Abstract
Purpose :
To investigate the association between the self-reported status of depression, the severity of depressive symptoms, and the thickness of single retinal layers in an elderly Chinese population.
Methods :
All participants of the population-based cross-sectional Beijing Eye Study 2011 free of any retinal or optic nerve diseases were enrolled. Applying spectral-domain optical coherence tomography (OCT), we obtained a macula cube scan of 30× 25°centered on the fovea. Using a self-developed multiple-surface method, the retina in the OCT cube scans was automatically segmented into 9 layers, from the retinal nerve fiber layer (RNFL) to the retinal pigment epithelium-Bruch membrane (RPE/BM) complex (Fig. 1). The mean thickness of each layer was assessed in 9 macular subregions based on the Early Treatment of Diabetic Retinopathy Study (ETDRS) map (Fig. 1B). Depressive symptom severity was assessed with the Zung self-rated depression scale (continuous score, 0-100), and a score of 37 or higher was defined as depression status.
Results :
The study included 2127 eyes (2127 participants; mean age: 61.8 years, 43.2% male), with 297 subjects identified as having a depression status (14.0%, 95%CI: 12.6, 15.5%). In univariate analysis, a higher prevalence of depression was related (all P≤0.03) with a thinner RNFL, ganglion cell layer (GCL), and a thicker ellipsoid zone (EZ). After multivariable adjustment for age, gender and axial length, these associations between depression and the thickness of three individual retinal layers persisted (RNFL: P=0.007; OR, 0.93 (0.88, 0.98); GCL: P=0.001; OR, 0.94 (0.91, 0.98); EZ: P=0.009; OR, 1.34 (1.08, 1.68)). A higher depression score was related with a thinner GCL (P = 0.031; correlation coefficient: -0.09; 95%CI: -0.18, -0.01) after multivariate analysis. Detailed subregional associations with depression status or depression scores are shown in Fig 2.
Conclusions :
In an elderly Chinese population, a significant thinner RNFL, GCL and a thicker EZ were observed in individuals with depression, and a thinner GCL was associated with higher severity of depressive symptoms. Furter studies may address a possible link between the retinal layer thickness and mental disorders.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.