Evaluation of retina nerve fiber layer, ganglion cell complex and macula thickness in optic coherence tomography in acute and chronic bipolar disorders

Aim: To evaluate retinal nerve fiber layer (RNFL), ganglion cell complex (GCC), macula in patients with bipolar disorder (BD) by optical coherence tomography (OCT). Methods: The prospective study included 62 eyes of 62 patients diagnosed with BD type 1 who were followed by HMKU Mental Health and Diseases Department between February 2019 and December 2019, and 63 eyes of 63 healthy volunteers who applied for control purposes. Patients were divided into 3 groups as those with 5 years or less diagnosis period, those with more than 5 years diagnosis period and all patients. Controls were divided into 3 groups as 1. control, 2. control and all controls. All groups underwent a complete ophthalmologic examination, followed by GCC, macular and RNFL thickness measurements performed by OCT. All groups were statistically compared to their control group. Results: In patients with a diagnosis period of 5 years or less, there was a significant decrease in upper-temporal (81,25±7,35), upper (83,97±6,77), upper-nasal (84,66±6,43), lower-nasal (83,72±6,43), lower (81,75±7,52), lower-temporal (82,53±7,99) quadrants of GCC; in central (240,63±22,50), inner-temporal (304,13±16,74), inner-nasal (320,91±18,39), inner-upper (321,00±16,84), inner-lower (317,41±17,41) quadrants of makula; in temporal (69,03±9,50) quadrant of RSLT. In those with more than 5 years diagnosis period, there was a significant decrease in upper-temporal (79,37±7,22), upper (80,40±7,05), upper-nasal (80,97±9,44), lower-nasal (78,97±8,14), lower (76,87±11,23), lower-temporal (80,40±9,16) quadrants of GCC; in inner-nasal (318,30±21,82), inner-upper (318,63±20,15), outer-upper (276,00±13,58), inner-lower (315,07±17,98) quadrants of macula; in temporal (112,27±21,94), nasal (115,57±22,67), upper (89,93±14,15) quadrants of RNFL. In all patients group, there was a significant decrease in all quadrants [upper-temporal (80,34±7,29), upper (82,24±7,08), upper-nasal (82,87±8,18), lower-nasal (81,42±7,63), lower (79,39± 9,73), lower-temporal (81,50±8,58)] of GCC; in central (243,21±23,00), inner-temporal (301,16±39,59), outer-temporal (261,68±14,03), inner-nasal (319,65±20.00), inner-upper (319,85±18,40), outer-upper (279,65±13,60), inner-lower (316,27±17,59) quadrants of macula; in upper (115,24±19,52) and nasal (66,92±11,68) quadrants of RNFL (p˂0,05). Conclusion: Degenerative changes detected with OCT have been shown in patients with BD. These changes correlate positively with the duration of diagnosis. Keywords: Bipolar Disorder, Retina, Optic coherence tomography.