Retinal morphology and microvasculature density alterations in generalized anxiety disorders

Purpose This study evaluates morphological alterations in the macula and peripapillary regions of patients with Generalized Anxiety Disorder (GAD) using optical coherence tomography (OCT) and OCT angiography (OCT-A). We compared these changes with healthy controls to determine GAD’s impact on the retina. Methods An observational case-control study was conducted from January to May 2024 at the Benghazi Teaching Eye Hospital, including 40 GAD patients and 40 healthy controls aged 30–65 years. Participants underwent comprehensive ophthalmic assessments, including OCT and OCT-A. We analyzed retinal parameters such as central macular thickness (CMT), Macular volume, Ganglion cell layer thickness, and retinal nerve fiber layer (RNFL) thickness, along with vessel density in the macular and peripapillary regions. Results GAD patients exhibited significantly lower CMT (243.30±21.15 μm vs. 268.79±17.34 μm, P =0.001), Macular volume (9.48±0.62 mm 3 vs. 10.17±0.39 mm 3 , P =0.001), Ganglion cell layer thickness (83.60±78.24 μm vs. 92.30±74.73 μm, P =0.001), and total RNFL thickness (93.90±11.05 μm vs. 97.76±8.67 μm, P =0.001) compared with controls. RNFL thinning was noted in the nasal, inferior, and temporal regions. However, OCT-A revealed no significant differences in vessel density in the peripapillary and central macular areas between GAD patients and controls. Conclusion Patients with GAD exhibit significant retinal structural changes, particularly in the macular and RNFL regions. However, no significant differences in retinal vessel density were observed. These findings suggest that GAD may impact retinal morphology but not vascular density, indicating potential biomarkers for early detection and monitoring of GAD-related neurodegeneration.