Non-pharmacological interventions on depression among eye disease patients: A systematic review
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Background
The objective of the current systematic review is to synthesize and qualitatively summarize data with regards to the effectiveness of non-pharmacological therapies in treating depression among visually impaired older adults.
Methods
MEDLINE, EMBASE, Cochrane Library, and CINAHL were initially searched on March 24, 2023, whereas Web of Science and all conference databases were searched on May 30, 2023. All databases were searched once again on June 16, 2025. Studies were uploaded to Covidence and following duplicate removal, 3509 studies proceeded to title and abstract screening. Studies that investigated the impact of non-pharmacological interventions to adults (aged 18 years old) with eye disease on depression were included. Studies administering both pharmacological therapies alone and in combination with non-pharmacological therapies were excluded. Review articles, editorials, case reports, and case series were excluded. Study quality was assessed using The Tool to Assess Risk of Bias in Randomized Controlled Trials, Tool to Assess Risk of Bias in Cohort Studies, and the Risk of Bias in Non-Randomized Studies – of Interventions (ROBINS-I). Following risk of bias assessment, study data were extracted and narratively synthesized.
Results
A total of 30 full-text articles were included. Outcome data such as depression score at each measurement timepoint, change in depression score at each measurement timepoint, effect measures for depression, and regression data on depression score were extracted and qualitatively analyzed.
Conclusion
Problem solving treatment (PST) appears to offer short term relief for depression, but further studies should be conducted to investigate the necessity of booster treatments to maintain long-term effectiveness. Physical activity shows promise in improving depression outcomes among visually impaired older adults, however, additional studies with stronger evidence from randomized control trials controlling for the amount and type of exercise are necessary before reaching a firm conclusion.
