Panic disorder causes an increase in choroid layer and a decrease in IPL, GCL, RNFL.

Abstract

Background: This study aimed to compare the retinal nerve fiber layer (RNFL), the inner plexiform layer (IPL), the ganglion cell layer (GCL), and the choroid thickness (CT) of patients diagnosed with panic disorder (PD) before and after four-weeks of the treatment and to compare the findings with the healthy subjects.

Subjects and methods: The PD group consisted of 32 subjects and the control group consisted of 64 subjects. All patients were managed by paroxetine plus alprazolam after PD diagnosis. The spectral-domain optical coherence tomography (SD-OCT) was applied twice to the PD group, before and after treatment, and once to the control group.

Results: Age (p=0.916) and smoking status (p=0.850) of PD (23 females, 9 males) and control (46 females, 18 males) groups were similar. Pre-treatment PD's RNFL sub-sectors, GCL, and IPL values were lower than the control group. Pre-treatment PD's CT value was higher than the control group. Four-weeks of PD treatment caused an increase in RNFL sub-sectors in the pre-treatment SD-OCT parameters of PD group, significantly in left mean and left TI. The sensitivity of mean CT (p<0.001) related to the diagnosis of pre-treatment PD was 71.9 percent and the specificity was 93.8 percent (Nagelkerke R2=0.636). The area under the ROC curve of mean CT was 0.915 (p<0.001; 95% CI [0.845-0.985]). The optimal cut-off value for mean CT was 321.75, and its sensitivity and specificity for the diagnosis of OUD were 68.8% and 98.4%, respectively.

Conclusion: This is the first study to examine the effect of PD treatment on SD-OCT parameters in patients diagnosed with PD. We suggest that acute exacerbation of PD is characterized by an increase in CT and a decrease in RNFL sub-sectors, GCL, and IPL. PD treatment causes an increase in RNFL sub-sectors.