Bidirectional relationship of diabetic retinopathy with anxiety and depression: a meta-analysis

Diabetic retinopathy (DR) stands as the most frequently observed microvascular complication caused by diabetes mellitus (DM). This study aimed to prove whether there was a bidirectional relationship of DR with anxiety and depression.

This study included 34 studies in total. Two researchers independently screened and extracted the data relevant to this study. The Newcastle-Ottawa Scale and the tools of the Agency for Healthcare Research and Quality were employed for the evaluation of the included studies. Stata 15.1 was applied for computing the odds ratio (OR), hazard ratio (HR), and 95% confidence interval (CI), and the relationship of DR with anxiety and depression was analyzed. The publication bias was evaluated leveraging funnel plots and Egger's test. The sensitivity analysis was conducted by sequentially removing each study.

This meta-analysis included 34 studies in total, involving 383,195 patients. A significantly positive correlation was observed between DR and depression (OR = 1.58; 95%CI:1.24-2.02; p<0.001). A significantly positive correlation was found between depression and DR (OR = 2.13; 95%CI:1.53-2.98; p<0.001). A significantly positive correlation existed between DR and anxiety (OR = 2.23; 95%CI:1.07-4.68; p=0.033).

This study suggests a bidirectional relationship exists between DR and depression. Therefore, it is recommended to carry out personalized psychological care during the treatment of DR.

https://www.crd.york.ac.uk/PROSPERO/view/CRD420251080025, identifier CRD420251080025.