Tan A, Schwitzer T, Conart J-B, Angioi-Duprez K
CHU de Nancy, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France.
Centre psychothérapique de Nancy, 1, rue Dr Archambault, 11010 Laxou, France.
J Fr Ophtalmol. 2020 Sep;43(7):586-597. doi: 10.1016/j.jfo.2019.10.029. Epub 2020 Jul 4.
Major depressive disorder, bipolar disorder and schizophrenia are currently among the most common psychiatric disorders, known to constitute a serious public health issue in terms of morbidity, mortality and functional handicap. Their pathophysiology is still unclear, but there is now increasing evidence supporting the existence of abnormalities of neurotransmission. As the retina is an extension of the central nervous system, it may be an interesting site of study which might provide a better understanding of the pathophysiology of psychiatric disorders. Several studies have demonstrated retinal abnormalities, with abnormal cone and rod responses on electroretinography (ERG), suggesting a process of functional neuronal loss, structurally supported by a decrease in the retinal nerve fiber layer thickness (RNFL) on optical coherence tomography (OCT), which suggests involvement of the molecular signal pathways of neurotransmission. These tests could be useful tools for diagnosing and monitoring psychiatric disorders. This article is an overview of the literature on retinal abnormalities observed in patients with major depressive disorder, bipolar disorder or schizophrenia, and discusses how they could be pathophysiologic markers.
重度抑郁症、双相情感障碍和精神分裂症目前是最常见的精神疾病,就发病率、死亡率和功能障碍而言,是严重的公共卫生问题。它们的病理生理学仍不清楚,但现在越来越多的证据支持神经传递异常的存在。由于视网膜是中枢神经系统的延伸,它可能是一个有趣的研究部位,可能有助于更好地理解精神疾病的病理生理学。多项研究已证实视网膜存在异常,视网膜电图(ERG)显示视锥和视杆反应异常,提示存在功能性神经元丧失过程,光学相干断层扫描(OCT)显示视网膜神经纤维层厚度(RNFL)降低在结构上支持了这一过程,这表明神经传递的分子信号通路受到了影响。这些检查可能是诊断和监测精神疾病的有用工具。本文概述了在重度抑郁症、双相情感障碍或精神分裂症患者中观察到的视网膜异常的文献,并讨论了它们如何可能成为病理生理标志物。