Impact of COVID-19 on Depressive Symptoms Among Patients with Low Vision and Blindness

Background

Disability is globally recognized as a key cause of depression. Likewise, the COVID-19 pandemic has significantly increased the vulnerability of patients with low vision to health and health-related issues, especially mental health. This study aimed to examine the association between the impact of COVID-19 and depressive symptoms in patients with low vision and blindness.

Methods

This cross-sectional study was conducted between February and July 2022 and involved face-to-face interviews. Patients with low vision and blindness diagnosed with depression were excluded. The following items were included in the questionnaire: sociodemographic information, Multi-Dimensional Scale of Perceived Social Support (MSPSS), the impact of COVID-19, and The Center for Epidemiological Studies-Depression (CES-D). Hierarchical linear regression analysis was used to examine the association between the impact of COVID-19 and depression.

Results

The prevalence of depression among patients with low vision and blindness was 43.0%. Three factors were associated with depressive symptoms: compliance with COVID-19 prevention strategies (β = 0.16, p<0.01), anxiety during COVID-19 (β = 0.24, p<0.001), and social support (β = -0.16, p<0.01).

Conclusion

The findings indicated that COVID-19 significantly increased depressive symptoms among patients with low vision and blindness. The psychological effects of the COVID-19 pandemic have been considered critical and emergent public health issues. Stakeholders, particularly public health organizations, need to urgently implement preventive and protective measures to help patients with physical and mental disabilities.

Prevalence and Factors Associated with Suicidal Ideation Among Older People with Visual Impairments Attending an Eye Center During the COVID-19 Pandemic: A Hospital-Based Cross-Sectional Study

Purpose

To evaluate the prevalence of suicidal ideation and associated factors among older people with visual impairments attending an eye center during the COVID-19 pandemic.

Patients and Methods

A total of 314 older people aged 60 and above with visual impairments who attended an eye center were included in this study. This was a hospital-based cross-sectional study conducted from February to July, 2022. Data were collected in person. Suicidal ideation was measured using the Columbia-Suicide Severity Rating Scale (C-SSRS). Multivariable logistic regression analysis was used to explore associations between related factors and suicidal ideation.

Results

Of 314 older people with visual impairments, the prevalence of suicidal ideation was 32.5%. Suicidal ideation was independently associated with diabetic retinopathy (adjusted odds ratio (AOR)=2.4, 95% confidence interval (CI): 1.0-5.8; p=0.038) and depression (AOR=6.3, 95% CI: 3.5-11.2; p<0.001).

Conclusion

This study found a relatively high prevalence of suicidal ideation among older people with visual impairments. There was also a significant association between depression and suicidal ideation among these individuals. Visual impairments can lead to negative émotions. This underscores the importance of addressing the mental health needs of older individuals with visual impairments, including suicide prevention efforts tailored to their needs. Ophthalmologists should be equipped with the skills necessary to identify the early signs of suicidal ideation and refer patients to mental healthcare specialists for appropriate treatment.

Effect of pupillary dilation on Haigis formula-calculated intraocular lens power measurement by using optical biometry

PURPOSE

The purpose of this study was to evaluate the effect of pupillary dilation on the Haigis formula-calculated intraocular lens (IOL) power and ocular biometry measurements by using IOLMaster(®).

METHODS

A prospective study was performed for biometry measurements of 373 eyes of 192 healthy subjects using the IOLMaster at the outpatient department of King Chulalongkorn Memorial Hospital from February 2013 to July 2013. The axial length (AL), anterior chamber depth (ACD), keratometry (K), and IOL power were measured before and after 1% tropicamide eye drop instillation. The Haigis formula was used in the IOL power calculation with the predicted target to emmetropia. Each parameter was compared by a paired t-test prior to and after pupillary dilation. Bland-Altman plots were also used to determine the agreement between each parameter.

RESULTS

The mean age of the subjects was 53.74±14.41 years (range 18-93 years). No differences in AL (P=0.03), steepest K (P=0.42), and flattest K (P=0.41) were obtained from the IOLMaster after pupillary dilation. However, ACD and IOL power were significantly different postdilation (P<0.01 and P<0.01, respectively). In ACD and IOL power measurements, the concordance rates were 93.03% and 97.05% within 95% limits of agreement (-0.48 to 0.26 mm and -1.09 to 0.88 D, respectively) in the Bland-Altman plots.

CONCLUSION

Biometry measurements in the cycloplegic stage should be considered in the IOL formulas that use parameters other than AL and K.

The effect of Nd:YAG laser treatment of posterior capsule opacification on anterior chamber depth and refraction in pseudophakic eyes

Purpose

This was a prospective descriptive study to determine the changes in intraocular lens (IOL) position after neodymium-doped yttrium–aluminum–garnet (Nd:YAG) laser posterior capsulotomy by measuring anterior chamber depth (ACD) and refraction, including the spherical equivalent (SE) and cylinder.

Materials and methods

Forty-seven pseudophakic eyes with posterior capsule opacification of 29 patients were included. Nd:YAG laser posterior capsulotomy was performed. Patients’ ACD and refraction were measured before the treatment, as well as after the treatment at 1 week and 3 months. IOLMaster^® and an automated refractometer were used at the Department of Ophthalmology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.

Results

There were no statistically significant differences in ACD and SE before and after laser treatment at 1 week and 3 months (repeated analysis of variance, P=0.582 and P=0.269, respectively). Both backward IOL movement (number [n]=29) and forward IOL movement (n=18) were found. Some changes in cylindrical refraction were found at 1 week, but decreased at 3 months after capsulotomy (baseline cylinder: −1.16; cylinder at 1 week and 3 months: −1.00 and −1.14, respectively; P=0.012). These changes were the same with one-piece and three-piece IOLs.

Conclusion

Nd:YAG laser posterior capsulotomy did not significantly change ACD and SE. It led to cylinder change at 1 week after laser, but the effect decreased at 3 months. This effect was small and may not be clinically significant.

Intrapersonal comparison of initial axial length, keratometric readings, and intraocular lens power over a 6-month interval using an IOLMaster device

Purpose

In order to improve current biometry practice, we investigated changes in axial length (AL), keratometry (K), and intraocular lens (IOL) power measured by the IOLMaster in adults within a 6-month period at the outpatient eye clinic, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.

Patients and methods

This was a nonrandomized prospective cohort study. The AL, steepest K, flattest K, and IOL power of nondilated eyes were measured at the initial examination and later at 6 months by the IOLMaster. Changes in AL, K, and IOL power using the SRK (Sanders, Retzlaff, and Kraff)-T formula within 6 months were compared using the paired-sample t-test.

Results

The study comprised 90 eyes from 90 patients. The mean age of the patients was 62.99±13.95 years (range 28–87 years). Mean values and standard deviation for AL, steepest K, flattest K, and IOL power at initial visit and 6 months later were 23.56±1.51 mm and 23.56±1.52 mm (P=1.0; 95% confidence interval [CI] −0.01 to 0), 44.94±1.37 D and 44.98±1.43 D (P=0.96; 95% CI −0.13 to 0.04), 43.85±1.43 D and 43.89±1.36 D (P=0.93; 95% CI −0.02 to 0.07), and 20.27±4.12 D and 20.15±4.51 D (P=0.99; 95% CI −0.05 to 0.29), respectively.

Conclusion

There was no statistically significant difference in AL (P=1.0), both K (P=0.96, P=0.93), or IOL power (P=0.99) within the 6-month period using the IOLMaster. Remeasurement at 6 months may be required in some cases, but should not be routine.

Original article. Repeatability assessment of the New Numbers Contrast Sensitivity Chart

Background: The validity and agreement of the New Numbers Contrast Sensitivity Chart with the original Mars chart have been found to be good. The two charts can be used interchangeably; however, evidence of the repeatability of the new chart remains to be sought. This study was to assess the repeatability of the New Numbers Contrast Sensitivity Chart.

Objectives: We assessed the repeatability of the Numbers Contrast Sensitivity Chart.

Methods: Two hundred subjects from the ophthalmic clinic of the King Chulalongkorn Memorial Hospital, who were able to communicate and read Arabic numerals were recruited. The contrast sensitivity (CS) scores were collected by reading the same Numbers Contrast Sensitivity Chart in the same environment with each eye and both eyes ten minutes apart. The repeatability of the CS score was assessed by Bland-Altman plot analysis.

Results: The visual acuity of subjects with variety in diagnoses ranged from 20/480 to 20/20. The mean differences were -0.006, -0.008, -0.002 log CS and the coefficients of repeatability were 0.155, 0.141, and 0.093 for the right eye, left eye, and both eyes, respectively. The plots showed a narrow range of 95% limit of agreement, which were (+0.146, -0.159) in the right eye, (+0.130, -0.147) in the left eye, and (+0.089, -0.093) in both eyes.

Conclusions: The New Numbers Contrast Sensitivity Chart has good repeatability. With proven good validity and repeatability, this easy and convenient numbers chart is beneficial for practical use in a clinical setting where English is not used as the primary language.