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. 2024 Apr 9:17:1573-1585.
doi: 10.2147/PRBM.S443146. eCollection 2024.

Association of Retinal Neurovascular Impairment with Disease Severity in Patients with Major Depressive Disorder: An Optical Coherence Tomography Angiography Study

Yan Wang #  1   2 , Cong Li #  1   2 , Lei Liu #  1 , Yuan Yang #  3 , Xue He  1   2 , Gang Li  3 , Xianzhen Zheng  3 , Yun Ren  1   4 , Hanpeng Zhao  1   5 , Zhenchao Du  1   4 , Jianrong Jiang  1   5 , Yu Kuang  1 , Fujun Jia  3 , Honghua Yu  1 , Xiaohong Yang  1   2
Affiliations

Association of Retinal Neurovascular Impairment with Disease Severity in Patients with Major Depressive Disorder: An Optical Coherence Tomography Angiography Study

Yan Wang et al. Psychol Res Behav Manag. .

Abstract

Background: Identifying the fundus objective biomarkers for the major depressive disorders (MDD) may help promote mental health. The aim of this study was to evaluate retinal neurovascular changes and further investigate their association with disease severity in MDD.

Methods: This cross-sectional study conducted in the hospital enrolled patients with MDD and healthy controls.The retinal neurovascular parameters for all subjects, including vessel density (VD), thickness of ganglion cell complex (GCC) and retinal nerve fiber layer (RNFL), and optic nerve head (ONH) eg are automatically calculated by the software in optical coherence tomography angiography (OCTA). The severity of MDD including depressive symptoms, anxiety, cognition, and insomnia was assessed by Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Scale (HAMA), Montreal Cognitive Assessment (MoCA), and Insomnia Severity Index (ISI) respectively.

Results: This study included 74 MDD patients (n=74 eyes) and 60 healthy controls (HCs) (n=60 eyes). MDD patients showed significantly decreased VD of superficial and deep capillary plexus, thickness of GCC and RNFL, and volume of ONH (all p<0.05) and increased vertical cup-to-disc ratio and global loss volume (GLV) (all p<0.05) compared to HCs. Positive associations were found between HAMD scores and cup area (r=0.30, p=0.035), cup volume (r=0.31, p=0.029), and disc area (r=0.33, p=0.020) as well as ISI scores and RNFL thickness (r=0.34, p=0.047).

Conclusion: We found the retinal neurovascular impairment and its association with disease severity in MDD patients. OCTA showed promise as a potential complementary assessment tool for MDD.

Keywords: disease severity; major depressive disorder; optical coherence tomography angiography; retinal neurovasculature.

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Conflict of interest statement

The authors declare that they have no competing interests in this work.

Figures

Figure 1
Figure 1
Comparison of retinal neurovascular parameters of healthy controls and major depressive disorder groups. (A) Comparison of DCP VD and GCC parameters between controls and MDD; (B) Comparison of GLV and optic nerve head volume between controls and MDD; For all figures, *p<0.05; **p<0.01; ***p<0.001.
Figure 2
Figure 2
Correlation analyses between the retinal neural parameters and questionnaire scores. The cup area (A), cup volume (B) and disc area (C) were positively correlated with HAMD scores; (D) The thickness of RNFL was positively correlated with ISI scores.
See this image and copyright information in PMC

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