Akut ve kronik bipolar bozukluklarda optik koherens tomografi ile retina sinir lifi tabakası, ganglion hücre kompleksi ve makula kalınlığının değerlendirilmesi
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Tarih
2020
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Hatay Mustafa Kemal Üniversitesi
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info:eu-repo/semantics/openAccess
Özet
Amaç: Bipolar bozukluk (BB) hastalarında optik koherens tomografi (OKT) ile retina sinir lifi tabakası (RSLT), ganglion hücre kompleksi (GHK) ve makulayı değerlendirmek. Yöntem: Prospektif olan çalışmaya, Şubat 2019-Aralık 2019 arasında HMKÜ Ruh Sağlığı ve Hastalıkları Anabilim Dalı tarafından takip edilen BB tip I tanısı alan 62 hastanın 62 gözü ile, kontrol amacı ile başvuran 63 sağlıklı gönüllünün 63 gözü dahil edildi. Hastalar; 5 yıl ve altı tanı süresi olanlar, 5 yıl üzeri tanı süresi olanlar ve tüm hastalar olarak 3 gruba ayrıldı. Kontroller; 1. kontrol, 2. kontrol ve tüm kontroller olarak 3 gruba ayrıldı. Tüm gruplara tam oftalmolojik muayene yapılıp, ardından OKT ile RSLT, GHK ve makula kalınlığı ölçümleri kaydedildi. Tüm grupların kendi kontrol grubuyla istatistiksel karşılaştırılması yapıldı. Bulgular: 5 yıl ve altı tanı süresi olan hastalarda; GHK açısından üst-temporal (81,25±7,35), üst (83,97±6,77), üst-nazal (84,66±6,43), alt-nazal (83,72±6,43), alt (81,75±7,52), alt-temporal (82,53±7,99); makula açısından santral (240,63±22,50), iç-temporal (304,13±16,74), iç-nazal (320,91±18,39), iç-üst (321,00±16,84), iç-alt (317,41±17,41); RSLT açısından temporal (69,03±9,50) kadranlarda anlamlı azalma saptandı. 5 yıl üzeri tanı süresi olanlarda, GHK açısından üst-temporal (79,37±7,22), üst (80,40±7,05), üst-nazal (80,97±9,44), alt-nazal (78,97±8,14), alt (76,87±11,23), alt-temporal (80,40±9,16); makula açısından iç-nazal (318,30±21,82), iç-üst (318,63±20,15), dış-üst (276,00±13,58), iç-alt (315,07±17,98); RSLT açısından temporal (112,27±21,94), nazal (115,57±22,67), üst (89,93±14,15) kadranlarda anlamlı azalma saptandı. Hastaların tümü değerlendirildiğinde, GHK açısından tüm kadranlarda [üst-temporal (80,34±7,29), üst (82,24±7,08), üst-nazal (82,87±8,18), alt-nazal (81,42±7,63), alt (79,39±9,73), alt-temporal (81,50±8,58)]; makula açısından santral (243,21±23,00), iç-temporal (301,16±39,59), dış-temporal (261,68±14,03), iç-nazal (319,65±20,00), iç-üst (319,85±18,40), dış-üst (279,65±13,60), iç-alt (316,27±17,59); RSLT açısından üst (115,24±19,52), nazal (66,92±11,68) kadranlarda anlamlı azalma saptandı (p˂0,05). Sonuç: BB hastalarında OKT ile tespit edilebilen dejeneratif değişiklikler olduğu gösterilmiştir. Bu değişiklikler, tanı süresi ile pozitif korelasyon göstermektedir.
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.
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.
Açıklama
Anahtar Kelimeler
Göz Hastalıkları, Eye Diseases, Bipolar Bozukluk, Retina, Optik koherens tomografi., Bipolar Disorder, Retina, Optic coherence tomography.
