Anksiyete Bozukluğu Hastalarında Santral Makula Kalınlığı ve Koroidal Vaskülarite İndeksinin Spektral-Domain Optik Koherens Tomografi ile Değerlendirilmesi

Öz

Amaç: Yaygın anksiyete bozukluğu hastalarında spektral-domain optik koherens tomografi (SD-OKT) kullanarak santral makula kalınlığı (SMK) ve koroidal vaskülarite indeksinde (KVİ) potansiyel değişi-kliklerin araştırılması. Materyal ve Metod: Bu retrospektif karşılaştırmalı çalışmada yaşa göre eşleştirilmiş 85 katılımcı (38 yaygın anksiyete bozukluğu hastası, 47 sağlıklı kontrol) analiz edildi. Kapsamlı oftalmolojik muay-eneler ve geliştirilmiş derinlik görüntüleme (EDI) ile makular SD-OKT görüntülemesi yapıldı. SMK otomatik olarak ölçüldü, KVİ ise standart ImageJ binarizasyon protokolleri kullanılarak hesaplandı. İstatistiksel analizler bağımsız t-testleri, duyarlılık analizleri, etki büyüklüğü hesaplamaları ve korela-syon değerlendirmelerini içerdi (α = 0.05). Bulgular: Gruplar benzer demografik özellikler gösterdi (yaş p=0.492; cinsiyet p=0.659; göz içi basıncı p=0.472). SMK (249.4±20.5 µm karşı 246.0±32.5 µm; p=0.582; d=0.12) veya KVİ (70.3±3.3% karşı 70.5±3.6%; p=0.787; d=-0.06) açısından anlamlı fark bulunmadı. Duyarlılık analizleri (ilaçsız alt grup, sigara içmeyenler) ve anksiyete şiddeti korelasyonları tutarlı anlamlı olmayan sonuçlar verdi. Sonuç: Bu analiz yaygın anksiyete bozukluğunda posterior segment değişikliklerinin bulunmadığına dair kanıt sağladı ve mevcut psikofizyolojik modelleri sorguladı. Bulgular koroidin kronik strese karşı direncini vurgulamakta ve psikofizyolojik oftalmoloji araştırmalarında multimodal biomarker yak-laşımlarının gerekliliğini göstermektedir.

Anahtar Kelimeler

• Generalized anxiety disorder
• Choroidal vascularity index
• Central macular thickness
• Optical coher-ence tomography
• Psychophysiology
• Biomarkers

Effects of Anxiety Disorder on Choroidal Vascularity Index and Central Macular Thickness: A Comprehensive Retrospective Analysis

Öz

Materials and Methods: This retrospective comparative study analyzed 85 participants (38 general-ized anxiety disorder patients, 47 age- and sex-matched healthy controls). Comprehensive oph-thalmic examinations and macular SD-OCT imaging with enhanced depth imaging (EDI) were per-formed. CMT was measured automatically, while CVI was calculated using standardized ImageJ binarization protocols. Statistical analyses included independent t-tests, sensitivity analyses, effect size calculations, and correlation assessments (α = 0.05). Results: Groups demonstrated comparable demographics (age p=0.492; sex p=0.659; IOP p=0.472). No significant differences emerged in CMT (249.4±20.5 µm vs. 246.0±32.5 µm; p=0.582; Cohen's d=0.12) or CVI (70.3±3.3% vs. 70.5±3.6%; p=0.787; d=-0.06). Sensitivity analyses (medication-free subgroup, non-smokers) and anxiety severity correlations yielded consistent null findings. Conclusions: This robust analysis found no evidence of structural posterior segment alterations in generalized anxiety disorder, challenging prevailing psychophysiological models. Findings highlight the choroid's resilience to chronic stress and underscore the need for multimodal biomarker ap-proaches in psychophysiological ophthalmology research. Keywords: Generalized anxiety disorder, Choroidal vascularity index, Central macular thickness, Optical coherence tomography, Psychophysiology, Biomarkers

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