Exploration of the Value of Optical Coherence Tomography (OCT) and OCT Angiography in Differentiating Between Major...

Major depressive disorder (MDD) and borderline personality disorder (BPD) are psychiatric conditions with overlapping clinical features but distinct pathologies. This study aims to explore the microvascular changes in superficial retinal capillary plexus (SRCP) in patients between MDD and BPD using Optical Coherence Tomography (OCT) and Optical coherence tomography angiography (OCTA), as well as determine their clinical diagnostic value.

The study involved 35 MDD patients, 36 BPD patients, and 36 healthy controls (HCs). OCTA and OCT were used to assess macular vessel density (MVD) and peripapillary vessel density (PVD), retinal nerve fiber layer (RNFL), and central retinal thickness (CRT). The study also evaluated the correlation of these ocular parameters with clinical symptoms.

Both MDD and BPD patients showed significant reductions in MVD, RNFL and CRT compared to HCs (all p < 0.05). BPD patients exhibited more pronounced decreases in the foveal area, RNFL and CRT than MDD patients (all p < 0.05). These ocular changes were associated with BPD symptom severity (all p < 0.05). The RNFL and CRT demonstrated potential as diagnostic markers for BPD (AUROCs of 0.625 and 0.695, p < 0.05).

OCT and OCTA might differentiate between MDD and BPD by identifying specific ocular changes, suggesting distinct neurobiological mechanisms for each disorder. These technologies hold promise for improving diagnostic accuracy.