Altun Ilkay Keles, Turedi Neslihan, Aras Neriman, Atagun Murat Ilhan
epartment of Psychiatry, Bursa Yüksek Ihtisas Research and Training Hospital, Bursa, Turkey.
Psychiatr Danub. 2020 Autumn-Winter;32(3-4):351-358. doi: 10.24869/psyd.2020.351.
Retina is considered as a window to the brain due to the similarities in terms of development and pathologies. Optical coherence tomography (OCT) can perform quantitative examinations in the retina. In this study, we aimed to investigate the effects of drugs used in schizophrenia and bipolar disorder (BD) on retinal nerve fiber layer (RNFL) and macular thickness.
The study included schizophrenia (n=35) and euthymic BD (n=46) patients on various medications, and age, gender matched healthy control group (n=31). For retinal evaluation, measurements of RNFL and macula were performed with Optovue RTVue Premier OCT.
In the schizophrenia group, chlorpromazine equivalent dose of antipsychotics was a statistically significant negative predictor of left RNFL nasal superior region thickness. In the BD group, serum valproate level was a significant positive predictor of thickness in the right macular inferior outer, left macular nasal outer region, right RNFL inferotemporal, left temporal and inferotemporal regions.
Since the retina consists of neurons, morphological or functional examination of retina may be beneficial for the evaluation of the effects of psychopharmalogical treatments in schizophrenia and BD. The outcome of this study implies that valproate has neuroprotective effects on the optic nerve and macula, and this finding is consistent with the literature implying neurotrophic effects of valproate.
由于视网膜在发育和病理方面的相似性,其被视为大脑的一扇窗口。光学相干断层扫描(OCT)可对视网膜进行定量检查。在本研究中,我们旨在探究用于治疗精神分裂症和双相情感障碍(BD)的药物对视网膜神经纤维层(RNFL)和黄斑厚度的影响。
该研究纳入了正在服用各种药物的精神分裂症患者(n = 35)和处于心境正常期的双相情感障碍患者(n = 46),以及年龄、性别匹配的健康对照组(n = 31)。为进行视网膜评估,使用Optovue RTVue Premier OCT对RNFL和黄斑进行测量。
在精神分裂症组中,抗精神病药物的氯丙嗪等效剂量是左RNFL鼻上区域厚度的统计学显著负向预测因子。在双相情感障碍组中,血清丙戊酸盐水平是右黄斑下外侧、左黄斑鼻外侧区域、右RNFL颞下、左颞侧和颞下区域厚度的显著正向预测因子。
由于视网膜由神经元组成,对视网膜进行形态学或功能检查可能有助于评估精神药物治疗对精神分裂症和双相情感障碍的影响。本研究结果表明丙戊酸盐对视神经和黄斑具有神经保护作用,这一发现与暗示丙戊酸盐具有神经营养作用的文献一致。