Murat Eren ÖZEN, Aysun KALENDEROĞLU, Ayşe Sevgi KARADAĞ, Mehmet Hamdi ÖRÜM

Comparison of optic coherence tomography results in patients diagnosed with OCD: findings in favor of neurodegeneration

Objective: Optic coherence tomography (OCT) is a contactless and fast neuroimaging method. Previous studies have observed thinning of the ganglion cell layer (GCL) and inner plexiform layer (IPL) in many neurodegenerative diseases. The aim of this study was to compare the GCL volume, retinal nerve fiber layer (RNFL), and IPL thickness in obsessive compulsive patients and controls using OCT to demonstrate neurodegeneration in obsessive compul- sive disorder (OCD). Methods: This study involved 50 OCD patients who were being followed by the Psychiatry Department of Adiyaman University Medical School and 50 healthy volunteers as control. OCT measurements were performed for both groups. The RNFL, IPL thickness, and GCL volumes were measured and recorded automatically by a spectral OCT device. Results: The RNFL thickness was lower in patients compared with controls at all mea- sured regions, and this decrease statistically significant in a few regions (left temporo-superior, left mean). The left and right choroid layer thickness acquired from three regions of choroid layer was higher in patients compared with controls. The GCL and IPL volumes were also significantly lower in the patient group. There was a significant nega- tive correlation between the disease duration and OCT results. Discussion: These findings suggest that neurode- generation occurs during the course of OCD. This degeneration may be demonstrated by decreased GCL at early stages, and as the disease progresses, involvement of other retinal layers, such as the RNFL and IPL, may be observed. (Anatolian Journal of Psychiatry 2019; 20(2):166-174)

Obsesif kompulsif bozukluk hastalarında optik koherans tomografi sonuçlarının karşılaştırılması: Nörodejenerasyon lehine bulgular

Amaç: Optik koherans tomografi (OCT), temassız ve hızlı bir görüntüleme yöntemidir. Önceki çalışmalarda birçok nörodejeneratif hastalıkta ganglion hücre tabakası (GCL) ve iç pleksiform tabakasında (IPL) incelme gözlemlemiştir. Bu çalışmanın amacı obsesif kompulsif bozuklukta (OKB) nörodejenerasyonun ortaya konulması amacıyla OKB hastalarında GCL hacmi, retina sinir lifi tabakası (İVFL) ve IPL kalınlığı ile OCT kullanılarak yapılan kontrollerin karşılaştırılmasıdır. Yöntem: Çalışmaya Adıyaman Üniversitesi Tıp Fakültesi Psikiyatri Anabilim Dalında tedavi edilen 50 OKB hastası ve 50 sağlıklı gönüllü kontrol olarak alındı. İki grup için de OCT ölçümleri yapıldı. RNFL, IPL kalınlığı ve GCL hacimleri, bir spektral OCT cihazı tarafından otomatik olarak ölçülmüş ve kaydedilmiştir. Sonuçlar: RNFL kalınlığı, tüm ölçülen bölgelerdeki kontrollere göre daha düşüktü ve bu, birkaç bölgede (sol temporo-superior, sol ortalama) istatistiksel olarak anlamlı bir düşüş gösterdi. Koroid tabakanın üç bölgesinden elde edilen sol ve sağ koroid tabaka kalınlığı, kontrol grubuna göre daha yüksekti. GCL ve IPL hacimleri de hasta grubunda anlamlı olarak düşüktü. Hastalık süresi ile OCT sonuçları arasında anlamlı negatif korelasyon vardı. Tartışma: Bu bulgular, OKB sürecinde nörodejenerasyonun meydana geldiğini düşündürmektedir. Bu dejenerasyon, erken evrelerde azalmış GCL ile gösterilebilir ve hastalık ilerledikçe, RNFL ve IPL gibi diğer retinal tabakaların katılımı gözlenebilir. (Anadolu Psikiyatri Derg 2019; 20(2):166-174)

PDF

___

Insel TR. Toward a neuroanatomy of obsessive- compulsive disorder. Arch Gen Psychiatry 1992; 49:739-744.

Jenike MA, Breiter HC, Baer L, Kennedy DN, Savage CR, Olivares MJ, et al. Cerebral structural abnormalities in obsessive-compulsive disorder. A quantitative morphometric magnetic resonance imaging study. Arch Gen Psychiatry 1996; 53:625- 632.

Baxter LR. Neuroimaging studies of obsessive– compulsive disorders. Psychiatr Clin North Am 1992; 15:871-884.

Andreasen NC. Brain imaging: applications in psychiatry. Science 1988; 239:1381-1388.

Robins LN, Helzer JE, Weismann MM. Life time prevalence of specific psychiatric disorders in three sites. Arch Gen Psychiatry 1984; 41:958- 967.

Leckman JF, Riddle MA. Tourette’s syndrome: when habit-forming systems form habits of their own? Neuron 2000; 28:349-354.

Singer HS, Giuliano JD, Hansen BH. Antibodies against human putamen in children with Tourette syndrome. Neurology 1998; 50:1618-1624.

Destefano N, Matthews P, Antel JP, Preul M, Francis G, Arnold DL. Chemical pathology of acute demyelinating lesions and its correlations with disability. Ann Neurol 1995; 8:901-909.

Ebert D, Speck O, Konig A, Berger M, Hennig J, Hohagen F. 1H-Magnetic resonance spectros- copy in obsessive-compulsive disorder: evidence for neuronal loss in the cingulate gyrus and the right striatum. Psychiatry Res 1997; 74:173-176.

Atmaca M, Yıldırım H, Ozdemir H, Koc M, Ozler S, Tezcan E. Neurochemistry of the hippocampus in patients with obsessive-compulsive disorder. Psychiat Clin Neuros 2009; 63:486-490.

Saidha S, Syc S, Ibrahim MA, Eckstein C, Warner CV, Farrel SK, et al. Primary retinal pathology in multiple sclerosis as detected by optical co- herence tomography. Brain 2011; 134:518-533.

He XF, Liu YT, Peng C, Zhang F, Zhuang S, Zhang JS. Optical coherence tomography as- sessed retinal nerve fiber layer thickness in pa- tients with Alzheimer’s disease: a meta-analysis. Int J Ophthalmol 2012; 5:401-405.

Cetin EN, Bir LS, Sarac G, Yaldizkaya F, Yaylali V. Optic disc and retinal nerve fibre layer changes in Parkinson’s disease. J Neuroophthalmol 2013; 37:20-23.

Tak AZA, Celik M, Kalenderoglu A, Saglam S, Altun Y, Gedik E. Evaluation of Optical Coherence Tomography Results and Cognitive Functions in Patients with Restless Legs Syndrome. Arch Neuropsychiatry doi:10.5152/npa.2017.21598.

Sergott RC, Frohman E, Glanzman R, Al- Sabbagh A. OCT in MS Expert Panel. The role of optical coherence tomography in multiple sclero- sis: expert panel consensus. J Neurol Sci 2007; 263:3-14.

Armarcegui C, Dolz I, Pueyo V. Correlation be- tween functional and structural assessments of the optic nevre and retina in multiple sclerosis patients. Neurophysiol Clin 2010; 40:129-135.

Lu Y, Li Z, Zhang X. Retinal nerve fiber layer structure abnormalities in early Alzheimer’s dis- ease: evidence in optical coherence tomography. Neurosci Lett 2010; 480:69-72.

Inzelberg R, Ramirez JA, Nisipeanu P, Ophir A. Retinal nerve fiber layer thinning in Parkinson disease. Vision Res 2004; 44:2793-2797.

Cohen AI. The retina. WM Hart, (Ed.), Adler's Physiology of the Eye. Ninth ed., Missouri: Mosby- YearBook; 1992, p.579-612.

Cristofaro DMT, Sessarego A, Pupi A, Biondi F, Faravelli C. Brain perfusion abnormalities in drug- naive, lactate sensitive panic patients: A SPECT study. Biol Psychiatry 1993; 33:505-512.

Pato MT, Pato CN, Pauls DL. Recent findings in the genetics of OCD. J Clin Psychiatry 2002; 63(6):30-33.

May-Yin Chu E, Kolappan M, Barnes TRE, Joyce EM, Ron MA. A window into the brain: An in vivo study of the retina in schizophrenia using optical coherence tomography. Psychiatry Res 2012; 203(1):89-94.

Saidha S, Syc SB, Durbin MK, Eckstein C, Oakley JD, Meyer SA, et al. Visual dysfunction in multiple sclerosis correlates better with optical coherence tomography derived estimates of macular gang- lion cell layer thickness than peripapillary retinal nerve fiber layer thickness. Mult Scler 2011; 17(12):1449-1463.

Celik M, Kalenderoglu A, Sevgi-Karadag A, Egil- mez OB, Han-Almis B. Decreases in ganglion cell layer and inner plexiform layer volumes correlate better with disease severity in schizophrenia pa- tients than retinal nerve fiber layer thickness: findings from spectral optic coherence tomog- raphy. Eur Psychiatry 2016; 19(32):9-15.

Kalenderoglu A, Sevgi-Karadag A, Celik M, Egil- mez OB, Han-Almis B, Ozen ME. Can the retinal ganglion cell layer (GCL) volume be a new marker to detect neurodegeneration in bipolar disorder? Compr Psychiatry 2016; 67:66-72.

Kalenderoglu A, Celik M, Sevgi-Karadag A, Egil- mez OB. Optic coherence tomography shows inflammation and degeneration in major depres- sive disorder patients correlated with disease severity. J Affect Disord 2016; 204:159-165.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fourth ed., Text Revised. Washington, DC: American Psychi- atric Association, 2000.

Chhablani J, Wong IY, Kozak I. Choroidal imaging: a review. Saudi J Ophthalmol 2014; 28(2):123-128.

Bora E, Fornito A, Pantelis C, Yucel M. Gray matter abnormalities in major depressive disorder: a meta-analysis of voxel based morphometry studies. J Affect Disord 2012; 138:9-18.

Lamirel C, Newman N, Biousse V. The use of optical coherence tomography in neurology. Rev Neurol Dis 2009; 6:105-120.

Schönfeldt-Lecuona C, Kregel T, Schmidt A, Pinkhardt EH, Lauda F, Kassubek J, et al. From imaging the brain to imaging the retina: optic co- herence tomography in schizophrenia. Schizophr Bull 2016; 42(1):9-14.

Gray SM, Bloch MH. Systematic review of pro- inflammatory cytokines in obsessive-compulsive disorder. Curr Psychiatry Rep 2012; 14(3):220- 228.

Parver LM. Temperature modulating action of choroidal blood flow. Eye (Lond) 1991; 5:181-185.

Kim M, Kim H, Kwon HJ, Kim SS, Koh HJ, Lee SC. Choroidal thickness in Behcet’s uveitis: an enhanced depth imaging optical coherence tomography and its association with angiographic changes. Investig Ophthalmol Vis Sci 2013; 54(9):6033-6039.

Coskun E, Gurler B, Pehlivan Y, Kisacik B, Okumus S, Yayuspayi R, et al. Enhanced depth imaging optical coherence tomography findings in Behcet disease. Ocul Immunol Inflamm 2013; 3:1- 6.

Takeuchi M, Iwasaki T, Kezuka T, Usui Y, Okunuki Y, Sakai J, et al. Functional and morpho- logical changes in the eyes of Behçet's patients with uveitis. Acta Ophthalmol 2010; 88(2):257- 262.

Honrubia F, Calonge B. Evaluation of the nerve fiber layer and peripapillary atrophy in ocular hypertension. Int Ophthalmol 1989; 13:57-62.

Quigley HA, Addicks EM. Quantitative studies of retinal nerve fiber layer defects. Arch Ophthalmol 1982; 100:807-814.