Elsevier

Journal of Affective Disorders

Volume 218, 15 August 2017, Pages 115-122
Journal of Affective Disorders

Research paper
Optical coherence tomography findings in patients with bipolar disorder

https://doi.org/10.1016/j.jad.2017.04.055Get rights and content

Highlights

  • Patients with bipolar disorder have thinner RNFL relative to controls.

  • OCT in bipolar disorder is not correlated to disease severity or duration.

  • No differences in OCT between male and female patients with bipolar disorder.

  • No differences in OCT between right and left eyes in patients with bipolar disorder.

Abstract

Background

Research in bipolar disorder suggests the presence of structural brain abnormalities. It is not clear whether these findings are trait markers or operate with the onset and progress with disease severity and duration. Optical coherence tomography (OCT) is a non-invasive technique that detects degenerative changes in the retina reflecting brain degeneration. This study aimed at detecting these changes and relating them to disease severity and clinical characteristics.

Methods

A case-control study conducted in Psychiatry and Addiction Medicine hospital, Faculty of Medicine at Cairo University. Forty inpatients with bipolar disorder -according to the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) - were compared to forty matched healthy controls. Patients were subjected to the Structured Clinical Interview of DSM-IV (SCID-I), Hamilton Depression Rating Scale (HAM-D) and Young Mania Rating Scale (YMRS). Both patients and controls were subjected to OCT.

Results

Patients showed thinning of Retinal Nerve Fiber Layer (RNFL) relative to control subjects in most of the OCT parameters including Right average (p<.001 and 95% CI [14.39, 19.84]), Lt average (p<.001 and 95% CI [13.03, 19.42]). Patients also showed decreased Ganglionic Cell Complex (GCC) significantly in Rt average (p=.002 and 95% CI [2.33, 9.78]), Lt average (p<.001) and 95% CI [4.47, 11.63]. Age at onset, number of episodes, and severity did not significantly correlate with OCT parameters.

Limitations

The small sample and absence of follow-up.

Conclusions

Patients with bipolar disorder show degenerative changes detected by OCT in relation to healthy controls.

Section snippets

Background

Bipolar disorder is a chronic episodic psychiatric disorder that has a worldwide prevalence of 1% and causes severe deterioration of patients’ quality of life and functions including social, occupational and cognitive (Cotrena et al., 2016, Merikangas et al., 2007).

Structural brain abnormalities are detected in patients with bipolar disorder starting from their first episode. Some changes are found to be progressive, such as reduction of brain gray matter in hipppocampus, fusiform gyrus and

Design and subjects

This was a case-control observational study that compared two groups. The first group enrolled 40 patients - ranged from 18 to 55 years old and of both sexes - who have bipolar I disorder according to the criteria of the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). While the second group included 40 psychiatry free subjects who matched the patients in age and sex. Psychiatric diagnoses were excluded in control subjects - who were selected from paramedical

Results

Patients included were 52.5% males and 47.5% females with mean age of 30.90±9.31. Majority of patients were single (52.5%) and (40%) were not working. There was no difference between patients and control subjects in age or gender (Table 1).

Patients showed thinning of RNFL in relation to control subjects in most of the OCT parameters (Fig. 1, Fig. 2). The difference was significant in right side (Rt) average (104.24±7.63 in patients, in controls 121.35±3.98, p<.001 and 95% CI [14.39, 19.84]),

Discussion

Bipolar disorder is a chronic mental disorder in which many factors are implicated in the disease etiology and pathogenesis. Although Different neuroimaging and neuropathological methods have been frequently used to identify specific abnormalities associated with this disorder, there are no clearly defined findings specific to the disorder. Increasing evidence of gray matter loss and ventricular enlargement in bipolar disorder, as observed in chronic psychoses, suggests that genetic factors,

References (35)

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