Associations Between Age-Related Eye Diseases and Mental Health Conditions.

Abstract

Purpose: Age-related eye conditions, including cataract, glaucoma, age-related macular degeneration (AMD), diabetic retinopathy (DR), and dry eye disease (DED), are prevalent and have been linked to mental health disorders, though findings are mixed. This study systematically examines associations between these ocular diseases and mental health conditions using a large real-world dataset.

Methods: A retrospective cohort study was conducted using the Global TriNetX database. Five cohorts (aged ≥ 40 years) with diagnoses of cataract, glaucoma, AMD, DR, and DED were propensity score matched 1:1 with controls without these eye diseases based on demographic and clinical covariates. Outcome measures were the incidence of mood, anxiety, and psychotic disorders, identified using ICD-10 codes. Hazard ratios (HRs) and 95% confidence intervals (95% CI) from the Cox proportional hazards models were used to assess associations.

Results: Study included patients with cataract (N = 121,060), glaucoma (N = 122,663), AMD (N = 39,915), DR (n = 43,495), DED (n = 148,221), and their median follow-up ranging 1263-2191 days. Cataracts, glaucoma, DR, and DED were each associated with mildly increased risks of mood (HR range: 1.05-1.10), anxiety (HR range: 1.04-1.12), and psychotic disorders (HR range: 1.18-1.36). When accompanied by visual impairment, risks were higher: mood (HR range: 1.22-1.57), anxiety (HR range: 1.16-1.32), and psychotic disorders (HR range: 1.54-2.15).

Conclusion: Age-related ocular diseases, particularly when presented with vision impairment, are independently associated with elevated risks of mental health disorders. These findings underscore the need for integrated ophthalmic-psychiatric care and early intervention before vision loss to address the complex needs of affected patients.