International Review of Ophthalmology ›› 2025, Vol. 49 ›› Issue (4): 297-303.doi: 10. 3760/cma.j.cn115500-20250304-25410

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Advanced research on psychological impact factors of macular diseases

Zhang Jinrong1,2, Zhang Yue1,3, Wang Jianing1,3, Yu Xiaobing1   

  1. 1Department of Ophthalmology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China; 2Peking University Fifth School of Clinical Medicine, Beijing 100730, China; 3Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
  • Received:2025-03-04 Online:2025-08-22 Published:2025-08-12
  • Contact: Yu Xiaobing, Email: yuxiaobing1214@163.com E-mail:yuxiaobing1214@163.com
  • Supported by:
    Clinical Research Program of the Special Fund for Clinical and Scientific Research of High-Level Central Hospitals (BJ-2024-089)

Abstract: Macular diseases, including central serous chorioretinopathy (CSCR), age-related macular degeneration (AMD), diabetic macular edema, and macular hole, could lead to varying degrees of visual impairment and are also closely associated with a range of psychological disorders. Anxiety, depression, and stress-related conditions are found at a higher prevalence among affected individuals. Type A personality traits and elevated psychological stress may increase the risk of CSCR onset and influence its progression and recurrence. The underlying mechanisms are thought to involve dysregulation of the hypothalamic-pituitary-adrenal axis, elevated levels of cortisol and catecholamines, abnormal activation of the mineralocorticoid receptor pathway, and autonomic nervous system dysfunction, among other pathological processes. Therapeutically, while anti-vascular endothelial growth factor (VEGF) therapy has shown significant efficacy in improving visual outcomes in AMD, the psychological burden of repeated intravitreal injections may contribute to increased stress and reduced treatment adherence. Clinical observational studies suggest that treatment-related anxiety and depressive symptoms may adversely affect patients' quality of life and visual prognosis. The critical role of psychological impact factors was highlighted in the management of the macular diseases.

Key words: Macular diseases, Psychological factor