Association Between Traditional Chinese Medicine Syndromes and Depression Severity in Glaucomatous Optic Atrophy: Therapeutic Implications of Integrated TCM Interventions

Objective This study aimed to clarify how the holistic traditional Chinese medicine (TCM) pattern, based on ocular and systemic findings in patients with glaucomatous optic atrophy, correlates with depression severity and evaluate the therapeutic impact of integrated TCM interventions. Methods A total of 40 patients (40 eyes) with glaucomatous optic atrophy were classified by TCM syndrome differentiation. One eye per patient was included; the worse-affected eye was selected for analysis. Among these, 20 patients (20 eyes) with liver depression and qi stagnation syndrome and depressive symptoms were randomly allocated (1:1) to the control group or the treatment group using block randomization. Results Liver depression and qi stagnation were the most prevalent syndrome (55.0%, 22/40), followed by phlegm-dampness obstructing the eyes (25.0%, 10/40), liver and kidney yin deficiency for 12.5% (5/40), and qi and blood deficiency for 7.5% (3/40). Depressive symptoms were present in 90.9% (20/22) and 60.0% (6/10) of these groups, respectively. In randomized trial ( n = 20), baseline Self-Rating Depression Scale (SDS) scores were 63.20 ± 8.04 in the control group and 64.30 ± 5.58 in the treatment group. By the end of the third treatment course, the SDS score in the treatment group decreased significantly to 54.90 ± 8.02, whereas the control group remained stable at 64.70 ± 7.82 (group × time interaction: F[2,40] = 27.42, P < 0.001; between-group difference at Course 3: P = 0.013). No significant changes in intraocular pressure were observed in either group. Conclusion Depressive symptoms were most frequently associated with liver depression and qi stagnation syndrome in individuals with glaucomatous optic atrophy, followed by phlegm-dampness obstructing the eyes. Integrated TCM interventions were associated with an improvement in depressive symptoms and visual function.