11 4 abstract eng fixation quality in patients with major depressive disorder and the influence of a

Fixation quality in patients with major depressive disorder and the influence of antipsychotic drugs.

Gerace E,1 Trabucco P,2 Carnevale C,1 Rigoni E1.

1 Università degli studi di Roma “Sapienza”- Policlinico Umberto I, Roma. 2Ospedale “S.M.Goretti”-Latina.

Purpose To evaluate retinal function and fixation stability in major depressive disorder (MDD) and to investigate the influence of antipsychotic therapy on quality of fixation, using the MP-1 microperimeter (Nidek Technologies).

Metodi 28 patients with MDD (62.5±12.51 years) with logMAR acuity ≤ 0.04 and 30 matched healthy subjects (HS) (63.62± 14.14 years) with logMAR acuity ≤ 0.0 were enrolled. According to the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), single (296.2) or recurrent episode (296.3) of MDD were included. Patients with any other diagnosed mental illness or ocular disease were excluded. Retinal sensitivity, fixation stability, fixation points within 2 and 4 degree, and bivariate contour ellipse area (BCEA) were obtained from the MP-1 in MDD and HS. Moreover patients were divided according to the therapy: 12 patients with (group A) and 16 without (group B) atypical antipsychotic drugs. Mean BCEA (deg2) was normalized by logarithmic transformation (Shapiro-Wilk test, p<0.05), and first standard deviation (68.2%) was considered. Statistical analysis was performed using ANOVA with Scheffé’s comparison and Pearson’s correlation.

Results Mean retinal sensitivity was 15.21±4.04 dB in MDD patients and 17.29±0.86 dB in HS (p=0.01). Fixation points within 2 degree were 78.25±21.62% and 93.32±8.21% within 4 degree, 17 MDD patients had a stable fixation, 10 relatively unstable and 1 unstable fixation. Mean BCEA values in MDD patients were significantly larger than HS (0.83±0.97 deg2 vs 0.29±0.25 deg2,p=0.02). There was a positive relationship between logBCEA and age in HS (r=0.46, P=0.01), but not in MDD patients (r=0.28,p=0.14). There was significant differences in BCEA between groups (F=9.34,p=0.001). Comparison between group A and group B showed a more restricted BCEA (p=0.01) in group A, whereas no differences were observed between groups A/HS (p=0.91). Moreover in group B mean BCEA was significantly larger than HS (p=0.001).

Conclusions Patients with MDD had a reduction in retinal function and fixation stability compared to HS. MDD patients treated with antipsychotic drugs showed a significantly better fixation stability respect to patients without antipsychotic therapy. In fact no significant differences were found when group A was compared with HS. This suggests the possible influence of antipsychotic drugs in improving quality of fixation in MDD patients.