Review

Research progress in retinal structural alterations in patients with mental disorders

  • WANG Sijia ,
  • WEI Yanyan ,
  • QIAN Zhenying ,
  • LI Qingwei ,
  • WANG Jijun
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  • 1.Department of Electroencephalography and Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
    2.Department of Psychiatry, Baoshan District Mental Health Center, Shanghai 201906, China
    3.Department of Psychiatry, Tongji Hospital of Tongji University, Shanghai 200065, China
WANG Jijun, E-mail: jijunwang27@163.com
LI Qingwei, E-mail: lianocd@tongji.edu.cn.

Received date: 2024-06-04

  Accepted date: 2024-11-04

  Online published: 2025-02-28

Supported by

Project of Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine(2022-YJ09)

Abstract

Mental disorders frequently co-occur with other physical illnesses, becoming one of the leading causes of disability worldwide. Early diagnosis and intervention are crucial for the effective management of these disorders. Currently, biomarker studies on mental disorders predominantly concentrate on genes, blood indicators, and imaging features of the brain. There is a growing interest in objective phenotypic markers as a research focus. It is established that the retina is part of the central nervous system (CNS), which extends from the mesencephalon and develops concurrently with the brain during the embryonic period. Given the overlapping pathophysiological mechanisms between neurodegenerative diseases and mental disorders, studying the structural and functional changes in the inner layers of the retina has emerged as a new direction in mental health research. The advent of optical coherence tomography (OCT) has enabled microscopic imaging of retinal structures. OCT is capable of objectively quantifying the retinal sub-layers and offers the advantages of being non-invasive, non-contact, and high-resolution. The use of OCT to explore structural changes in the retina among individuals with schizophrenia, bipolar disorder, major depression and other psychiatric disorders has been well documented; however, there is a paucity of reviews on this topic. This review summarizes current research on retinal structural alterations in patients with mental disorders, and the results demonstrate reduced thickness in certain sub-layers of the retina structure in patients with several mental disorders, which supports that the retina structure has the potential to be a biomarker for mental disorders and offers a novel avenue for research in the diagnosis and treatment.

Cite this article

WANG Sijia , WEI Yanyan , QIAN Zhenying , LI Qingwei , WANG Jijun . Research progress in retinal structural alterations in patients with mental disorders[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2025 , 45(2) : 247 -252 . DOI: 10.3969/j.issn.1674-8115.2025.02.015

References

1 GBD 2019 Mental Disorders Collaborators. Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990?2019: a systematic analysis for the Global Burden of Disease Study 2019[J]. Lancet Psychiatry, 2022, 9(2): 137-150.
2 CLARK L A, CUTHBERT B, LEWIS-FERNáNDEZ R, et al. Three approaches to understanding and classifying mental disorder: ICD-11, DSM-5, and the national institute of mental health's research domain criteria (RDoC)[J]. Psychol Sci Public Interest, 2017, 18(2): 72-145.
3 THOMPSON S M. Modulators of GABAA receptor-mediated inhibition in the treatment of neuropsychiatric disorders: past, present, and future[J]. Neuropsychopharmacology, 2024, 49(1): 83-95.
4 LONDON A, BENHAR I, SCHWARTZ M. The retina as a window to the brain-from eye research to CNS disorders[J]. Nat Rev Neurol, 2013, 9(1): 44-53.
5 MAUSCHITZ M M, LOHNER V, KOCH A, et al. Retinal layer assessments as potential biomarkers for brain atrophy in the Rhineland Study[J]. Sci Rep, 2022, 12(1): 2757.
6 LIM J K L, LI Q X, HE Z, et al. Retinal functional and structural changes in the 5×FAD mouse model of Alzheimer's disease[J]. Front Neurosci, 2020, 14: 862.
7 GAIRE B P, KORONYO Y, FUCHS D T, et al. Alzheimer's disease pathophysiology in the retina[J]. Prog Retin Eye Res, 2024, 101: 101273.
8 CHEUNG C Y, MOK V, FOSTER P J, et al. Retinal imaging in Alzheimer's disease[J]. J Neurol Neurosurg Psychiatry, 2021, 92(9): 983-994.
9 GEEVARGHESE A, WOLLSTEIN G, ISHIKAWA H, et al. Optical coherence tomography and glaucoma[J]. Annu Rev Vis Sci, 2021, 7: 693-726.
10 OKUGAWA G, SEDVALL G C, AGARTZ I. Reduced grey and white matter volumes in the temporal lobe of male patients with chronic schizophrenia[J]. Eur Arch Psychiatry Clin Neurosci, 2002, 252(3): 120-123.
11 ASCASO F J, LAURA C, QUINTANILLA M á, et al. Retinal nerve fiber layer thickness measured by optical coherence tomography in patients with schizophrenia: a short report[J]. Eur J Psychiat, 2010, 24(4): 227-235.
12 LEE W W, TAJUNISAH I, SHARMILLA K, et al. Retinal nerve fiber layer structure abnormalities in schizophrenia and its relationship to disease state: evidence from optical coherence tomography[J]. Invest Ophthalmol Vis Sci, 2013, 54(12): 7785-7792.
13 YILMAZ U, Kü?üK E, üLGEN A, et al. Retinal nerve fiber layer and macular thickness measurement in patients with schizophrenia[J]. Eur J Ophthalmol, 2016, 26(4): 375-378.
14 BOUDRIOT E, SCHWORM B, SLAPAKOVA L, et al. Optical coherence tomography reveals retinal thinning in schizophrenia spectrum disorders[J]. Eur Arch Psychiatry Clin Neurosci, 2023, 273(3): 575-588.
15 徐淑莉, 禚传君, 陈清刚. 精神分裂症患者黄斑及视神经纤维损害研究[J]. 精神医学杂志, 2023, 36(6): 638-641.
  XU S L, ZHUO C J, CHEN Q G. Research on the lesions of macula and optic nerve fibers in patients with schizophrenia[J]. Journal of Psychiatry, 2023, 36(6): 638-641.
16 SILVERSTEIN S M, PATERNO D, CHERNESKI L, et al. Optical coherence tomography indices of structural retinal pathology in schizophrenia[J]. Psychol Med, 2018, 48(12): 2023-2033.
17 JEROTIC S, RISTIC I, PEJOVIC S, et al. Retinal structural abnormalities in young adults with psychosis spectrum disorders[J]. Prog Neuropsychopharmacol Biol Psychiatry, 2020, 98: 109825.
18 MILLER M, ZEMON V, NOLAN-KENNEY R, et al. Optical coherence tomography of the retina in schizophrenia: inter-device agreement and relations with perceptual function[J]. Schizophr Res, 2020, 219: 13-18.
19 KANGO A, GROVER S, GUPTA V, et al. A comparative study of retinal layer changes among patients with schizophrenia and healthy controls[J]. Acta Neuropsychiatr, 2023, 35(3): 165-176.
20 ASCASO F J, RODRIGUEZ-JIMENEZ R, CABEZóN L, et al. Retinal nerve fiber layer and macular thickness in patients with schizophrenia: influence of recent illness episodes[J]. Psychiatry Res, 2015, 229(1/2): 230-236.
21 SAIDHA S, SOTIRCHOS E S, OH J, et al. Relationships between retinal axonal and neuronal measures and global central nervous system pathology in multiple sclerosis[J]. JAMA Neurol, 2013, 70(1): 34-43.
22 DINKIN M. Trans-synaptic retrograde degeneration in the human visual system: slow, silent, and real[J]. Curr Neurol Neurosci Rep, 2017, 17(2): 16.
23 TüRK?ZER H B, LIZANO P, ADHAN I, et al. Regional and sex-specific alterations in the visual cortex of individuals with psychosis spectrum disorders[J]. Biol Psychiatry, 2022, 92(5): 396-406.
24 SEKAR A, BIALAS A R, DE RIVERA H, et al. Schizophrenia risk from complex variation of complement component 4[J]. Nature, 2016, 530(7589): 177-183.
25 KURTULMUS A, ELBAY A, PARLAKKAYA F B, et al. An investigation of retinal layer thicknesses in unaffected first-degree relatives of schizophrenia patients[J]. Schizophr Res, 2020, 218: 255-261.
26 KAYA H, AYIK B, TASDELEN R, et al. Comparing retinal changes measured by optical coherence tomography in patients with schizophrenia and their siblings with healthy controls: are retinal findings potential endophenotype candidates?[J]. Asian J Psychiatr, 2022, 72: 103089.
27 KOMATSU H, ONOGUCHI G, SILVERSTEIN S M, et al. Retina as a potential biomarker in schizophrenia spectrum disorders: a systematic review and meta-analysis of optical coherence tomography and electroretinography[J]. Mol Psychiatry, 2024, 29(2): 464-482.
28 MEHRABAN A, SAMIMI S M, ENTEZARI M, et al. Peripapillary retinal nerve fiber layer thickness in bipolar disorder[J]. Graefes Arch Clin Exp Ophthalmol, 2016, 254(2): 365-371.
29 MUSTAFA A, TURGAY U. Optical coherence tomography angiography in patients with euthymic bipolar disorder[J]. J Affect Disord, 2022, 317: 15-21.
30 KALENDEROGLU A, SEVGI-KARADAG A, CELIK M, et al. Can the retinal ganglion cell layer (GCL) volume be a new marker to detect neurodegeneration in bipolar disorder?[J]. Compr Psychiatry, 2016, 67: 66-72.
31 KHALIL M A, SALEH A A, GOHAR S M, et al. Optical coherence tomography findings in patients with bipolar disorder[J]. J Affect Disord, 2017, 218: 115-122.
32 POLO V, SATUE M, GAVIN A, et al. Ability of swept source OCT to detect retinal changes in patients with bipolar disorder[J]. Eye, 2019, 33(4): 549-556.
33 GOKCINAR N B, BUTURAK S V, OZKAL F, et al. Optical coherence tomography neurodegenerative findings in patients with bipolar disorder[J]. Asia Pac Psychiatry, 2020, 12(4): e12394.
34 AYIK B, KAYA H, TASDELEN R, et al. Retinal changes in bipolar disorder as an endophenotype candidate: comparison of OCT-detected retinal changes in patients, siblings, and healthy controls[J]. Psychiatry Res, 2022, 313: 114606.
35 KURT A, ZOR K R, Y?LD?R?M BI?ER G, et al. Optical coherence tomography findings in bipolar disorder patients and the related factors[J]. Psychiatry Clin Psychopharmacol, 2023, 33(4): 254-263.
36 ALTUN I K, TUREDI N, ARAS N, et al. Psychopharmacological signatures in the retina in schizophrenia and bipolar disorder: an optic coherence tomography study[J]. Psychiatr Danub, 2020, 32(3/4): 351-358.
37 PRASANNAKUMAR A, KUMAR V, MAILANKODY P, et al. A systematic review and meta-analysis of optical coherence tomography studies in schizophrenia, bipolar disorder and major depressive disorder[J]. World J Biol Psychiatry, 2023, 24(8): 707-720.
38 JUNG K I, HONG S Y, SHIN D Y, et al. Attenuated visual function in patients with major depressive disorder[J]. J Clin Med, 2020, 9(6): 1951.
39 LIU Y H, TONG Y S, HUANG L Z, et al. Factors related to retinal nerve fiber layer thickness in bipolar disorder patients and major depression patients[J]. BMC Psychiatry, 2021, 21(1): 301.
40 LIU X, LAI S K, MA S S, et al. Development of a novel retina-based diagnostic score for early detection of major depressive disorder: an interdisciplinary view[J]. Front Psychiatry, 2022, 13: 897759.
41 YILDIZ M, ALIM S, BATMAZ S, et al. Duration of the depressive episode is correlated with ganglion cell inner plexifrom layer and nasal retinal fiber layer thicknesses: optical coherence tomography findings in major depression[J]. Psychiatry Res Neuroimaging, 2016, 251: 60-66.
42 S?NMEZ ?, K??GER F, AYKAN ü. Retinal nerve fiber layer thickness measurement by spectral-domain optical coherence tomography in patients with major depressive disorder[J]. Noro Psikiyatr Ars, 2017, 54(1): 62-66.
43 SCH?NFELDT-LECUONA C, SCHMIDT A, KREGEL T, et al. Retinal changes in patients with major depressive disorder: a controlled optical coherence tomography study[J]. J Affect Disord, 2018, 227: 665-671.
44 GENC A, DALKIRAN M, PIRDO?AN AYD?N E, et al. The alteration of retinal nerve fibre layer thickness with repetitive transcranial magnetic stimulation in patients with treatment resistant major depression[J]. Int J Psychiatry Clin Pract, 2019, 23(1): 57-61.
45 KALENDEROGLU A, ?ELIK M, SEVGI-KARADAG A, et al. Optic coherence tomography shows inflammation and degeneration in major depressive disorder patients correlated with disease severity[J]. J Affect Disord, 2016, 204: 159-165.
46 van der HEIDE F C T, STEENS I L M, GERAETS A F J, et al. Association of retinal nerve fiber layer thickness, an index of neurodegeneration, with depressive symptoms over time[J]. JAMA Netw Open, 2021, 4(11): e2134753.
47 POLAT S, GEDIZ B S, ERCAN A C, et al. The place of optical coherence tomography in patients with obsessive compulsive disorder[J]. Eurasian J Med, 2019, 51(3): 237-241.
48 BAYKARA S, KAZ?AN A, YILDIRIM H, et al. Retinal changes in generalized anxiety disorder patients[J]. Int J Psychiatry Med, 2024, 59(3): 270-286.
49 BAYKARA S, YILDIRIM H, KAZ?AN A, et al. Retinal changes in panic disorder patients[J]. Psychiatry Res Neuroimaging, 2022, 324: 111496.
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