Ganglion Cell and Retinal Nerve Fiver Layers Correlated with Time Disease of Bipolar Disorder Using 64 Cell Grid OCT Tool

ABSTRACT

Purpose of the study: To assess the ability of the new Spectralis Optical Coherence Tomography (OCT) Posterior Pole protocol to detect degeneration of the inner retinal layers in patients with bipolar disorder (BD) and to assess the correlation between the neuroretinal thickness and disease duration.

Materials and Methods

Twenty-five eyes of 25 patients with bipolar disorder and 74 eyes of 74 healthy controls underwent retinal measurements of retinal nerve fiber layer (RNFL) and ganglion cell layer (GCL) thickness. Measurements were obtained using the Spectralis-OCT device with the new Posterior Pole protocol which assesses the macular area by analyzing retinal thickness in a grid of 64 (8*8) cells.

Results

Significant differences (p < 0.05) in RNFL and GCL thickness were found between BD patients and healthy controls, in parafoveal and perifoveal cells respectively. Significant inverse correlations were found between RNFL and GCL thinning at their thickest location and the duration of bipolar disorder. Several predictive variables were observed with a binary logistic regression for the presence/absence of BD: cell 1.3 RNFL (p = 0.028) and GCL in cells 7.8 (p = 0.012), 2.7 (p = 0.043) and 1.3 (p = 0.047).

Conclusion

Posterior Pole OCT protocol is a useful tool to assess changes in the inner retinal layers in bipolar disorder. These observed changes, especially those affecting the GCL, may be associated with disease evolution and may be predictive of the presence of the disease. OCT data could potentially be a useful tool for clinicians to diagnose and monitor BD patients.

KEYWORDS:

• Optical coherence tomography
• retinal nerve fiber layer
• ganglion cell layer
• bipolar disorder
• inner retinal layers
• posterior pole protocol

Acknowledgments

The authors thank the patients in this study and colleges contribution.

Declaration of interest statement

The authors report no conflicts of interest and have no proprietary interest in any of the materials mentioned in this article.

Authorship

E.G.M., E.V. and E.O.H. designed the research. J.G.C. recruited the bipolar disorder subjects. E.O.H., E.V. and B.C. performed the experiments. E.G.M. and E.O.H did the statistical calculations, made tables and critically reviewed the manuscript. M.S., V.P., J.M.L., Y.L.H and L.E.P. critically reviewed the manuscript for important intellectual content, reviewed the data and the OCT images. M.S. did the eye fundus examinations. E.O.H. wrote the manuscript. All authors gave final approval of the version of the manuscript to be submitted and any revised version. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted.

Additional information

Funding

This work was supported by PI17/01726 (Instituto de Salud Carlos III), FI16/00055 (Instituto de Salud Carlos III) and by MAT2017-83858-C2-2 MINECO/AEI/FEDER, UE, DPI2016-79302R. The sponsor or funding organization had no role in the design or conduct of this research.