Association of Retinal Neurovascular Impairment with Disease Severity in Patients with Major Depressive Disorder: An Optical Coherence Tomography Angiography Study

Yan Wang; Cong Li; Lei Liu; Yuan Yang; Xue He; Gang Li; Xianzhen Zheng; Yun Ren; Hanpeng Zhao; Zhenchao Du; Jianrong Jiang; Yu Kuang; Fujun Jia; Honghua Yu; Xiaohong Yang

doi:10.2147/PRBM.S443146

Association of Retinal Neurovascular Impairment with Disease Severity in Patients with Major Depressive Disorder: An Optical Coherence Tomography Angiography Study

Psychol Res Behav Manag. 2024 Apr 9:17:1573-1585. doi: 10.2147/PRBM.S443146. eCollection 2024.

Authors

Yan Wang^#^{1

2}, Cong Li^#^{1

2}, Lei Liu^#¹, Yuan Yang^#³, Xue He^{1

2}, Gang Li³, Xianzhen Zheng³, Yun Ren^{1

4}, Hanpeng Zhao^{1

5}, Zhenchao Du^{1

4}, Jianrong Jiang^{1

5}, Yu Kuang¹, Fujun Jia³, Honghua Yu¹, Xiaohong Yang^{1

2}

Affiliations

¹ Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People's Republic of China.
² School of Medicine, South China University of Technology, Guangzhou, People's Republic of China.
³ Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, People's Republic of China.
⁴ Shantou University Medical College, Shantou, People's Republic of China.
⁵ The Second School of Clinical Medicine, Southern Medical University, Guangzhou, People's Republic of China.

^# Contributed equally.

Abstract

Background: Identifying the fundus objective biomarkers for the major depressive disorders (MDD) may help promote mental health. The aim of this study was to evaluate retinal neurovascular changes and further investigate their association with disease severity in MDD.

Methods: This cross-sectional study conducted in the hospital enrolled patients with MDD and healthy controls.The retinal neurovascular parameters for all subjects, including vessel density (VD), thickness of ganglion cell complex (GCC) and retinal nerve fiber layer (RNFL), and optic nerve head (ONH) eg are automatically calculated by the software in optical coherence tomography angiography (OCTA). The severity of MDD including depressive symptoms, anxiety, cognition, and insomnia was assessed by Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Scale (HAMA), Montreal Cognitive Assessment (MoCA), and Insomnia Severity Index (ISI) respectively.

Results: This study included 74 MDD patients (n=74 eyes) and 60 healthy controls (HCs) (n=60 eyes). MDD patients showed significantly decreased VD of superficial and deep capillary plexus, thickness of GCC and RNFL, and volume of ONH (all p<0.05) and increased vertical cup-to-disc ratio and global loss volume (GLV) (all p<0.05) compared to HCs. Positive associations were found between HAMD scores and cup area (r=0.30, p=0.035), cup volume (r=0.31, p=0.029), and disc area (r=0.33, p=0.020) as well as ISI scores and RNFL thickness (r=0.34, p=0.047).

Conclusion: We found the retinal neurovascular impairment and its association with disease severity in MDD patients. OCTA showed promise as a potential complementary assessment tool for MDD.

Keywords: disease severity; major depressive disorder; optical coherence tomography angiography; retinal neurovasculature.

Grants and funding

This work was supported by the National Natural Science Foundation of China (82271125 and 82171075), the Special Fund Project of Technology Achievement Transformation in Life and Health Innovation of the Greater Bay Area (GBALH202308), the launch fund of Guangdong Provincial People’s Hospital for NSFC (8217040449, 8227040339 and 8217040546), Precision Medicine Research and Industrial Innovation Development Fund-Individualized Medical Incubation Project 2022 (KH012023367), the Science and Technology Program of Guangzhou (20220610092 and 202103000045), the Outstanding Young Talent Trainee Program of Guangdong Provincial People’s Hospital (KJ012019087), the Talent Introduction Fund of Guangdong Provincial People’s Hospital (Y012018145), the GDPH Scientific Research Funds for Leading Medical Talents and Distinguished Young Scholars in Guangd ong Province (KJ012019457) and the GDPH Supporting Fund for Talent Program (KY0120220263). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.