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This study was aimed to investigate the risk of mood disorders in patients who experienced retinal detachment (RD) by using the National Health Insurance Research Database in Taiwan. A total of 4129 participants diagnosed with RD and 16,516 non-RD individuals who served as control group were enrolled in the study. Participants were age and sex-matched in the two groups. To make the general status of each participant more homogenous, the current study also considered the effects of education level, marriage status, and the systemic comorbidities in the regression model, namely hypertension, diabetes mellitus, ischaemic heart diseases, hyperlipidaemia, congestive heart failure, cerebrovascular disease, and malignancy. Higher education levels (p < 0.0001) and a larger number of unmarried individuals (p=0.0053) were found in the study group, and all systemic comorbidities were also significantly higher in the study group (p < 0.05), except cerebrovascular disease (p=0.4591).The outcomes related to mood disorders after RD included: (1) psychiatric outpatient department visits; (2) behavioural therapy; (3) sleep or anxiety-related disorders; and (4) major depressive disorder (MDD). After a follow-up period of up to 16 years, 549 events of mood disorders occurred in the study group (13.3%), while 972 cases were found in the control group (5.89%). No significant differences in the incidence rate were observed among all the four mood- disorder-related outcomes, including psychiatric outpatient department (OPD) visits (p=0.534), behavioural therapy (p=0.609), sleep or anxiety-related disorders (p=0.815), and MDD (p=0.067), based on the multivariable analysis. Patients with recurrent RD who received more than two treatments showed a higher probability of developing MDD than did the non-RD subjects. Incidence rate: 0.96 vs. 0.36; adjusted hazard ratio [aHR]: 2.382, 95% confidence interval [CI]: 1.032-5.496, log-rank p=0.0325; and aHR: 6.895, 95% CI: 1.659-28.656, log-rank p=0.0060, respectively. In the sex-based subgroup analysis, male sex demonstrated no significant association with the occurrence of different mood disorders. Females had a significantly higher rate of MDD development among those with repeated surgeries, compared to controls. Limitations: Retrospective nature. Usage of data, rather than original medical records. The use of data may have led to gaps in information such as postoperative visual acuity, macular detachment status etc, and thus other contributory factors leading to psychiatric disorders were not taken into consideration.

Elevated risk of mood disorders after the occurrence of recurrent retinal detachment: a population-based cohort study.
Lee CY, Chen HC, Huang JY, et al.
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Sofia Rokerya

MBBS MRCOphth FRCSI, King's College University Hospital, UK.

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