{
  "abstract": "Purpose\n\nVision-threatening diabetic retinopathy (VTDR) poses significant blindness risks and the study aimed to identify the impact of psychological factors on its ocular outcomes.Methods\n\nThis retrospective cohort study enrolled 782 VTDR patients from three ophthalmological centers (2018-2021). DR severity was graded using ETDRS criteria. Primary outcomes included tractional retinal detachment (TRD) involving the fovea, neovascular glaucoma (NVG), final best-corrected visual acuity (BCVA) <0.3, and recurrent vitreous hemorrhage (VH). Anxiety and depression were assessed via the hospital anxiety and depression scale (HADS). Univariable and multivariable logistic regression evaluated the associations between HADS scores and ocular outcomes.Results\n\nAfter a median follow-up of 24.8 months, depressive symptoms (HADS-D ≥8) were associated with higher rates of BCVA <0.3 (67.8% vs. 57.2%, p = 0.033) and NVG (13.6% vs. 6.9%, p = 0.020). Recurrent VH was more frequent in patients with anxiety (21.0% vs. 10.6%, p = 0.031) or depression (20.3% vs. 10.7%, p = 0.045). Multivariable logistic analysis revealed that each 1-point increase in HADS-D score significantly increased adjusted odds of TRD (aOR = 1.06, 95% CI: 1.01-1.11), BCVA <0.3 (aOR = 1.07, 95% CI: 1.02-1.11), recurrent VH (aOR = 1.09, 95% CI: 1.02-1.17), and NVG (aOR = 1.10, 95% CI: 1.03-1.17; all p < 0.05). There was a consistent positive gradient between HADS severity and adverse outcomes.Conclusion\n\nDepressive symptoms are independently associated with worse ocular prognoses in VTDR patients. Systematic psychological screening and intervention is essential to mitigate vision deterioration risk in this population.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Ophthalmology The Fourth Affiliated Hospital of Soochow University No. 9 Chongwen Road, Suzhou Industrial Park Suzhou 215123 Jiangsu Province China.",
    "Department of Ophthalmology Shanghai General Hospital National Clinical Research Center for Eye Diseases Shanghai Jiao Tong University School of Medicine No.100 Haining Road, Hongkou District Shanghai 200080 China shsmu.edu.cn.",
    "Department of Ophthalmology Ninth People's Hospital Shanghai Jiao Tong University School of Medicine No. 639 Zhizaoju Road, Huangpu District Shanghai 200011 China shsmu.edu.cn."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Bo Li",
      "orcid": "0000-0002-1319-1454"
    },
    {
      "affs": [
        1
      ],
      "name": "Yujin Jiang",
      "orcid": "0009-0000-6470-7791"
    },
    {
      "affs": [
        1
      ],
      "name": "Chenxin Li",
      "orcid": "0009-0006-7069-170X"
    },
    {
      "affs": [
        1
      ],
      "name": "Yikeng Huang",
      "orcid": "0000-0002-2534-9466"
    },
    {
      "affs": [
        1
      ],
      "name": "Shuzhi Zhao",
      "orcid": "0009-0000-1880-4208"
    },
    {
      "affs": [
        2
      ],
      "name": "Chuandi Zhou",
      "orcid": "0009-0004-3177-2860"
    },
    {
      "affs": [
        1
      ],
      "name": "Zhi Zheng",
      "orcid": "0000-0001-8435-0240"
    },
    {
      "affs": [
        0
      ],
      "name": "Xiaofeng Zhang",
      "orcid": "0009-0007-3904-3832"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7rkd5xbwapnnd.bib",
  "cited_by": 0,
  "doi": "10.1155/da/6998782",
  "fulltext_url": "https://europepmc.org/articles/PMC13695853",
  "id": "7rkd5xbwapnnd",
  "issns": [
    "1091-4269",
    "1520-6394"
  ],
  "landing_url": "https://europepmc.org/article/MED/42928730",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2731|Retinal Diseases and Treatments"
    ]
  ],
  "openalex": "W7223565414",
  "pdf_url": "https://europepmc.org/articles/PMC13695853?pdf=render",
  "pmcid": "PMC13695853",
  "pmid": "42928730",
  "published": "2026-10-25",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/7rkd5xbwapnnd.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:18Z",
      "native_id": "MED:42928730",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42928730"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2731|Retinal Diseases and Treatments",
      "subfield": "general"
    }
  ],
  "title": "HADS-Assessed Anxiety/Depression Status and Ocular Outcomes in Vision-Threatening Diabetic Retinopathy: A Multicenter Retrospective Cohort Study.",
  "title_text": "HADS-Assessed Anxiety/Depression Status and Ocular Outcomes in Vision-Threatening Diabetic Retinopathy: A Multicenter Retrospective Cohort Study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:18Z",
  "url": "https://research.draconitic.com/paper/7rkd5xbwapnnd",
  "venue": "Depression and anxiety",
  "versions": []
}