精神障碍患者视网膜结构变化的研究进展  

Research progress in retinal structural alterations in patients with mental disorders

作　　者：王偲佳 魏燕燕 钱禛颖 李清伟[1,3] 王继军[1] WANG Sijia;WEI Yanyan;QIAN Zhenying;LI Qingwei;WANG Jijun(Department of Electroencephalography and Imaging,Shanghai Mental Health Center,Shanghai Jiao Tong University School of Medicine,Shanghai 200030,China;Department of Psychiatry,Baoshan District Mental Health Center,Shanghai 201906,China;Department of Psychiatry,Tongji Hospital of Tongji University,Shanghai 200065,China)

机构地区：[1]上海交通大学医学院附属精神卫生中心脑电影像眼动研究室,上海200030 [2]上海市宝山区精神卫生中心精神科,上海201906 [3]同济大学附属同济医院精神医学科,上海200065

出　　处：《上海交通大学学报(医学版)》2025年第2期247-252,共6页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海交通大学医学院附属精神卫生中心院级课题(2022-YJ09)。

摘　　要：精神障碍常与其他躯体疾病共病,已成为全球患者致残的主要原因之一。早期诊断和治疗对于精神障碍的管理至关重要。目前,精神障碍生物标志物的研究主要集中在基因、血液指标和脑部影像;此外,一些客观的表型标志物也逐渐成为研究的热点。视网膜是中枢神经系统的一部分,由间脑延伸而来,在胚胎发育期间与大脑共同发育。鉴于神经退行性疾病和精神障碍在病理生理学中的重叠机制,研究视网膜内各层组织的结构和功能变化,已成为精神障碍研究的新方向。随着光学相干断层扫描(optical coherence tomography,OCT)技术的发展,研究人员能够无创、非接触地对视网膜结构进行显微成像,精确量化各视网膜亚层的厚度。已有研究利用OCT探索精神分裂症、双相情感障碍、抑郁症等精神疾病患者的视网膜结构变化,但目前缺乏系统的总结与归纳。将目前已有精神障碍患者视网膜结构变化的研究结果及进展进行总结,发现部分精神障碍患者的视网膜亚层厚度显著减小。这些发现提示视网膜结构有潜力成为精神障碍的生物标志物,为精神障碍的诊断和治疗提供新的研究思路。Mental disorders frequently co-occur with other physical illnesses,becoming one of the leading causes of disability worldwide.Early diagnosis and intervention are crucial for the effective management of these disorders.Currently,biomarker studies on mental disorders predominantly concentrate on genes,blood indicators,and imaging features of the brain.There is a growing interest in objective phenotypic markers as a research focus.It is established that the retina is part of the central nervous system(CNS),which extends from the mesencephalon and develops concurrently with the brain during the embryonic period.Given the overlapping pathophysiological mechanisms between neurodegenerative diseases and mental disorders,studying the structural and functional changes in the inner layers of the retina has emerged as a new direction in mental health research.The advent of optical coherence tomography(OCT)has enabled microscopic imaging of retinal structures.OCT is capable of objectively quantifying the retinal sub-layers and offers the advantages of being non-invasive,non-contact,and high-resolution.The use of OCT to explore structural changes in the retina among individuals with schizophrenia,bipolar disorder,major depression and other psychiatric disorders has been well documented;however,there is a paucity of reviews on this topic.This review summarizes current research on retinal structural alterations in patients with mental disorders,and the results demonstrate reduced thickness in certain sub-layers of the retina structure in patients with several mental disorders,which supports that the retina structure has the potential to be a biomarker for mental disorders and offers a novel avenue for research in the diagnosis and treatment.

关 键 词：光学相干断层扫描 精神障碍 精神分裂症 情感障碍 视网膜神经纤维层 视网膜 

分 类 号：R749[医药卫生—神经病学与精神病学]