Insomnia Might Influence the Thickness of Choroid, Retinal Nerve Fiber and Inner Plexiform Layer

Abstract

Sleep may play a fundamental role in retinal regulation and the degree of retinal variables. However, no clinical study has investigated optical coherence tomography (OCT) parameters in patients with primary insomnia. All participants were evaluated with the insomnia severity index (ISI) and the Pittsburgh sleep quality index (PSQI). The retinal nerve fiber layer (RNFL), ganglion cell layer (GC), inner plexiform layer (IPL), macula and choroidal (CH) thickness were compared between 52 drug-naïve patients with primary insomnia and 45 age-gender-BMI-smoke status matched healthy controls (HC). The patients with primary insomnia differed from the HC regarding RNFL-Global (p = 0.024) and RNFL-Nasal inferior (p = 0.010); IPL-Temporal (p < 0.001), IPL-Nasal (p < 0.001); CH-Global (p < 0.001), CH-Temporal (p = 0.004), CH-Nasal (p < 0.001), and CH-Fovea (p = 0.019). ISI correlated with RNFL-Global and RNFL-Nasal inferior. The regression analysis revealed that ISI was the significant predictor for the thickness of RNFL- Nasal inferior (p = 0.020), RNFL-Global (p = 0.031), and CH-Nasal (p = 0.035) in patients with primary insomnia. Sleep disorders are seen commonly in patients with psychiatric, including ocular diseases. Adjusting the effect of insomnia can help to clarify the consistency in findings of OCT.

Association of Choroidal Thickness with Sleep Deprivation in Night-shift Healthcare Workers

“…Our average choroidal thickness measures are consistent with previous studies measuring the choroidal thickness in healthy human eyes (20)(21)(22)(23). Shahbaz et al studied the choroidal thickness changes in patients with primary insomnia (24). They reported significant thickening in the choroidal layer in these patients comparing to healthy controls.…”

Optical Coherence Tomography in Chronic Relapsing Inflammatory Optic Neuropathy, Neuromyelitis Optica and Multiple Sclerosis: A Comparative Study

“…There are limited data on the effect of different immunomodulatory treatments on retinal integrity, and this could potentially skew our results, as we cannot eliminate the possibility of treatment heterogeneity with different impact on retinal injury [ 33 ]. Furthermore, we did not take into consideration various lifestyle factors, such as race, obesity, sleep duration and quality, and smoking that might interfere with the interpretation of our findings, as they can potentially affect the retinal structure and contribute to RNFL thinning [ 10 , 11 , 12 ]. Moreover, we have not studied any correlations with visual outcomes or serum neurofilament light chain levels that previous reports showed positive correlation with accelerated rates of neuro-axonal loss association in RRMS±ON [ 34 ].…”

“…RNFL is the innermost layer of the retina, consisting of unmyelinated axons originating from the ganglion cell neurons, which enters the neural retinal rim of the optic disc and, subsequently, coalesces as the optic nerve [ 8 ]. Retinal-layer thickness is used to monitor the progression of MS and the effect of modifiable risk factors for MS on retinal health and to mirror cortical atrophy in the MS population [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. More recently, OCT outcomes have been used in clinical trials [ 16 ].…”

Sharing the Same Perspective. Mental Disorders and Central Serous Chorioretinopathy: A Systematic Review of Evidence from 2010 to 2020

“…Recent evidence supports a link between psychiatric disorders and choroidal thickness, regardless of the presence of CSC or another ophthalmological diagnosis: Ayyildiz D and Ayyildiz T (2020) [36] reported a significant thickening of the central choroid in 41 children and adolescents with anxiety disorders compared with HC. Likewise, further evidence indicated that choroidal thickness is significantly increased in adult patients with primary insomnia [37], bruxism [38] and obsessive-compulsive disorder [39]. Regarding insomnia, previous authors suggested that excessive exposure to light, through the increase in retinal dopamine and the subsequent nitric oxide release, may lead to an upper blood flow in the choroid and, ultimately, to its thickening [40].…”