Correlation Between Diabetic Retinopathy, Depression Level and Quality of Life in Eye Clinic Zainoel Abidin Hospital

Lia Meuthia Zaini, Devia Alfiza Sari, Vera Dewi Mulia, Annisa Meivira Budiman


Diabetic retinopathy (DR) is one of the eye disorders caused by complications of diabetes mellitus (DM). Indonesia has a high prevalence of DR (43.1%) compared to other Asia-Pacific countries. Damage and blockage of blood vessels in the retina causes impaired vision, which may lead to a total vision loss. DR requires special treatment, coupled with regular treatment, that is expensive and may result in depression and poor quality of life. This study aimed to determine the association between the degree of diabetic retinopathy with the level of depression and quality of life in people with DR in the eye clinic of Zainoel Abidin General Hospital Banda Aceh. This cross-sectional study was conducted from April 2018 to January 2019. Data were obtained through funduscopy reading, Hamilton Depression Rating Scale (HDRS) questionnaire, and Short-Form Health Survey (SF-36). The subjects of this study were all diabetic retinopathy patients who were sampled using the accidental sampling method. Based on the Spearman correlation analysis, there was a correlation between degree of DR and depression level (p value of 0.004) and quality of life (p value of 0,037). In conclusion, there is a moderate correlation between the degree of DR with depression level and quality of life among DM patients.


Diabetic retinopathy; hamilton depression rating scale (HDRS); level of depression; quality of life

Full Text:



  1. Lee R, Wong TY, Sabanayagam C. Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss. Eye Vision. 2015;2(1):17.
  2. Chua J, Lim CXY, Wong TY, Sabanayagam C. Diabetic Retinopathy in the Asia-Pacific. Asia-Pacific J Ophthalmol. 2018;7(1):3–16.
  3. Zheng Y, He M, Congdon N. The worldwide epidemic of diabetic retinopathy. Indian Journal of Ophthalmology. 2012;60(5):428–31.
  4. Castillo JL de los R, Sosa JJS, Santiago PB, Rojas TLÁ. Quality of life in patients with diabetic retinopathy. Holistic Nursing Midwifery. 2017;23(1):69–77.
  5. Rees G, Xie J, Fenwick EK, Sturrock BA, Finger R, Rogers SL, et al. Association between diabetes-related eye complications and symptoms of anxiety and depression. JAMA Ophthalmol. 2016;134(9):1007–14.
  6. Roy T, Lloyd CE. Epidemiology of depression and diabetes: A systematic review. J Affec Dis. 2012;142:S8–21.
  7. Wu CS, Hsu LY, Wang SH. Association of depression and diabetes complications and mortality: a population-based cohort study. Epidemiol Psychiatr Sci. 2020;29:e96.
  8. Xu X, Zhao X, Qian D, Dong Q, Gu Z. Investigating factors associated with depression of type 2 diabetic retinopathy patients in China. PLoS One. 2015;10(7):e0132616.
  9. Granado-casas M, Castelblanco E, Ram A, Mart M, Alcubierre N, Valldeperas X, et al. Poorer Quality of life and treatment satisfaction is associated with diabetic retinopathy in patients with type 1 diabetes without other advanced late complications. J Clin Med. 2019;8(3):377.
  10. Mauricio D. Quality of life and treatment satisfaction are highly relevant patient-reported outcomes in type 2 diabetes mellitus. Ann Transl Med. 2018;6(11):220.
  11. Alcubierre N, Rubinat E, Traveset A, Hernandez M, Jurjo C, Mauricio D. A prospective cross-sectional study on quality of life and treatment satisfaction in type 2 diabetic patients with retinopathy without other major late diabetic complications. Health Qual Life Outcomes. 2014;12:131.
  12. Sasongko MB, Widyaputri F, Agni AN, Wardhana FS, Kotha S, Gupta P, et al. Prevalence of diabetic retinopathy and blindness in Indonesian adults with type 2 diabetes. Am J Ophthalmol. 2017;181:79–87.
  13. Kajiwara A, Miyagawa H, Saruwatari J, Kita A, Sakata M, Kawata Y, et al. Gender differences in the incidence and progression of diabetic retinopathy among Japanese patients with type 2 diabetes mellitus: A clinic-based retrospective longitudinal study. Diabetes Res Clin Pract. 2014;103(3):e7–e10.
  14. Srinivasan NK, John D, Rebekah G, Kujur ES, Paul P, John SS. Diabetes and diabetic retinopathy: knowledge, attitude, and practice (KAP) among diabetic patients in a Tertiary Eye Care Centre. J Clin Diagnostic Res. 2017;11(7):1–7.
  15. Amin MR, Santoso B. Kemajuan visus penderita retinopati diabetik yang diterapi dengan laser fotokoagulasi dan atau injeksi intravitreal di Rumah Sakit Mohammad Hoesin Palembang. Majalah Kedokteran Sriwijaya. 2015;47(2):115–22.
  16. Zhang X, Low S, Kumari N, Wang J, Ang K, Yeo D, et al. Direct medical cost associated with diabetic retinopathy severity in type 2 diabetes in Singapore. PLoS ONE. 2017;12(7):1–11.
  17. Chen X, Lu L. Depression in Diabetic Retinopathy: A Review and Recommendation for Psychiatric Management. Psychosomatics. 2016;57(5):465–71.
  18. Fenwick E, Rees G, Pesudovs K, Dirani M, Kawasaki R, Wong TY, et al. Social and emotional impact of diabetic retinopathy: A review. Clin Exp Ophthalmol. 2012;40(1):27–38.
  19. Trento M, Passera P, Trevisan M, Schellino F, Sitia E Albani S, et al. Quality of life, impaired vision and social role in people with diabetes: a multicenter observational study. Acta Diabetol. 2013;50(6):873–7.
  20. Fenwick E, Rees G, Pesudovs K, Dirani M, Kawasaki R, Wong TY, et al. Social and emotional impact of diabetic retinopathy: a review. Clin Exp Ophthalmol. 2012;40(1):27–38.


Article Metrics

Abstract view : 370 times
PDF - 376 times

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.


Creative Commons License
MKB is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License


View My Stats