Schönthaler Elena M D, Aminfar Haleh, Dalkner Nina, Fellendorf Frederike T, Georgi Johanna, Lenger Melanie, Wedrich Andreas, Reininghaus Eva Z
Clinical Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria.
Clinical Division of Ophthalmology, Medical University of Graz, Graz, Austria.
Neuropsychobiology. 2025;84(2):100-112. doi: 10.1159/000543290. Epub 2024 Dec 24.
Bipolar disorder (BD) is a psychiatric condition with significant health implications due to its comorbidities, premature mortality, and functional impairments. Despite extensive research on treatment and rehabilitation, gaps remain in diagnosis and monitoring. Therefore, there is a need for biomarkers to identify individuals at risk for disease progression or exacerbation. Developmentally part of the central nervous system, the retina represents a possible marker for observing BD-related structural and functional alterations in the brain.
The retina's structure can be assessed through optical coherence tomography (OCT), a noninvasive and cost-effective method. Retinal alterations, particularly in the retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL), have been associated with neurodegenerative and psychiatric disorders in cross-sectional OCT studies. This scoping review discusses findings on retinal changes in BD as well as their association with disease characteristics like symptom severity and illness duration and highlights OCT as a potential diagnostic tool in BD treatment.
The majority of studies indicate RNFL and GCL thinning in BD patients, which was found to correlate with clinical characteristics in some studies. Although the data are currently limited, there is a possibility that retinal biomarkers could facilitate monitoring of BD, but more research needs to be conducted to observe the relationship between these parameters and BD. Moreover, other factors (e.g., treatment, metabolic and inflammatory conditions) may impact retinal changes, which highlights the need for longitudinal studies to clarify these relationships. Further research should focus on replicating current findings, understanding the role of inflammation, and differentiating between retinal regions affected by BD.
Bipolar disorder (BD) is a psychiatric condition with significant health implications due to its comorbidities, premature mortality, and functional impairments. Despite extensive research on treatment and rehabilitation, gaps remain in diagnosis and monitoring. Therefore, there is a need for biomarkers to identify individuals at risk for disease progression or exacerbation. Developmentally part of the central nervous system, the retina represents a possible marker for observing BD-related structural and functional alterations in the brain.
The retina's structure can be assessed through optical coherence tomography (OCT), a noninvasive and cost-effective method. Retinal alterations, particularly in the retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL), have been associated with neurodegenerative and psychiatric disorders in cross-sectional OCT studies. This scoping review discusses findings on retinal changes in BD as well as their association with disease characteristics like symptom severity and illness duration and highlights OCT as a potential diagnostic tool in BD treatment.
The majority of studies indicate RNFL and GCL thinning in BD patients, which was found to correlate with clinical characteristics in some studies. Although the data are currently limited, there is a possibility that retinal biomarkers could facilitate monitoring of BD, but more research needs to be conducted to observe the relationship between these parameters and BD. Moreover, other factors (e.g., treatment, metabolic and inflammatory conditions) may impact retinal changes, which highlights the need for longitudinal studies to clarify these relationships. Further research should focus on replicating current findings, understanding the role of inflammation, and differentiating between retinal regions affected by BD.
双相情感障碍（BD）是一种精神疾病，因其合并症、过早死亡和功能障碍而对健康有重大影响。尽管对治疗和康复进行了广泛研究，但在诊断和监测方面仍存在差距。因此，需要生物标志物来识别有疾病进展或加重风险的个体。视网膜作为中枢神经系统发育的一部分，可能是观察大脑中与BD相关的结构和功能改变的一个标志物。
视网膜结构可通过光学相干断层扫描（OCT）进行评估，这是一种无创且经济高效的方法。在横断面OCT研究中，视网膜改变，特别是视网膜神经纤维层（RNFL）和神经节细胞层（GCL）的改变，已与神经退行性疾病和精神疾病相关联。本综述讨论了BD患者视网膜变化的研究结果及其与症状严重程度和病程等疾病特征的关联，并强调OCT作为BD治疗中一种潜在诊断工具的作用。
大多数研究表明BD患者的RNFL和GCL变薄，在一些研究中发现这与临床特征相关。尽管目前数据有限，但视网膜生物标志物有可能有助于BD的监测，但需要更多研究来观察这些参数与BD之间的关系。此外，其他因素（如治疗、代谢和炎症状况）可能会影响视网膜变化，这突出了进行纵向研究以阐明这些关系的必要性。进一步的研究应侧重于重复当前的研究结果、了解炎症的作用以及区分受BD影响的视网膜区域。
双相情感障碍（BD）是一种精神疾病，因其合并症、过早死亡和功能障碍而对健康有重大影响。尽管对治疗和康复进行了广泛研究，但在诊断和监测方面仍存在差距。因此，需要生物标志物来识别有疾病进展或加重风险的个体。视网膜作为中枢神经系统发育的一部分，可能是观察大脑中与BD相关的结构和功能改变的一个标志物。
视网膜结构可通过光学相干断层扫描（OCT）进行评估，这是一种无创且经济高效的方法。在横断面OCT研究中，视网膜改变，特别是视网膜神经纤维层（RNFL）和神经节细胞层（GCL）的改变，已与神经退行性疾病和精神疾病相关联。本综述讨论了BD患者视网膜变化的研究结果及其与症状严重程度和病程等疾病特征的关联，并强调OCT作为BD治疗中一种潜在诊断工具的作用。
大多数研究表明BD患者的RNFL和GCL变薄，在一些研究中发现这与临床特征相关。尽管目前数据有限，但视网膜生物标志物有可能有助于BD的监测，但需要更多研究来观察这些参数与BD之间的关系。此外，其他因素（如治疗、代谢和炎症状况）可能会影响视网膜变化，这突出了进行纵向研究以阐明这些关系的必要性。进一步的研究应侧重于重复当前的研究结果、了解炎症的作用以及区分受BD影响的视网膜区域。
