Background Glaucoma may cause physiological and behavioural circadian misalignment because of the loss of intrinsically photosensitive retinal ganglion cells, the primary receptors of environmental light. Although studies have suggested a high prevalence of depression in patients with glaucoma, it is unclear whether the association is independent of the light exposure profiles as an important confounding factor.
Methods In this cross-sectional study of a community-based cohort of 770 elderly individuals (mean age, 70.9 years), glaucomatous optic discs were assessed using fundus photographs and depressive symptoms were assessed using the short version of the Geriatric Depression Scale (GDS). Daytime and night-time ambient light exposures were objectively measured for 2 days.
Results Depressive symptoms (GDS score ≥6) were observed in 114 participants (prevalence, 14.8%) and glaucomatous optic discs were detected in 40 participants (prevalence, 5.2%). The prevalence of depressive symptoms was significantly higher in the group with glaucomatous optic disc than in the group without it (30.0% vs 14.0%, respectively; p=0.005). Multivariable logistic regression analysis adjusted for potential confounding factors, including daytime and night-time light exposures, revealed that the OR for depressive symptoms was significantly higher in the group with glaucomatous optic disc than in the group without it (OR 2.45, 95% CI 1.18 to 5.08; p=0.016).
Conclusions In this general elderly population, glaucomatous optic disc was significantly associated with higher prevalence of depressive symptoms independent of a number of potential confounding factors, including daily light exposure profiles.
- light exposure
- circadian rhythms
- intrinsically photosensitive retinal ganglion cell
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Contributors KO and KS contributed to study concept and design, acquisition of subjects and/or data, analysis and interpretation of data, and preparation of manuscript. TY and KM contributed to acquisition of data, analysis and interpretation of data, and preparation of manuscript. NK contributed to acquisition of subjects, analysis and interpretation of data, and preparation of manuscript. The other authors contributed to analysis and interpretation of data and preparation of manuscript.
Funding This work was supported by research funding from Department of Indoor Environmental Medicine, Nara Medical University; JSPS KAKENHI (grant nos. 24790774, 22790567, 25860447, 25461393, 15H04776 and 10124877); Mitsui Sumitomo Insurance Welfare Foundation; Meiji Yasuda Life Foundation of Health and Welfare; Osaka Gas Group Welfare Foundation; Japan Diabetes Foundation; Daiwa Securities Health Foundation; Japan Science and Technology Agency; YKK AP Inc.; Ushio Inc.; Nara Prefecture Health Promotion Foundation; Nara Medical University Grant-in-Aid for Collaborative Research Projects; Tokyo Electric Power Company; EnviroLife Research Institute Co., Ltd.; and Sekisui Chemical Co., Ltd.
Disclaimer The funders had no role in the study design, data collection and analysis, decision to publish and preparation of the manuscript.
Competing interests KO and KS received research grant from YKK AP Inc.; Ushio Inc.; Tokyo Electric Power Company; EnviroLife Research Institute Co., Ltd.; and Sekisui Chemical Co., Ltd.
Patient consent Obtained.
Ethics approval The Nara Medical University ethics committee.
Provenance and peer review Not commissioned; externally peer reviewed.
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