Abstract
Purpose :
To use optical coherence tomography (OCT) to assess individual retinal layers in individuals with post-traumatic stress disorder (PTSD) vs. controls.
Methods :
Adults ≥18 years old with PTSD between 01/1/2018 and 12/31/2021 were identified via Duke Enterprise Data Unified Content Explorer (DEDUCE) and recruited via email or phone. Participants with pre-existing non-PTSD cognitive disorders, brain injury, glaucoma, diabetes, uncontrolled hypertension, refractive errors > +6 or < -6 diopters, or vision < 20/40 were excluded. Age- and sex-matched controls (± 5 years) were recruited. We obtained OCT images using Zeiss Cirrus HD-5000 Spectral-Domain OCT. Duke Reading Center Visualizer algorithm segmented the ganglion cell and inner plexiform layer (GC+IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), photoreceptor layer, and retinal pigment epithelium (RPE) layer. Each algorithm result was corrected manually by readers (SDP and NK). Mean neurosensory retinal thickness and total volume were calculated for all specified retinal layers within 1-, 3-, and 6-mm ETDRS rings wherein 3- and 6-mm rings were further divided into superior, temporal, inferior, and nasal quadrants. Welch t-tests were performed on thickness and volume results (α=0.05).
Results :
47 eyes of 25 adults with PTSD and 47 eyes of 26 age- and sex-matched controls were prospectively enrolled. PTSD patients exhibited a significantly (p<0.05) lower mean thickness and volume of RPE layer and increased thickness of the photoreceptor layer in all perifoveal rings and quadrants. In PTSD, GC+IPL inferior 6-mm ring thickness was significantly decreased (56.99 ± 5.15μm) vs. controls (61.26 ± 5.75μm) as was the superior 3-mm ring (93.67 ± 6.59μm) vs. controls (96.5 ± 8.98μm), and nasal 6-mm ring (66.61 ± 6.56μm) vs. controls (69.35 ± 5.39μm) (p<0.05). Mean INL thickness (p<0.05) was significantly reduced in the inferior 6-mm ring in PTSD (28.16 ± 2.08μm) vs. controls (29.55 ± 2.35μm) as well as the in temporal 6-mm ring in PTSD (30.77 ± 2.13μm) vs. controls (31.92 ± 2.8μm).
Conclusions :
PTSD may alter the thickness of retinal layers, particularly the GC+IPL, INL, RPE, and photoreceptor layers. Further study of retinal layer thickness may identify relevant biomarkers for PTSD.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.