Retinal layer structure on optical coherence tomography in post-traumatic stress disorder
- 1Department of Ophthalmology, iMIND Study Group, Duke University School of Medicine, Durham, NC, United States of America
- 2Walter Reed National Military Medical Center, Bethesda, MD, United States of America
- 3Department of Neurology, Duke University School of Medicine, Durham, NC, United States of America
Abstract
Purpose: To assess individual retinal layer thickness and volume changes on optical coherence tomography (OCT) in individuals with post-traumatic stress disorder (PTSD) compared to controls. Methods: Adults ≥18 years with a PTSD diagnosis were identified. Age- and sex-matched controls (±5 years) without PTSD were recruited. Exclusion criteria included any cognitive disorder, brain injury, glaucoma, diabetes, optic nerve or vitreoretinal disease, uncontrolled hypertension, refractive error >±6 diopters, or best corrected visual acuity <20/40. Non-mydriatic OCT macular cube 512x128 images were obtained using Zeiss Cirrus HD-5000 AngioPlex. The Duke Reading Center DRCVisualizer software was used to segment the ganglion cell/inner plexiform (GC-IPL), inner nuclear (INL), outer plexiform (OPL), outer nuclear (ONL), photoreceptor, and retinal pigment epithelium (RPE) layers. Mean retinal thickness and volume were calculated for all layers within the central 1-mm subfield and 3- and 6-mm ETDRS rings, further divided into nasal, superior, temporal, and inferior quadrants. Results: 81 eyes of 42 PTSD patients and 81 eyes of 42 controls were analyzed. Average ages were 48 ± 15 years for PTSD and 51 ± 19 years for controls. Groups were 36% male. PTSD eyes showed significantly decreased photoreceptor thickness and volume and increased RPE thickness/volume across all ETDRS rings and quadrants (all p < 0.05). OPL thicknesses were decreased in PTSD eyes versus controls for temporal 3-mm (25.29 ± 1.36 µm vs. 26.64 ± 3.80µm) and temporal 6-mm (23.47 ± 0.88µm vs. 24.00 ± 1.54µm) rings (p < 0.05). OPL inferior 6-mm thickness was decreased in PTSD eyes (23.98 ± 1.58 µm vs. 24.78 ± 2.34 µm) versus controls (p < 0.05). The ONL nasal 6-mm thickness was decreased in PTSD versus controls (55.96 ± 7.90 µm vs. 56.74 ± 7.47µm) (p < 0.05). After adjusting for multiple testing, RPE differences remained significant across all evaluated regions, while photoreceptor differences remained significant within the central 1-mm and 3-mm ETDRS regions. Conclusions: PTSD eyes demonstrated decreased photoreceptor layer and increased RPE thickness and volume.
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BibTeX
@article{patel2026retinal,
title = {{Retinal layer structure on optical coherence tomography in post-traumatic stress disorder}},
author = {Sejal D. Patel and Naveen Karthik and Grant A. Justin and Alice Haystead and Stephanie J. Chiu and Sandra S. Stinnett and Kim G. Johnson and Dilraj S. Grewal and Sharon Fekrat},
journal = {PLOS One},
year = {2026},
month = oct,
doi = {10.1371/journal.pone.0360471},
url = {https://doi.org/10.1371/journal.pone.0360471},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Retinal layer structure on optical coherence tomography in post-traumatic stress disorder
AU - Sejal D. Patel
AU - Naveen Karthik
AU - Grant A. Justin
AU - Alice Haystead
AU - Stephanie J. Chiu
AU - Sandra S. Stinnett
AU - Kim G. Johnson
AU - Dilraj S. Grewal
AU - Sharon Fekrat
PY - 2026
DA - 2026/10/27
JO - PLOS One
DO - 10.1371/journal.pone.0360471
UR - https://doi.org/10.1371/journal.pone.0360471
AB - Purpose: To assess individual retinal layer thickness and volume changes on optical coherence tomography (OCT) in individuals with post-traumatic stress disorder (PTSD) compared to controls. Methods: Adults ≥18 years with a PTSD diagnosis were identified. Age- and sex-matched controls (±5 years) without PTSD were recruited. Exclusion criteria included any cognitive disorder, brain injury, glaucoma, diabetes, optic nerve or vitreoretinal disease, uncontrolled hypertension, refractive error >±6 diopters, or best corrected visual acuity <20/40. Non-mydriatic OCT macular cube 512x128 images were obtained using Zeiss Cirrus HD-5000 AngioPlex. The Duke Reading Center DRCVisualizer software was used to segment the ganglion cell/inner plexiform (GC-IPL), inner nuclear (INL), outer plexiform (OPL), outer nuclear (ONL), photoreceptor, and retinal pigment epithelium (RPE) layers. Mean retinal thickness and volume were calculated for all layers within the central 1-mm subfield and 3- and 6-mm ETDRS rings, further divided into nasal, superior, temporal, and inferior quadrants. Results: 81 eyes of 42 PTSD patients and 81 eyes of 42 controls were analyzed. Average ages were 48 ± 15 years for PTSD and 51 ± 19 years for controls. Groups were 36% male. PTSD eyes showed significantly decreased photoreceptor thickness and volume and increased RPE thickness/volume across all ETDRS rings and quadrants (all p < 0.05). OPL thicknesses were decreased in PTSD eyes versus controls for temporal 3-mm (25.29 ± 1.36 µm vs. 26.64 ± 3.80µm) and temporal 6-mm (23.47 ± 0.88µm vs. 24.00 ± 1.54µm) rings (p < 0.05). OPL inferior 6-mm thickness was decreased in PTSD eyes (23.98 ± 1.58 µm vs. 24.78 ± 2.34 µm) versus controls (p < 0.05). The ONL nasal 6-mm thickness was decreased in PTSD versus controls (55.96 ± 7.90 µm vs. 56.74 ± 7.47µm) (p < 0.05). After adjusting for multiple testing, RPE differences remained significant across all evaluated regions, while photoreceptor differences remained significant within the central 1-mm and 3-mm ETDRS regions. Conclusions: PTSD eyes demonstrated decreased photoreceptor layer and increased RPE thickness and volume.
SN - 1932-6203
ER -