Mustafa, Akkus; Turgay, Ucak

Objective: The number of studies conducted on the evaluation of retinal microvascularity in patients with Bipolar Disorder (BD) is very few. Therefore, in the present study it was aimed to provide a significant diagnostic support and to better understand the relationship between BD and vascular changes by making vascular measurements with Optical Coherence Tomography Angiography (OCTA). Method: The statistical analysis was performed by comparing OCTA measurements of 48 eyes of 48 euthymic patients followed up with a diagnosis of BD and in remission for at least 6 months, and 45 eyes of 45 age-matched healthy volunteers in the control group. Among the OCTA measurements compared were retinal vessel density analysis, foveal avascular zone measurements, retinal nerve fiber layer, radial peripapillary capillary plexus, ganglion cell-inner plexiform layer values. Results: In the multivariate regression model, such variables as nasal quadrant of retinal nerve fiber layer, inferior and nasal quadrants of radial peripapillary capillary plexus and superficial vessel density variables were determined to have a significant and independent effect in differentiating patients with BD from the participants in the healthy control group. Conclusion: In the present study, for the first time, the OCTA method was used to compare both retinal neurodegeneration and vascularization measurements in those in the BD and the healthy groups. That the effects of drugs other than mood stabilizers were not taken into account is among the limitations of our study.

Akkus, Mustafa

Tardive dyskinesia (TD) is a serious side effect that manifests itself mainly with choreiform and athetotic movement disorders, and generally occurs in the long term during antipsychotic treatments and is generally irreversible. We report a 67-year-old female patient having a diagnosis of Bipolar Disorder (BD) for 25 years, receiving 1200 mg/day lithium monotherapy for 10 years and in remission. The patient had been showing signs of TD-like syndrome for the last 6 months. Because the patient responded to lithium well and because other treatment options for TD were unsuccessful, the lithium dose was reduced to 600 mg/day and the patient was monitored. Three months after the dose reduction, the patient's remission state continued, and the TD findings regressed. TD mainly due to antipsychotics is known as irreversible. This case suggests that lithium-induced TD may be reversible in a dose-dependent manner.