Reduction in Retinal Ganglion Cell Layer, Inner Plexiform Layer, and Choroidal Thickness in Children With Autism Spectrum Disorder

Mahmut Zabit Kara; Mehmet Hamdi Örüm; Ayşe Sevgi Karadağ; Aysun Kalenderoğlu; Aslıhan Kara

doi:10.7759/cureus.49981

Reduction in Retinal Ganglion Cell Layer, Inner Plexiform Layer, and Choroidal Thickness in Children With Autism Spectrum Disorder

Cureus. 2023 Dec 5;15(12):e49981. doi: 10.7759/cureus.49981. eCollection 2023 Dec.

Authors

Mahmut Zabit Kara¹, Mehmet Hamdi Örüm², Ayşe Sevgi Karadağ³, Aysun Kalenderoğlu⁴, Aslıhan Kara⁵

Affiliations

¹ Child Adolescent Psychiatry, University of Health Sciences, Antalya, TUR.
² Psychiatry, Elazığ Mental Health and Diseases Hospital, Elazığ, TUR.
³ Ophthalmology, Dünyagöz Istanbul, Istanbul, TUR.
⁴ Psychiatry, Private Clinic, Izmir, TUR.
⁵ Biological Sciences, Semikal Technology, Antalya, TUR.

Abstract

Purposes: The aim of this study was to evaluate the retinal nerve fiber layer (RNFL), choroidal layer, inner plexiform layer (IPL), and ganglion cell layer (GCL) in patients with autism spectrum disorder (ASD).

Methods: In this study, we measured the thickness of the RNFL, GCL, IPL, and choroidal thickness using a spectral optical coherence tomography (OCT) device and we compared the results between the children diagnosed with ASD and healthy controls. Correlation between the Childhood Autism Rating Scale (CARS) and the OCT data was evaluated.

Results: Both ASD and control group consisted of 40 subjects (30 males and 10 females). Of the children in the ASD group, 29 had normal intelligence and 11 had mild intellectual disability (MID). The mean age of patients in the ASD group and control groups were 9.77 ± 3.37 years and 9.85 ± 3.97 years (p = 0.928). There was a statistically significant difference between the ASD group and the control group in the nasal and nasal-superior sectors of the RNFL layers in the left eye when all the lower layers of RNFL were assessed. In both eyes, the children with ASD had considerably lower mean choroidal thicknesses than the controls. When compared to the controls, the GCL and IPL volumes in the individuals with ASD were considerably lower in both eyes. Compared to the MID group, the left GCL volume of the nasal-inferior group was noticeably higher. A significant correlation was found between CARS scores and left GCL left IPL.

Conclusions: In contrast to RNFL in the ASD group, significant reductions in IPL, GCL, and choroidal thickness were observed in both eyes. It is thought that GCL may be a much more important biomarker than RNFL in terms of representing the structural deterioration in the brain. In addition, these results may form the basis for a new perspective on the use of OCT for the diagnosis and clinical course of autism.

Keywords: autism spectrum disorder; choroidal layer; ganglion cell layer; inner plexiform layer; optical coherence tomography (oct).