Optical coherens tomography results in patients with anxiety disorder and their relationship with clinical variables

To compare the central macular thickness, choroidal thickness, retinal nerve fiber layer, ganglion cell complex and choroidal vascular index values obtained by optic coherence tomography (OCT) of patients diagnosed with anxiety disorder with the healthy control group. This prospective study included the right eye of 31 patients who were admitted to the psychiatry outpatient clinic of Gaziosmanpaşa University Medical Faculty Hospital between September 2022 and February 2023 and were diagnosed with anxiety disorder and then referred to the ophthalmology clinic. The right eyes of 31 age- and gender-matched volunteers without psychiatric or additional systemic disease were included as the control group. In addition to the routine ophthalmological examinations of the patients, the central macular thickness, choroidal thickness, retinal nerve fiber layer, ganglion cell complex and choroidal vascular index values were measured using the Cirrus HD-OCT (Cirrus HD-OCT, Carl Zeiss Meditec, Model 5000, Dublin, USA) device. Choroidal thickness was measured from the subfoveal area and a total of 5 points made at a distance of 1000 µm from the subfovea to the nasal and temporal directions. ImageJ software was used on OCT images taken in EDI (Enhanced Depth Imaging) mode of the patients to calculate the choroidal vascular index. In addition, sociodemographic data form, Penn State Anxiety Scale, Generalized Anxiety Disorder-7 test were applied to all participants. All statistical analyzes were performed using SPSS version 22.0 (IBM Corporation 2013, Armonk, North Castle, New York, United States) and were considered statistically significant when the p value was <0.05. In all quadrants measured in the patient group, the choroidal thickness was found to be higher than the control group, and the increase in choroidal thickness at the subfoveal, 1000 µm and 2000 µm distance from the fovea to the nasal point was statistically significant (p=0.03, p=0.001 p<0.001, respectively). In the choroidal area measurement, it was observed that both total choroidal area measurements and vascular area measurements were significantly higher than the control group (p=0.03, p=0.01, respectively). However, there was no difference in the choroidal vascular index between the two groups (p=0.27). When the patient and control groups were compared, there was no significant difference in the upper, nasal, lower and mean retinal nerve fiber plate values, while it was significantly higher in the temporal quadrant patient group (p=0.95, p=0.32, p=0.85, p=0,63, p=0.02 respectively) There was no difference between the two groups in central macular thickness, minimum and mean ganglion cell complex values (p=0.17, p=0.76, p=0.42, respectively). In conclusion, our study did not support the presence of neurodegeneration in the etiopathogenesis of anxiety disorders, but showed that inflammatory processes are effective considering the increased choroidal thickness. As a result of the development of SD-OCT, EDI-OCT technologies and a more detailed examination of structures such as retina and choroid, it can be predicted that parameters such as central macular thickness, retinal nerve fiber layer, ganglion cell complex, choroidal thickness, and choroidal vascular index can be used in the diagnosis and follow-up of psychiatric diseases. However, there is a need for more comprehensive, long-term and large series studies on this subject. Key words: Anxiety disorder, Optical coherence tomography, Retinal nerve fiber layer, Ganglion cell complex, Choroidal thickness.