Estimating Accelerated Retinal Decline in Mental Health Disorders Through Normative Modeling

Area of Science:

• Ophthalmology
• Neuroscience
• Psychiatry

Background:

• Retinal tissue is thinner in individuals with mental health disorders compared to healthy controls.
• Previous studies often examined group-level differences, neglecting biological variability and hindering transdiagnostic comparisons.
• Normative modeling offers a method to account for expected biological variation and compare age-related decline across disorders.

Purpose of the Study:

• To estimate age-related retinal decline using normative modeling in a large healthy cohort.
• To compare retinal decline in individuals with schizophrenia, bipolar disorder, and major depressive disorder against normative data.
• To test the hypothesis of accelerated retinal decline in mental health disorders, with schizophrenia most affected.

Main Methods:

• Utilized UK Biobank data from 51,225 healthy controls (age 40-70) to establish normative age-related retinal thickness decline.
• Analyzed macular thickness and 8 sublayers, comparing decline in schizophrenia (n=170), bipolar disorder (n=263), and major depressive disorder (n=95) to healthy controls.
• Adjusted for known confounding variables to ensure robust comparisons.

Main Results:

• Age-related retinal decline showed a curve-like pattern in healthy controls, more pronounced in males.
• Individuals with mental health disorders exhibited significantly more pronounced retinal thinning, especially in schizophrenia and specific macular subfields.
• An enrichment of infranormal retinal thickness values was observed in the patient groups.

Conclusions:

• Major mental health disorders, particularly schizophrenia, are associated with accelerated retinal thinning.
• Normative modeling effectively detects these accelerated declines, highlighting potential biomarkers.
• Findings suggest a link between psychiatric conditions and ocular structural changes.