. 2013 Jul 19;8:931–943. doi: 10.2147/CIA.S27717

Table 2.

Description of the selected studies

Study details^a	Population^b	Outcome measures of interest	Results	Methodological quality^c
Rovner 2002⁴² USA II (FU: 6 months) Note: Rovner 2001⁴³	51 AMD (baseline) 40 AMD (6-month FU) (from a specialty eye hospital) ≥ 64 years (81 ± 6) Best corrected visual acuity (BCVA) <6/21 in the better eye	Depression: CES-D HRQOL: CDS VRQOL: FVSQ	Subjects with DS (n = 17) had worse HRQOL (mean ± SD = 16.8 ± 8.8) than nondepressed subjects (n = 34) (8.7 ± 8.4)^** (d = .95). The former also had worse VRQOL (10.1 ± 3.6) than the latter (7.6 ± 3.8)(d = .67). Fewer DS were significantly related to better HRQOL (r = 0.57 at baseline) and VRQOL (r = 0.31 * at baseline). Change in DS score was related to change in VRQOL score (r = 0.32)^*.	0.77 (good)
Horowitz 2005⁴⁰ USA II (FU: 2 years) Note: FU of Horowitz 2003³⁹	155 VI (baseline) 95 (2-year FU) (seeking rehabilitation services) 65–89 years (77) 57% with severe VI (BCVA ≤ 6/60)	Depression: CES-D HRQOL: OARS MFAQ VRQOL: FVSQ	Better HRQOL at baseline was significantly associated with fewer DS (r = 0.38^* at baseline and r = 0.27^* at 2 years).Better VRQOL at baseline was significantly associated with fewer DS at baseline only (r = 0.27)^**.	0.69 (fair)
Horowitz 2006⁴¹ USA II (FU: 6 months) Note: Horowitz 2005,¹⁵ analysis of baseline (n = 584)	584 VI (baseline) 438 VI (6-month FU) (VI seeking rehabilitation services) 65–99 years (80 ± 7) 20.5% with severe VI (BCVA ≤6/60)	Depression: CES-D HRQOL: OARS MFAQ VRQOL: FVSQ (baseline only)	Subjects with subthreshold depression (n = 157) (26.3 ± 8.6) or major depression (n = 42) (27.5 ± 9.2) had worse HRQOL than nondepressed subjects (n = 385) (21.9 ± 6.9)^* (d = .59 for subthreshold vs nondep, and d = .78 for major dep. vs nondep), but no significant difference in VRQOL (d = .17 for subthreshold vs nondep, and d = .24 for major dep. vs nondep). Fewer DS were associated with better HRQOL (r = 0.23^* at baseline and 0.29^*** at 6 mths).	0.69 (fair)
Reinhardt 2009³⁷ USA II (FU:6 and 18 months) Note: FU to Reinhardt 2001²⁰	313 VI (from a vision rehabilitation agency) 65–99 years (mean ± SD = 79 ± 7) VA criteria not reported	Depression: CES-D HRQOL: OARS MFAQ VRQOL: FVSQ	Better HRQOL and VRQOL at baseline were associated with fewer DS (r = 0.3 1 ^* at baseline, 0.27^* at 6 mths and 0.28^* at 18 mths with HRQOL; r = 0.22^* at baseline, 0.18^*** at 6 mths and 0.12* at 18 mths with VRQOL).	0.67 (fair)
Rovner 1996²⁴ USA II (FU: 2 years) Note: FU to Shmuely-Dulitzki 1995³⁸	70 VI (baseline) 31 VI (2-year FU) (from a low vision clinic of an eye hospital) >65 years 90.7% with VA ≤6/15	Depression: GDS, DSM-III-R HRQOL: CDS	Subjects with depression (n = 27) had worse HRQOL (17.7 ± 6.0) than nondepressed subjects (n = 43) (13.2 ± 7.0)^** (d = .68). Fewer DS were associated with better HRQOL (r = 0.40^* at baseline and r = 0.68^*** at 2 years) (n = 31).	0.62 (fair)
Mathew 2011¹³ Australia III	145 AMD 104 controls >55 years (78 ± 8 AMD, 78 ± 6 controls) VA ≥ 6/60	Depression: GAD (depression subscale) HRQOL: SF-36	For the AMD group, fewer DS were correlated with better HRQOL (all the SF-36 subscales, varying between r = −0.33 to −0.53 for the PC^ and −0.53 to −0.61 for the MC^).	0.74 (good)
Hayman 2007⁴⁴ New Zealand IV	391 VI ≥ 75 years (84 ± 5) BCVA ≤6/24 in the better eye	Depression: GDS HRQOL: SF-36 VRQOLVF-14	Subjects with DS (n = 115) had worse HRQOL (PC = 37.4 ± 11.1; MC = 49.7± 10.4) than nondepressed subjects (n = 276) (PC = 42.3 ± 9.4; MC = 56.9 ± 6.1 )^* (d = .49 for PC and .95 for MC). The former also had worse VRQOL (16.3 ± 11.6) than the latter (23.1 ± 16.0)^* (d = .46). Fewer DS were significantly related to better HRQOL^* and VRQOL^*.	0.70 (good)
Renaud 2010¹⁴ Canada IV	64 VI (seeking rehabilitation services) 67–92 years (79 ± 6) BCVA <6/21 in the better eye	Depression: GDS VRQOL: NEI-VFQ-25 SQOL: Quality of Life Index	More DS were related to worse VRQOL (r = −0.64^*) and SQOL (r = −0.68^). DS explained 45%^** of SQOL but were not a significant determinant of VRQOL.	0.70 (good)
Rovner 2011⁵⁷ USA IV	241 AMD ≥ 65 years (83 ± 7) BCVA between 6/21 and 6/120 in the better eye	Depression: PHQ VRQOL: NEI-VFQ (near-vision subscale only, 6 items)	Depressive symptoms were not significantly (P = 0.07) related to and did not explain VRQOL.	0.70 (good)
Brody 2001⁴⁵ USA IV	151 AMD ≥ 60 years (80 ± 6) VA ≤6/18 in the better eye	Depression: GDS, SCID-IV HRQOL: SIP VRQOL: NEI-VFQ-25, SIPV	Subjects with depression (SCID-IV criteria) (n = 49) had worse HRQOL (15.8 ± 9.5) than nondepressed subjects (n = 102) (8.9 ± 7.5)^* (d = .84). The former also had worse VRQOL (SIPV = 10.1 ± 6.6; NEI-VFQ = 49.4 ± 13.4) than the latter (SIPV = 6.0 ± 5.1; NEI-VFQ = 60.6 ± 12.6)^* (d = .73 for SIPV and .87 for NEI-VFQ). More DS were significantly related to worse HRQOL (r = 0.53^) and VRQOL (r = −0.51^ NEI-VFQ and r = 0.46^* SIPV).	0.67 (fair)
Rovner 2006⁵⁶ USA IV	206 AMD (exclusion: DSM-IV depression diagnosis) >64 years (81 ±6) BCVA in the better eye mean = 6/24	Depression : HDRS VRQOL: NEI-VFQ-17	Subjects with minimal DS (representing nonsignificant DS under HDRS criteria) (n = 49) had worse VRQOL (43.1 ± 1 1.7) than nondepressed subjects (n = 157) (35.3 ± 13.2)^* (d = .61 ). More DS were significantly associated with worse VRQOL (r = 0.28^*).	0.67 (fair)
Reinhardt 1996⁵⁰ USA IV	241 VI (from a vision rehabilitation agency) 65–99 years (79 ± 7) Self-reported VI	Depression: CES-D HRQOL: OARS MFAQ VRQOL: FVSQ SQOL: LSI-A	Fewer DS were associated with better HRQOL (r = 0.42^*), VRQOL (r = 0.28^) and SQOL (r = −0.72)^**.	0.64 (fair)
Tabrett 2011⁵⁸ United Kingdom IV	100 VI (from low vision services) 73–86 years (81) Binocular VA with current glasses mean ~6/41	Depression: GDS VRQOL: AI	Fewer DS were significantly related to better VRQOL (r = −0.50)^**.	0.62 (fair)

Notes:

P < 0.05

^**

P < 0.01

^***

P < 0.001.

Study details include first author, year of publication, country, and study level. Study levels: I, randomized controlled trial; II, cohort, quasi-experimental; III, case control; IV, case series

number of participants, age, and visual acuity criteria

Methodological quality refers to the Cho score which is a fraction, therefore the result is between 0 and 1 (higher score indicates a better study).

Abbreviations: AMD, age-related macular degeneration; AI, Activity Inventory; BCVA, best-corrected visual acuity; CDS, Community Disability Scale; CES-D, Center for Epidemiological Studies-Depression Scale; DS, depressive symptoms; DSM-III-R, Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition, Revised; FVSQ, Functional Vision Screening Questionnaire; GDA, Goldberg Anxiety and Depression scale; GDS, Geriatric Depression Scale; HDRS, Hamilton Depression Rating Scale; HRQOL, health-related quality of life; LSI-A, Life Satisfaction Index-A; NEI-VFQ, National Eye Institute Visual Function questionnaire; OARS MFAQ, Older Americans Resources and Services Multidimensional Functional Assessment Questionnaire; MC, mental component; PC, physical component; PHQ, Patient Health Questionnaire; SF-36, Medical Outcomes Study Short-Form Health Survey; SCID-IV, Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition; SIP, Sickness Impact Profile; SIPV, Sickness Impact Profil specific to vision; SQOL, subjective quality of life; VF-14, Visual Functioning Index; VA, visual acuity; VI, visual impairment; VRQOL, vision-related quality of life.