Association Between Mental Health Disorders in Age-Related Macular Degeneration: A Cohort Study Using a Global Health Records Network

Background and Objective: This study assessed risk of mental health disorders in patients with age-related macular degeneration (AMD). Patients and Methods: Data were obtained from an aggregated electronic health records database. Patients who were diagnosed with AMD with cataract were propensity score-matched with cataract controls. Diagnoses were identified using International Classification of Diseases, 10th Revision (ICD-10) codes. Subgroup analyses evaluated relative risk (RR) of new diagnoses of mental health disorders among patients with dry AMD, neovascular AMD (nAMD), vision impairment, and receipt of intravitreal therapy. Results: After matching, 126,799 cases comprising 53.1% female patients with a mean age of 74.6 ± 8.9 years were included. Patients with AMD and cataract had elevated risk of receiving diagnoses of depression (RR = 1.27; 95% CI 1.24–1.29) and anxiety (RR = 1.19; 1.17–1.22). These patients were also at increased risk for self-harm (RR = 1.16), substance use (RR = 1.10), dysthymia (RR = 1.41), and psychosis (RR = 1.22) (all P < .05). The presence of visual impairment amplified these risks, particularly for depression (RR = 1.97) and anxiety (RR = 1.62). Patients with dry AMD had an increased risk of depression and anxiety compared to those with nAMD. Treatment with intravitreal injections in nAMD patients was associated with decreased risk of depression (RR = 0.88) and anxiety (RR = 0.82). Conclusions AMD is associated with increased risk of mental health disorders, including anxiety, depression, and self-harm, particularly in the first year following diagnosis. Risk varies by disease subtype, visual function, and treatment status.