Friedel Evelyn B N, Beringer Malina, Endres Dominique, Runge Kimon, Maier Simon, Küchlin Sebastian, Kornmeier Jürgen, Domschke Katharina, Heinrich Sven P, Tebartz van Elst Ludger, Nickel Kathrin
Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Eye Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
BMC Psychiatry. 2025 Apr 9;25(1):356. doi: 10.1186/s12888-025-06775-7.
Optical coherence tomography (OCT) has emerged as a significant non-invasive imaging technique in psychiatric research, allowing for detailed structural assessment of the retinal layers. While OCT has been promising for monitoring neurodegeneration in Alzheimer's and Parkinson's diseases, results in major depressive disorder (MDD) remain inconsistent. Building on findings of attenuated electroretinogram (ERG) responses in MDD, indicating functional retinal alterations, this study investigated whether structural retinal changes, such as thinning of retinal layers, also occur in patients with MDD and whether these changes are associated with the severity of depressive symptoms.
OCT examinations were conducted on 31 MDD patients and 60 healthy controls (HC). The thickness and volumes of macular retinal layers were analyzed and correlated with depressive symptoms.
The thickness of the outer nuclear layer (ONL) was significantly reduced in MDD patients (p = 0.003) and negatively correlated with depressive symptoms (BDI-II scores; p = 0.001). The thickness and volume of the ganglion cell and inner plexiform layer were further inversely associated with depressive symptoms in MDD patients (BDI-II and MADRS scores; p < 0.02).
ONL thinning in MDD suggests possible neurodegenerative processes that may disturb signal transmission downstream, as indicated by altered ERG responses in MDD. Further research is essential to determine the reversibility of these structural changes following remission. Structural retinal analysis with OCT offers the potential to complement functional ERG examinations and represents a promising approach for developing diagnostic and therapeutic monitoring tools for MDD.
光学相干断层扫描(OCT)已成为精神病学研究中一项重要的非侵入性成像技术,可对视网膜各层进行详细的结构评估。虽然OCT在监测阿尔茨海默病和帕金森病的神经退行性变方面前景广阔,但在重度抑郁症(MDD)中的研究结果仍不一致。基于MDD患者视网膜电图(ERG)反应减弱的研究结果,提示存在功能性视网膜改变,本研究调查了MDD患者是否也存在视网膜结构变化,如视网膜层变薄,以及这些变化是否与抑郁症状的严重程度相关。
对31例MDD患者和60名健康对照者(HC)进行了OCT检查。分析黄斑视网膜层的厚度和体积,并与抑郁症状进行相关性分析。
MDD患者的外核层(ONL)厚度显著降低(p = 0.003),且与抑郁症状呈负相关(BDI-II评分;p = 0.001)。MDD患者神经节细胞层和内网状层的厚度和体积与抑郁症状进一步呈负相关(BDI-II和MADRS评分;p < 0.02)。
MDD患者的ONL变薄提示可能存在神经退行性变过程,这可能会干扰下游的信号传递,如MDD患者ERG反应改变所示。进一步的研究对于确定缓解后这些结构变化的可逆性至关重要。OCT进行的视网膜结构分析有可能补充功能性ERG检查,并为开发MDD的诊断和治疗监测工具提供了一种有前景的方法。