Development of a Novel Retina−Based Diagnostic Score for Early Detection of Major Depressive Disorder: An Interdisciplinary View

Abstract

BackgroundClinically effective markers for the diagnosis of major depressive disorder (MDD) are lacking. Alterations in retinal features are closely related to the pathophysiological progression of MDD. However, the reliable retina-related diagnostic model for MDD remains to be developed. Thus, our study aimed to quantitatively evaluate retinal vascular and structural changes in MDD patients and to develop a reliable diagnostic model of MDD based on retinal parameters.MethodsSeventy-eight patients with MDD and 47 healthy controls (HCs) underwent retinal vessel density and structure examination using optical coherence tomography angiography and visual field examination using perimetry. Independent-sample t test was used to assess the differences in retinal parameters between the groups. Meanwhile, we constructed the corresponding retina-based diagnostic model by LASSO logistic regression. Finally, the diagnostic ability of the model was evaluated by area under the curve (AUC) of receiver operating characteristic curves and calibration plot of nomogram.ResultsMDD patients showed lower retinal vessel density (including radial peripapillary capillary vessel density, superficial and deep capillary plexus vessel density), thinner subfoveal choroidal thickness, and poorer visual fields compared to HCs (all p < 0.05). Furthermore, a retina-based diagnostic model was constructed and shows a strong diagnostic capability for MDD (AUC = 0.9015, p < 0.001).ConclusionPatients with MDD showed distinct retinal features compared to HCs. The retina-based diagnostic model is expected to be a necessary complement to the diagnosis of MDD.

The use of optical coherence tomography (OCT) and OCT angiography in borderline personality disorder compared to health control subjects

“…Previous studies have also revealed retinal changes in various psychiatric disorders, 8,9 but the specificity of these findings for BPD remains unclear. Therefore, while our study is scientifically significant, its clinical application is yet to be determined.…”

“…In comparison to previous studies, our research on BPD shows distinct findings. While major depressive disorder was associated with lower retinal vessel density, thinner retinal superficial macular layers, and poorer visual function, 9 and schizophrenia and bipolar disorder were linked to significantly lower vessel density and macular thickness in the deep capillary complex, 8 TA B L E 2 Superficial retinal capillary plexus (SRCP) vessel densities in the BPD patients and healthy controls (HC) eyes.…”

“…7 Interestingly, OCTA has been used for researching psychiatric disorders (schizophrenia, bipolar disorder, and major depressive disorder) in recent years. [8][9][10] All three psychiatric disorders show retinal changes detectable through OCT and OCTA. This suggests a potential common pathway in these psychiatric disorders where retinal microvascular changes are involved.…”

“…As a non‐invasive imaging technology, OCTA has the advantage of evaluating vascular abnormalities in multiple diseases and therefore has broad prospects for application in the medical field 7 . Interestingly, OCTA has been used for researching psychiatric disorders (schizophrenia, bipolar disorder, and major depressive disorder) in recent years 8–10 . All three psychiatric disorders show retinal changes detectable through OCT and OCTA.…”

“…This suggests a potential common pathway in these psychiatric disorders where retinal microvascular changes are involved. In patients with major depressive disorder, OCTA has shown reduced retinal vessel density and thinning of the subfoveal choroid 9,10 . Patients with schizophrenia and bipolar disorder have demonstrated microvascular dysfunction in the retina, especially in its central part 8 .…”