Older people with hyperopia are more likely to develop depression

Hyperopia was significantly associated with an increased risk of developing clinically significant depression (CSD) in middle-aged and elderly people, particularly those without optical correction.

Despite this, the results were independent of genetic predisposition to hyperopia, suggesting that genetics may not be a crucial risk factor for this association.

“These results underscore the importance of hyperopia screening and treatment in middle-aged and older adults regardless of genetic risk, which may help reduce the burden of CSD,” wrote study authors Prof Honghua Yu, Prof Xiaohong Yang and dr Zhuoting Zhu, Ophthalmology , Guangdong Academy of Medical Sciences.

Visual impairment is a common cause of deterioration in visual function in adults 50 years and older and is associated with a deterioration in health-related quality of life. The link between visual impairment and depression is established, but the relationship between farsightedness and onset of depression in at-risk groups has limited data.

Study researchers uncovered the phenotypic association between hyperopia and CSD risk in a large sample from the UK biobank cohort, and additionally examined the impact of genetic determinants of hyperopia on CSD incidents.

For the phenotypic association, hyperopia was defined as mean spherical equivalent (MSE) of +2.00 diopters (D) or greater. The grades of hyperopia were classified as mild (+2.00 dpt ≤ MSE < +2.25 dpt), moderate (+ 2.25 dpt ≤ MSE < + 5.25 dpt) and high (MSE ≥ + 5.25 dpt) assigned.

CSD diagnosis through follow-up was determined based on electronic inpatient hospital records from 2006 to April 2021. Follow-up time was calculated as the duration between the date of initial assessment and censored to the date of onset of depression, date of death, date of loss to follow-up, or April 2021.

For the genotypic association between hyperopia and CSD incident, the researchers assessed the effect of the hyperopia polygenic risk score (PRS) on the hyperopia phenotype. To examine the causal relationship, 1-sample Mendelian randomization (MR) was performed using a two-stage least-squares regression adjusted for age and sex.

Of the 502,645 patients enrolled in the UK Biobank baseline study between 2006 and 2010, a total of 94,669 participants were included in this analysis. This population consisted of 25,786 individuals with emmetropia (27.2%), 25,897 with myopia (27.3%), and 11,393 (12.10) with hyperopia.

At a median follow-up of 11.11 years, 574 participants (1.54%) developed an incident of CSD. After further adjustment by the investigators, it was found that hyperopia was independently associated with a 29% greater risk of depression (hazard ratio [HR], 1.29; 95% confidence interval [CI]1.05 – 1.59; P = 0.015).

Participants with a higher degree of hyperopia were more likely to have CSD episodes compared to participants with a mild degree of hyperopia (P for trend = 0.009). The researchers added that hyperopic patients without hyperopic correction had a higher risk of depression (HR, 1.38; 95% CI, 1.07-1.76; P = 0.011).

Genetic analyzes revealed no significant associations between hyperopia and CSD incident (P ≥ 0.1), according to the investigators.

“Since genetics had limited impact in explaining the link between hyperopia and CSD, further work should aim to understand the underlying sources of phenotypic variance,” the researchers wrote.

The study “Association of Hyperopia with Clinically Significant Depression: Epidemiological and Genetic Evidence in the Middle-Aged and Older Population” was published in British Journal of Ophthalmology.