A systematic review and meta-analysis of optical coherence tomography studies in schizophrenia, bipolar disorder and major depressive disorder

Abstract

Objectives

Due to the common neurodevelopmental origin and easy accessibility, the retina serves as a surrogate marker for changes in the brain. Hence, Optical Coherence Tomography (OCT), a tool to examine the neuronal layers of retina has gained importance in investigating psychiatric disorders. Several studies in the last decade have reported retinal structural alterations in schizophrenia (SCZ), bipolar disorder (BD), and major depressive disorder (MDD). However, the findings are inconsistent. Hence, we conducted a meta-analysis to investigate alterations in OCT parameters in patients with SCZ, BD and MDD.

Methods

We searched electronic databases for studies that examined OCT parameters in patients with SCZ, BD and MDD published up to January 2023. The primary outcome measures were thickness and volumes of the retinal Nerve Fibre Layer (RNFL). We conducted meta-analysis using a random effects model.

Results

The searches yielded 2638 publications of which 43 studies were included in the final analysis across all disorders. Compared to controls, the RNFL was thinner in SCZ patients (SMD = −0.37, p = <0.001) and BD patients (SMD = −0.67, p = < 0.001), but not in MDD patients (SMD = −0.08, p = 0.54). On quadrant wise analysis, temporal quadrant RNFL was thinner in SCZ but not in BD, while all other quadrants were thinner in both SCZ and BD.

Conclusion

We found significant reductions in RNFL thickness in SCZ and BD, but not in MDD. The differential involvement in various quadrants and parameters across the disorders has potential implications for using retinal parameters as a diagnostic biomarker.

Keywords:

• Psychosis
• retina
• optical coherence tomography
• mood disorder

Acknowledgments

None.

Author contributions

AP and VK were involved in the literature search, data extraction, data analysis, interpretation of results, and manuscript preparation. PM, AA, RB, TTJMB were involved in the interpretation of results and manuscript preparation. NPR was involved in conceptualisation, data extraction, interpretation of results, and manuscript preparation. All authors approved the final manuscript.

Statement of interest

Dr Naren Rao has received research grants from Forus Health Pvt Ltd Bangalore, India.