# Linking diabetic retinal changes with the occurrence of anxiety and depression in working population

**Authors:** Sonja P. Cekić, Dijana S. Risimić, Maja M. Simonović, Nikola M. Stojanović, Aleksandra Ignjatović

PMC · DOI: 10.1515/med-2026-1377 · Open Medicine · 2026-03-06

## TL;DR

This study found that people with diabetic retinopathy experience higher anxiety and depression, especially if they have left-side macular edema.

## Contribution

The study links diabetic retinal changes specifically with increased anxiety and depression in working-age individuals.

## Key findings

- Patients with diabetic retinopathy had significantly higher anxiety and depression levels than healthy controls.
- Higher anxiety and depression scores were observed in patients with left-side OCT macular edema.
- No significant correlation was found between anxiety/depression scores and gender, therapy type, or DR type.

## Abstract

Diabetic retinopathy (DR) is a severe complication of diabetes mellitus (DM) leading to vision loss and blindness, which typically develops 12–20 years after the diagnosis of DM. Anxiety and depression frequently co-occur with chronic medical conditions like DM and DR, impacting their onset, course, and prognosis. This study aimed to examine the link between anxiety, depression, DR, and macular changes.

A cross-sectional study was conducted at the Clinic for Ophthalmology, University Clinical Center Niš, Serbia, involving 80 adult participants, naïve to psychiatric and invasive ophthalmological therapy, divided into two groups: 40 patients with DR, and 40 healthy controls. Ophthalmic examinations, biochemical measurements, and assessments of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS) and Montgomery and Asberg Depression Rating Scale (MADRS) were performed.

Results indicated that patients with DR had significantly higher levels of anxiety and depression compared to controls. The study found no significant correlation between HADS and MADRS scores with patients’ gender, type of therapy, or the type of DR. However, a higher HADS and MADRS score was observed in patients with left-side OCT macular edema.

The study highlights the complex interaction between psychiatric disorders and somatic illnesses, emphasizing the need for comprehensive care strategies that address both physical and mental health to improve patient outcomes.

## Linked entities

- **Diseases:** diabetic retinopathy (MONDO:0005266), diabetes mellitus (MONDO:0005015), anxiety (MONDO:0005618), depression (MONDO:0002050)

## Full-text entities

- **Genes:** VEGFA (vascular endothelial growth factor A) [NCBI Gene 7422] {aka L-VEGF, MVCD1, VEGF, VPF}, INS (insulin) [NCBI Gene 3630] {aka IDDM, IDDM1, IDDM2, ILPR, IRDN, MODY10}, IL1B (interleukin 1 beta) [NCBI Gene 3553] {aka IL-1, IL1-BETA, IL1F2, IL1beta}, CHMP2B (charged multivesicular body protein 2B) [NCBI Gene 25978] {aka ALS17, CHMP2.5, DMT1, FTDALS7, VPS2-2, VPS2B}, APP (amyloid beta precursor protein) [NCBI Gene 351] {aka AAA, ABETA, ABPP, AD1, APPI, CTFgamma}, TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, POMC (proopiomelanocortin) [NCBI Gene 5443] {aka ACTH, CLIP, LPH, MSH, NPP, OBAIRH}, IL6 (interleukin 6) [NCBI Gene 3569] {aka BSF-2, BSF2, CDF, HGF, HSF, IFN-beta-2}
- **Diseases:** metabolic disorders (MESH:D008659), hearing impairment (MESH:D034381), ischemia (MESH:D007511), inability (MESH:C564980), blindness (MESH:D001766), anxiety disorders (MESH:D001008), concentration difficulties (MESH:C567712), affective disorders (MESH:D019964), intraocular inflammatory diseases (MESH:D064090), uveitis (MESH:D014605), chest pain (MESH:D002637), lassitude (MESH:D005221), retinopathy (MESH:D058437), psychiatric (MESH:D001523), Alzheimer's disease (MESH:D000544), Diabetes (MESH:D003920), age-related macular degeneration (MESH:D008268), Anxiety (MESH:D001007), scleritis (MESH:D015423), edema (MESH:D004487), inflammatory (MESH:D007249), tension (MESH:D018781), hyperglycemia (MESH:D006943), inherited macular disorders (MESH:C535968), loss of central vision (MESH:D014786), dyslipidemia (MESH:D050171), reduced sleep (MESH:D012893), skin conditions (MESH:D012871), vascular occlusive diseases (MESH:D008641), mitochondrial dysfunction (MESH:D028361), neuropathy (MESH:D009422), type 2 diabetes (MESH:D003924), nephropathy (MESH:D007674), depressed (MESH:D003866), glaucoma (MESH:D005901), retinal neurodegeneration (MESH:D012164), reduced appetite (MESH:D001068), cardiovascular diseases (MESH:D002318), DME (MESH:D008269), PDR (OMIM:603933), foot problems (MESH:D005530), DR (MESH:D003930), neurovascular abnormalities (MESH:D013901), diabetic retinal changes (MESH:D012173), mental health disorder (OMIM:603663), HPA-axis dysregulation (MESH:C566610), cerebral microvascular dysfunction (MESH:D017566), premature death (MESH:D003643), atherosclerotic (MESH:D050197)
- **Chemicals:** nitric oxide (MESH:D009569), cholesterol (MESH:D002784), blood glucose (MESH:D001786), triglycerides (MESH:D014280), OCT (MESH:C051883), glucose (MESH:D005947), lipid (MESH:D008055), fluorescein (MESH:D019793), mineral (MESH:D008903), DMT2 (-), melatonin (MESH:D008550)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## References

38 references — full list in the complete paper: https://tomesphere.com/paper/PMC12962732/full.md

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Source: https://tomesphere.com/paper/PMC12962732