The Second Affiliated Hospital of Kunming Medical University, Kunming, China.
BMC Psychiatry. 2024 Sep 30;24(1):640. doi: 10.1186/s12888-024-06100-8.
Retinal nerve fiber layer thickness, as a new visual indicator that may help diagnose mental disorders, is gaining attention from researchers. However, the causal relationship between retinal nerve fiber layer thickness and mental disorders is still to be effectively proved.
A bidirectional Two-sample Mendelian randomization analysis was utilized to analyse aggregated data from large-scale genome-wide association studies, we selected genetic loci for retinal nerve fiber layer thickness in independent retinal abnormalities and three prevalent psychiatric disorders (schizophrenia, depression, bipolar disorder) as instrumental variables. The Two-sample Mendelian randomization analysis was mainly performed by inverse variance weighting and weighted median method. The Cochran Q test and leave-one-out sensitivity were used to ensure the robustness of the results. The Mendelian random polymorphism residuals and outliers were used to detect single nucleotide polymorphism outliers, and MR-Egger intercept test was used to test single nucleotide polymorphism horizontal pleiotropy.
IVW showed that retinal nerve fiber layer thickness was positively associated with schizophrenia (OR = 1.057, 95%CI: 1.000-1.117, P < 0.05), in the study of bipolar disorder, MR analysis also suggested a positive causal relationship between retinal nerve fiber layer thickness and bipolar disorder (OR = 1.025, 95%CI: 1.005-1.046, P < 0.05), which indicated possible causal relationships between retinal nerve fiber layer thickness and these two diseases. Depression (OR = 1.000143, 95%CI: 0.9992631-1.001024, P = 0.74) indicated no significant causal association. No reverse causal effects of psychiatric disorders on retinal nerve fiber layer thickness were found.
A statistically significant causal relationship between retinal nerve fiber layer thickness and schizophrenia and bipolar disorder has been supported by genetic means, indicating RNFL has potential to aid in the diagnosis of schizophrenia and bipolar disorder.
视网膜神经纤维层厚度作为一种新的视觉指标,可能有助于诊断精神疾病,引起了研究人员的关注。然而,视网膜神经纤维层厚度与精神疾病之间的因果关系仍有待有效证明。
采用双向两样本 Mendelian 随机化分析方法,对独立的视网膜病变和三种常见精神障碍(精神分裂症、抑郁症、双相情感障碍)的视网膜神经纤维层厚度的全基因组关联研究的汇总数据进行分析,选择视网膜神经纤维层厚度的遗传位点作为工具变量。两样本 Mendelian 随机化分析主要采用逆方差加权和加权中位数法进行。采用 Cochran Q 检验和剔除一个样本的敏感性检验来确保结果的稳健性。采用 Mendelian 随机多态性残差和异常值检测单核苷酸多态性异常值,采用 MR-Egger 截距检验检测单核苷酸多态性水平的平行多效性。
IVW 结果显示,视网膜神经纤维层厚度与精神分裂症呈正相关(OR=1.057,95%CI:1.000-1.117,P<0.05),在双相情感障碍的研究中,MR 分析也提示视网膜神经纤维层厚度与双相情感障碍之间存在正因果关系(OR=1.025,95%CI:1.005-1.046,P<0.05),这表明视网膜神经纤维层厚度与这两种疾病之间可能存在因果关系。抑郁症(OR=1.000143,95%CI:0.9992631-1.001024,P=0.74)无显著因果关系。未发现精神疾病对视网膜神经纤维层厚度的反向因果效应。
通过遗传手段支持了视网膜神经纤维层厚度与精神分裂症和双相情感障碍之间存在统计学上显著的因果关系,表明 RNFL 有可能辅助精神分裂症和双相情感障碍的诊断。