Retinal and choroidal alterations in patients with anorexia nervosa without vision loss

Evaluate the alterations of retinal anatomy and function, as well as choroidal thickness changes, in patients with anorexia nervosa (AN).

13 female AN patients (26 eyes) and 20 female controls (40 eyes) were included. Assessment of the retinal and choroidal anatomy was performed by optical-coherence-tomography, while multifocal-electroretinogram was used for measurements of the electrical activity of the macula. Statistical analysis was performed using t-test.

Central macular thickness was found to be thinner in AN (140.04 ± 14.45, 150.85 ± 16.03, p = 0.007), likewise the ganglion cell complex and outer retinal layer (ORL) at most areas. ORL superiorly was thicker in AN (169.12 ± 2.55, 163.00 ± 8.70, p < 0.001), while retinal nerve fiber layer was not different between the two groups, except the inferior region (121.08 ± 18.52, 137.60 ± 7.30, p < 0.001). Choroidal thickness was evenly diminished in the anorectic group (p = 0.001-0.027). Multifocal-electroretinogram showed lower P1-retinal response density amplitude of ring 1 in AN (159.04 ± 60.83, 292.43 ± 11.59, p < 0.001), but no significant difference concerning the P1-response density amplitude of ring 2 (79.04 ± 21.89, 82.63 ± 9.10, p = 0.36).

In AN patients, even without vision loss, significant changes occur in retinal and choroidal thickness, as well as in the electrical activity of the macula. However, this is a pilot study in a small sample that needs replication.