Selective serotonin reuptake inhibitors may lead to improved cataract surgery outcomes in patients with amblyopia

Kevin Z. Xin, Christina R. Prescott

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate the effects of selective serotonin reuptake inhibitor (SSRI)/serotonin norepinephrine reuptake inhibitor (SNRI) medications in combination with cataract surgery in treating amblyopia in adult patients. Patients and methods: A retrospective chart review study was conducted on patients who had undergone cataract surgery at the Johns Hopkins Hospital Wilmer Eye Institute. Six inclusion criteria were used to assess patient eligibility: 1) >18 years of age, 2) diagnosis of amblyopia, 3) diagnosis of cataract and treatment with surgery, 4) electronic medical record contains pre-surgery and post-surgery visual acuity (VA) measurements, 5) electronic medical record contains information on whether the patient was ever prescribed a SSRI/SNRI and the treatment duration, and 6) interocular VA difference of two lines or more on Snellen chart prior to cataract surgery. From each record, preoperative VA, postoperative VA, date of surgery, date at which postoperative VA was measured, and age at surgery were collected. Results: A total of 237 patients were included, with 38 of them being on SSRI/SNRI. The mean improvement in VA after surgery was not significantly greater in patients on SSRI/ SNRI (SSRI/SNRI: −0.276 logMAR, control: −0.192 logMAR, p=0.15). Multivariable regression was subsequently performed and while holding all other variables constant, demonstrated a statistically significant improvement in VA in patients on SSRI/SNRI (95% CI: −0.194, −0.0116, p=0.03). The regression analysis further demonstrated that advanced age has an adverse effect on the change in post-op VA (CI: 3.34×10−3 logMAR, 9.77×10−3 logMAR, p<0.005). Worse baseline VA is associated with a greater improvement in post-op VA (95% CI: −0.659 logMAR, −0.463 logMAR, p<0.005) but adverse effect on the absolute post-op VA (95% CI: 0.341 logMAR, 0.544 logMAR, p<0.005). Conclusion: This study suggests that patients with amblyopia undergoing cataract surgery may potentially have a greater visual improvement when treated with SSRI/SNRIs.

Original languageEnglish (US)
Pages (from-to)1517-1522
Number of pages6
JournalClinical Ophthalmology
Volume13
DOIs
StatePublished - Jan 1 2019

Fingerprint

Amblyopia
Serotonin Uptake Inhibitors
Cataract
Visual Acuity
Electronic Health Records
Serotonin and Noradrenaline Reuptake Inhibitors
Regression Analysis

Keywords

  • Amblyopia
  • Cataract surgery
  • Dopamine
  • Selective serotonin reuptake inhibitor (SSRI)/ selective norepinephrine reuptake inhibitor
  • Visual plasticity

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Selective serotonin reuptake inhibitors may lead to improved cataract surgery outcomes in patients with amblyopia. / Xin, Kevin Z.; Prescott, Christina R.

In: Clinical Ophthalmology, Vol. 13, 01.01.2019, p. 1517-1522.

Research output: Contribution to journalArticle

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abstract = "Purpose: To evaluate the effects of selective serotonin reuptake inhibitor (SSRI)/serotonin norepinephrine reuptake inhibitor (SNRI) medications in combination with cataract surgery in treating amblyopia in adult patients. Patients and methods: A retrospective chart review study was conducted on patients who had undergone cataract surgery at the Johns Hopkins Hospital Wilmer Eye Institute. Six inclusion criteria were used to assess patient eligibility: 1) >18 years of age, 2) diagnosis of amblyopia, 3) diagnosis of cataract and treatment with surgery, 4) electronic medical record contains pre-surgery and post-surgery visual acuity (VA) measurements, 5) electronic medical record contains information on whether the patient was ever prescribed a SSRI/SNRI and the treatment duration, and 6) interocular VA difference of two lines or more on Snellen chart prior to cataract surgery. From each record, preoperative VA, postoperative VA, date of surgery, date at which postoperative VA was measured, and age at surgery were collected. Results: A total of 237 patients were included, with 38 of them being on SSRI/SNRI. The mean improvement in VA after surgery was not significantly greater in patients on SSRI/ SNRI (SSRI/SNRI: −0.276 logMAR, control: −0.192 logMAR, p=0.15). Multivariable regression was subsequently performed and while holding all other variables constant, demonstrated a statistically significant improvement in VA in patients on SSRI/SNRI (95{\%} CI: −0.194, −0.0116, p=0.03). The regression analysis further demonstrated that advanced age has an adverse effect on the change in post-op VA (CI: 3.34×10−3 logMAR, 9.77×10−3 logMAR, p<0.005). Worse baseline VA is associated with a greater improvement in post-op VA (95{\%} CI: −0.659 logMAR, −0.463 logMAR, p<0.005) but adverse effect on the absolute post-op VA (95{\%} CI: 0.341 logMAR, 0.544 logMAR, p<0.005). Conclusion: This study suggests that patients with amblyopia undergoing cataract surgery may potentially have a greater visual improvement when treated with SSRI/SNRIs.",
keywords = "Amblyopia, Cataract surgery, Dopamine, Selective serotonin reuptake inhibitor (SSRI)/ selective norepinephrine reuptake inhibitor, Visual plasticity",
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AU - Prescott, Christina R.

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N2 - Purpose: To evaluate the effects of selective serotonin reuptake inhibitor (SSRI)/serotonin norepinephrine reuptake inhibitor (SNRI) medications in combination with cataract surgery in treating amblyopia in adult patients. Patients and methods: A retrospective chart review study was conducted on patients who had undergone cataract surgery at the Johns Hopkins Hospital Wilmer Eye Institute. Six inclusion criteria were used to assess patient eligibility: 1) >18 years of age, 2) diagnosis of amblyopia, 3) diagnosis of cataract and treatment with surgery, 4) electronic medical record contains pre-surgery and post-surgery visual acuity (VA) measurements, 5) electronic medical record contains information on whether the patient was ever prescribed a SSRI/SNRI and the treatment duration, and 6) interocular VA difference of two lines or more on Snellen chart prior to cataract surgery. From each record, preoperative VA, postoperative VA, date of surgery, date at which postoperative VA was measured, and age at surgery were collected. Results: A total of 237 patients were included, with 38 of them being on SSRI/SNRI. The mean improvement in VA after surgery was not significantly greater in patients on SSRI/ SNRI (SSRI/SNRI: −0.276 logMAR, control: −0.192 logMAR, p=0.15). Multivariable regression was subsequently performed and while holding all other variables constant, demonstrated a statistically significant improvement in VA in patients on SSRI/SNRI (95% CI: −0.194, −0.0116, p=0.03). The regression analysis further demonstrated that advanced age has an adverse effect on the change in post-op VA (CI: 3.34×10−3 logMAR, 9.77×10−3 logMAR, p<0.005). Worse baseline VA is associated with a greater improvement in post-op VA (95% CI: −0.659 logMAR, −0.463 logMAR, p<0.005) but adverse effect on the absolute post-op VA (95% CI: 0.341 logMAR, 0.544 logMAR, p<0.005). Conclusion: This study suggests that patients with amblyopia undergoing cataract surgery may potentially have a greater visual improvement when treated with SSRI/SNRIs.

AB - Purpose: To evaluate the effects of selective serotonin reuptake inhibitor (SSRI)/serotonin norepinephrine reuptake inhibitor (SNRI) medications in combination with cataract surgery in treating amblyopia in adult patients. Patients and methods: A retrospective chart review study was conducted on patients who had undergone cataract surgery at the Johns Hopkins Hospital Wilmer Eye Institute. Six inclusion criteria were used to assess patient eligibility: 1) >18 years of age, 2) diagnosis of amblyopia, 3) diagnosis of cataract and treatment with surgery, 4) electronic medical record contains pre-surgery and post-surgery visual acuity (VA) measurements, 5) electronic medical record contains information on whether the patient was ever prescribed a SSRI/SNRI and the treatment duration, and 6) interocular VA difference of two lines or more on Snellen chart prior to cataract surgery. From each record, preoperative VA, postoperative VA, date of surgery, date at which postoperative VA was measured, and age at surgery were collected. Results: A total of 237 patients were included, with 38 of them being on SSRI/SNRI. The mean improvement in VA after surgery was not significantly greater in patients on SSRI/ SNRI (SSRI/SNRI: −0.276 logMAR, control: −0.192 logMAR, p=0.15). Multivariable regression was subsequently performed and while holding all other variables constant, demonstrated a statistically significant improvement in VA in patients on SSRI/SNRI (95% CI: −0.194, −0.0116, p=0.03). The regression analysis further demonstrated that advanced age has an adverse effect on the change in post-op VA (CI: 3.34×10−3 logMAR, 9.77×10−3 logMAR, p<0.005). Worse baseline VA is associated with a greater improvement in post-op VA (95% CI: −0.659 logMAR, −0.463 logMAR, p<0.005) but adverse effect on the absolute post-op VA (95% CI: 0.341 logMAR, 0.544 logMAR, p<0.005). Conclusion: This study suggests that patients with amblyopia undergoing cataract surgery may potentially have a greater visual improvement when treated with SSRI/SNRIs.

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KW - Cataract surgery

KW - Dopamine

KW - Selective serotonin reuptake inhibitor (SSRI)/ selective norepinephrine reuptake inhibitor

KW - Visual plasticity

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