Psychosocial effects of age-related macular degeneration

Background: Age-related macular degeneration (AMD) affects approximately 10% of persons aged 65-74 years and 30% of those aged 75 and older and is the major cause of blindness in old age. AMD is progressive and irreversible. Aim: To review the psychosocial effects of AMD. Method: OVID data bases (MEDLINE, psycINFO and CINAHL) from 1966 to 2004 were reviewed. Results: AMD is associated with functional impairment, high rates of depression, anxiety and emotional distress and increased mortality. Risk factors for depression are not well-defined, except for the degree of functional impairment and impending or actual loss of vision in the second eye. Behavioral and self-management programs may be effective in managing depression associated with AMD, but few studies have been performed, and none using drugs or multimodal therapy. Conclusion: AMD will become even more prevalent as the population ages. Identification of risk factors for psychological consequences and of effective interventions remain to be recognized.