Selective serotonin reuptake inhibitors and ocular health: Analyzing retinal and choroidal thickness variations

PURPOSE: This study evaluated the posterior segment parameters of the eye in patients using selective serotonin reuptake inhibitors (SSRIs) without systemic disease, using spectral-domain optical coherence tomography (SD-OCT), and compared the effects of different durations of SSRI use on the eye.
METHODS: The study involved 104 participants, divided into three groups: those using SSRIs for less than a year (group 1a), those using SSRIs for 1 year or longer (group 1b), and healthy controls (group 2). The posterior segment parameters of the eye were measured using the SD-OCT, and the data were analyzed using descriptive statistics, analysis of variance, post hoc tests, and correlation analysis.
RESULTS: The results showed that the retinal nerve fiber layer (RNFL) thickness and central foveal thickness (CFT) were significantly lower in Group 1a than in Group 2 (p<0.05), while there was no significant difference between Group 1b and Group 2 (p>0.05). The choroidal thickness was significantly lower in both Group 1a and Group 1b than in Group 2 (p<0.05), but there was no significant difference between the two patient groups (p>0.05). The axial length (AXL) was not significantly different among the groups (p>0.05). There was a weak negative correlation between the duration of SSRI use and the RNFL thickness (r=−0.25, p=0.039), and a moderate negative correlation between the duration of SSRI use and the CFT (r=−0.37, p=0.002). There was no significant correlation between the duration of SSRI use and the choroidal thickness or the AXL (p>0.05).
CONCLUSION: This study suggests that SSRIs may affect the retina and choroid due to various mechanisms. The effects may be time dependent and dose dependent, with longer-term use potentially causing adaptations. Ophthalmologists and psychiatrists should monitor patients for symptoms.