.org/10.1016/j.genhosppsych.2010.03.006CrossRefPubMed

27.

Chacón-López H, Pelayo FJ, López-Justicia MD, Morillas CA, Ureña R, Chacón-Medina A, Pino B (2013) Visual training and emotional state of people with retinitis pigmentosa. J Rehabil Res Dev 50:1157–1168. https://doi.org/10.1682/JRRD.2012.06.0113CrossRefPubMed

28.

Jokelainen J, Timonen M, Keinänen-Kiukaanniemi S, Härkönen P, Jurvelin H, Suija K (2019) Validation of the Zung self-rating depression scale (SDS) in older adults. Scand J Prim Health Care 37:353–357. https://doi.org/10.1080/02813432.2019.1639923CrossRefPubMedPubMedCentral

29.

Branch LG, Horowitz A, Carr C (1989) The implications for everyday life of incident self-reported visual decline among people over age 65 living in the community. Gerontologist 29:359–365. https://doi.org/10.1093/geront/29.3.359CrossRefPubMed

30.

Buch H, Vinding T, La Cour M, Appleyard M, Jensen GB, Nielsen NV (2004) Prevalence and causes of visual impairment and blindness among 9980 Scandinavian adults: the Copenhagen city Eye Study. Ophthalmology 111:53–61. https://doi.org/10.1016/j.ophtha.2003.05.010CrossRefPubMed

31.

Hartong DT, Berson EL, Dryja TP (2006) Retinitis pigmentosa. Lancet 368:1795–1809. https://doi.org/10.1016/S0140-6736(06)69740-7CrossRefPubMed

32.

Bjelland I, Dahl AA, Haug TT, Neckelmann D (2002) The validity of the hospital anxiety and depression scale. An updated literature review. J Psychosom Res 52:69–77. https://doi.org/10.1016/s0022-3999(01)00296-3CrossRefPubMed

33.

Torrance GW, Feeny D (1989) Utilities and quality-adjusted life years. Int J Technol Assess Health Care 5:559–575. https://doi.org/10.1017/s0266462300008461CrossRefPubMed

34.

Stein JD, Brown GC, Brown MM, Sharma S, Hollands H, Stein HD (2002) The quality of life of patients with hypertension. J Clin Hypertens 4:181–188. https://doi.org/10.1111/j.1524-6175.2002.00970.xCrossRef

35.

Duncan PW, Lai SM, Keighley J (2000) Defining post-stroke recovery: implications for design and interpretation of drug trials. Neuropharmacology 39:835–841CrossRefPubMed

36.

Smith RD, Hall J, Gurney H, Harnett PR (1993) A cost-utility approach to the use of 5-fluorouracil and levamisole as adjuvant therapy for Duke’s C colonic cancer. Med J Aust 158:319–322. https://doi.org/10.1016/s0028-3908(00)00003-4CrossRefPubMed

37.

Tsevat J, Solzan JG, Kuntz KM, Ragland J, Currier JS, Sell RL, Weinstein MC (1996) Health values of patients infected with HIV. Relationship to mental health and physical functioning. Med Care 34:44–57. https://doi.org/10.1097/00005650-199601000-00004CrossRefPubMed

38.

Wada K, Tanaka K, Theriault G, Satoh T, Mimura M, Miyaoka H, Aizawa Y (2007) Validity of the Center for Epidemiologic Studies Depression Scale as a screening instrument of major depressive disorder among Japanese workers. Am J Ind Med 50:8–12. https://doi.org/10.1002/ajim.20403CrossRefPubMed

39.

Noble RE (2005) Depression in women. Metabolism 54:49–52. https://doi.org/10.1016/j.metabol.2005.01.014CrossRefPubMed

Title: The association of symptomatic vitreous floaters with depression and anxiety
Authors: Nikolaos Gouliopoulos
Dimitra Oikonomou
Foteini Karygianni
Alexandros Rouvas
Stylianos Kympouropoulos
Marilita M. Moschos
Publication date: 01-12-2024
Publisher: Springer Netherlands
Keywords: Mood Disorders
Affective Disorder
Anxiety
Published in: International Ophthalmology / Issue 1/2024
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI: https://doi.org/10.1007/s10792-024-03006-y

At a glance: The STEP trials

Springer Medicine

The association of symptomatic vitreous floaters with depression and anxiety

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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