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All Journal Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Universitas Sriwijaya Majalah Kedokteran Sriwijaya Syntax Literate: Jurnal Ilmiah Indonesia Buletin Farmatera International Journal of Retina Jurnal Biomedika dan Kesehatan Bioscientia Medicina : Journal of Biomedicine and Translational Research Scientia Psychiatrica Sriwijaya Journal of Surgery Sriwijaya Journal of Ophthalmology Eureka Herba Indonesia Jurnal Pengabdian Masyarakat: Humanity and Medicine Open Access Indonesian Journal of Medical Reviews Archives of The Medicine and Case Reports Bioscientia Medicina : Journal of Biomedicine and Translational Research Community Medicine and Education Journal Journal of Anesthesiology and Clinical Research Conferences of Medical Sciences Dies Natalis IJRETINA - International Journal of Retina Sriwijaya Journal of Forensic and Medicolegal Ophthalmologica Indonesiana
Ramzi Amin, Ramzi
Universitas Sriwijaya
Humanities Biochemistry, Genetics & Molecular Biology Dentistry Education Environmental Science Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Other

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Journal : Scientia Psychiatrica

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The Eye as a Window to Neuroinflammation in Psychiatric Disorders?: A Meta-Analysis of Retinal Structural and Vascular Biomarkers Ramzi Amin; Siti Pradyta Phiskanugrah
Scientia Psychiatrica Vol. 6 No. 4 (2025): Scientia Psychiatrica
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/scipsy.v6i2.186

Abstract

Introduction: Psychiatric disorders like schizophrenia, bipolar disorder (BD), and major depressive disorder (MDD) represent major global health challenges with complex pathophysiology, potentially involving neuroinflammation. The retina, an extension of the central nervous system (CNS), offers an accessible site for investigating structural and vascular changes that may parallel CNS processes. Optical Coherence Tomography (OCT) and OCT Angiography (OCT-A) allow non-invasive, high-resolution assessment of retinal neural and vascular layers. This study aimed to meta-analyze current evidence on retinal structural and vascular alterations in major psychiatric disorders and explore these findings within the conceptual framework of shared neuroinflammatory pathways. Methods: A systematic literature search was conducted in PubMed, Scopus, and Web of Science databases for studies published between January 1st, 2013, and December 31st, 2024. We included case-control studies comparing OCT and/or OCT-A parameters (Retinal Nerve Fiber Layer [RNFL] thickness, Ganglion Cell-Inner Plexiform Layer [GCL-IPL] thickness, Macular Thickness [MT], Superficial Capillary Plexus Vessel Density [SCP-VD], Deep Capillary Plexus Vessel Density [DCP-VD], and Foveal Avascular Zone [FAZ] area) between patients with diagnosed schizophrenia, BD, or MDD and healthy controls (HC). Data were pooled using a random-effects model, calculating Standardized Mean Differences (SMD) with 95% confidence intervals (CI). Heterogeneity was assessed using I² statistics. The risk of bias was evaluated using the Newcastle-Ottawa Scale (NOS). Results: Seven studies met the inclusion criteria, encompassing a total of 485 patients (180 Schizophrenia, 155 BD, 150 MDD) and 515 healthy controls. Patients with psychiatric disorders exhibited significantly thinner global RNFL (SMD = -0.68; 95% CI [-0.95, -0.41]; p < 0.00001; I²=75%), GCL-IPL (SMD = -0.75; 95% CI [-1.08, -0.42]; p < 0.0001; I²=80%), and reduced macular SCP-VD (SMD = -0.55; 95% CI [-0.88, -0.22]; p = 0.001; I²=72%) compared to HC. DCP-VD also showed a trend towards reduction (SMD = -0.40; 95% CI [-0.85, 0.05]; p = 0.08; I²=79%). No significant difference was found in central macular thickness (SMD = -0.15; 95% CI [-0.45, 0.15]; p = 0.33; I²=60%) or FAZ area (SMD = 0.20; 95% CI [-0.10, 0.50]; p = 0.19; I²=55%). High heterogeneity was observed across most analyses. Study quality varied, with NOS scores ranging from 6 to 8. Conclusion: This meta-analysis confirms consistent findings of inner retinal neural thinning and microvascular density reduction in individuals with major psychiatric disorders. These alterations, detectable non-invasively via OCT/OCT-A, align with the hypothesis of shared pathophysiological mechanisms, potentially involving neuroinflammation and microvascular compromise, affecting both the brain and the retina. While providing indirect support, these findings underscore the retina's potential as a valuable site for biomarker research in psychiatry.
Pediatric Psychiatric Disorders and Retinal Structure: A Systematic Review and Meta-Analysis of OCT Findings in ADHD and Autism Spectrum Disorder Ramzi Amin; Ririn Rahayu MS
Scientia Psychiatrica Vol. 6 No. 1 (2025): Scientia Psychiatrica
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/scipsy.v6i1.187

Abstract

Introduction: Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are prevalent neurodevelopmental conditions sharing potential etiological overlaps, including neurotransmitter dysregulation and altered neural connectivity, processes which might manifest structurally in the retina, an accessible part of the central nervous system. Optical Coherence Tomography (OCT) provides high-resolution, non-invasive imaging of retinal layers. This study aimed to systematically review and meta-analyze existing evidence on retinal structural changes measured by OCT in children and adolescents with ADHD or ASD compared to typically developing controls (TDC). Methods: A systematic literature search was conducted across PubMed, Scopus, Embase, and Web of Science databases for studies published between January 1st, 2013, and December 31st, 2024. Keywords related to ADHD, ASD, pediatric populations, OCT, and retinal structures were used. Observational studies (case-control, cross-sectional) reporting quantitative OCT measurements (Retinal Nerve Fiber Layer [RNFL] thickness, Ganglion Cell Layer [GCL] thickness, Inner Plexiform Layer [IPL] thickness, macular thickness) in individuals ≤18 years with diagnosed ADHD or ASD and a TDC group were included. Data were pooled using a random-effects model, calculating Mean Differences (MD) with 95% Confidence Intervals (CI). Heterogeneity was assessed using the I² statistic. This meta-analysis synthesized data from seven studies. Results: Seven studies met the inclusion criteria for the meta-analysis, encompassing a total of 285 ADHD patients, 340 ASD patients, and 650 TDC participants. Risk of bias assessment indicated moderate-to-high quality (NOS scores 6-8). For ADHD, meta-analysis revealed a statistically significant thinning of the global average RNFL (MD = -3.15 µm; 95% CI [-4.95, -1.35]; p=0.0006; I²=45%) and GCL thickness (MD = -2.05 µm; 95% CI [-3.10, -1.00]; p=0.0001; I²=30%) compared to TDC. No significant difference was found in average macular thickness. For ASD, a significant thinning was observed in the GCL (MD = -2.50 µm; 95% CI [-3.80, -1.20]; p=0.0002; I²=55%) and IPL (MD = -1.85 µm; 95% CI [-2.90, -0.80]; p=0.0006; I²=40%) compared to TDC. Global RNFL thickness showed a trend towards thinning but did not reach statistical significance (MD = -1.90 µm; 95% CI [-4.10, 0.30]; p=0.09; I²=60%). Macular thickness was not significantly different. Heterogeneity was moderate for most analyses. Conclusion: This systematic review and meta-analysis suggested subtle but potentially significant thinning of specific inner retinal layers (RNFL, GCL, IPL) in children and adolescents with ADHD and ASD compared to typically developing controls. These findings lend support to the hypothesis of shared neurodevelopmental alterations affecting both the brain and retina in these disorders. However, considerable heterogeneity and the limited number of studies underscore the need for larger, longitudinal, well-controlled investigations with standardized protocols before OCT could be considered a reliable biomarker.
Co-Authors A.A. Ketut Agung Cahyawan W A.K Ansyori Ahmad Ghiffari Alfin Radhian Alfurqon Alfurqon Ammar Fardhana Ansyori, A.K. Ansyori, AK Ansyori, AK. Anwar, Chairil Ashita Hulwah A Ayu Aliyah Aziztama, Rezandi Budi Santoso Chairil Anwar Chairil Anwar Charil Anwar Cicilia, Monica Putri Cindy Kesty Defayudina Dafilianty Rosataria Devi Eryanti Devi Eryanti Dezca Nindita Dian Ariani Dian Puspita Sari Dina Fatwa Dio Asgira Rizky Dita Mintardi Dwiana Ocviyanti Dyah Rahayu Utami Elisa Taurisia Elza Iskandar, Elza Evasha, Agung Putra Faika Novadianaz Faiz Muhammad Ikhsan Faneisha Febrina Art Fensilia Yolanda, Gina Sonia Ferry Yusrizal Fidalia Galuh Ismayanti Ginda Chitra H. A. K. Ansyori H. A.K Ansyori Haloho, Agustina Br. Hamzah Hasyim Handayani, Retno Tharra Hartati Hartati Herdana, Nova Indiarsih, Tiara Bunga Indri Seta Septadina Irsan Saleh Kms Yusuf Effendi Krisna Murti Laksono Trisnantoro Linda Tri Wulandari M. Usman Salim Mandy Putriyudi Maria Ulfa Maya Ija Maya Sari, prima Mgs. Irsan Saleh, Mgs. Irsan Mistur Rozian Mufida Muzakkie Muhammad Baqir MUHAMMAD FAHMI Muhammad Irsan Saleh mulyati mulyati Mutiara, Ria Nailul Authoriyah Naufallah Dinda Harumi Nova Herdana Nur Farida Rahmawati Nyayu Fauziah Zen Oliffa Salma Atthahiroh Petty Purwanita Prima Maya Sari Purwanita, Purwanita Putra, Chani Sinaro Putri, Dwi Octaverina Radiyati Umi Partan Rafika Rafika Novianti Rahmah, Meidina Rajendra Ekki Maulana Reny Violeta Rika Anggraini Rika Anggraini Ririn Rahayu Ririn Rahayu MS Rizma Adlia Syakurah Roland Iqbal Rosataria, Defayudina Dafilianty Salim, Muhammad Usman Shaelva Lassa Sabatini Shariff, Muhammad Apriliandy Silvia Rahmi Siti Pradyta Phiskanugrah Sukmono, Nafila Mahida Syarif Husin Theodorus Tiara Mayasari Tribowo, Anang Vicela Patricia Virgyna Widya Wira Putri Yuanita Windusari Yuanita Windusari Zamzam, Avizena Muhammad Zen Hafy