AMD patients who receive frequent injections were shown to have heightened levels of anxiety.

AMD patients who receive frequent injections have heightened levels of anxiety vs. controls with no AMD. Photo: Leonid Skorin Jr., DO, OD, MS. Click image to enlarge.

Previous studies have demonstrated that integrated mental health intervention can significantly reduce the proportion of depressive disorders in age-related macular degeneration (AMD) patients. A recent study investigated the prevalence of anxiety in patients with wet AMD and found that the condition was more prevalent when compared with a control group and that optometrists should be aware of this possible association when treating these patients.

The retrospective cross-sectional study included data from 3,304 wet AMD patients and 16,515 age- and gender-matched controls from the largest health maintenance organization in Israel with 4,200,000 members. The mean age of patients was 79.7, and 54.8% of the study group was female.

Anxiety was more common in patients with wet AMD (13.2%) compared with the control group (10.2%). Multivariate logistic regression analysis revealed a significant association between anxiety and wet AMD after adjusting for age, gender and socioeconomic status. Male gender was also found to be associated with anxiety in the wet AMD patients in this study cohort.

“The significant higher prevalence of anxiety in the patients’ diagnoses with wet AMD could be explained by the fact that this disease is treated with regular (monthly, as needed or every several weeks) intravitreal anti-VEGF,” the researchers wrote in their paper. “Furthermore, patients are regularly photographed (by optical coherence tomography) and examined which also can increase their anxiety levels.”

The team also proposed that another possible explanation for the higher prevalence of anxiety in wet AMD patients may be that the condition and anxiety share some pathogenic mechanism.

The researchers concluded that high levels of anxiety can lead to lower compliance of patients to treatment and follow-up, which can lead to progression of the disease and worsen prognosis.

“Healthcare providers should take this into consideration when treating patients diagnosed with wet AMD as the burden of anxiety disorders among these patients is likely to increase,” they wrote. “The continuous follow-up and comparison with previous examination can increase anxiety in these patients too.”

Weinstein Or, Cohen AD, Levy J, et al. Anxiety in patients with neovascular age-related macular degeneration. Ophthalmic Epidemiol. July 11, 2022. [Epub ahead of print].