Title : The Emotional Retina: Revealing Invisible Suffering Through Retinal Vascular Biomarkers In Young Adults Using Octa — A New Era In Psych-Ophthalmology
Abstract:
Purpose:
To investigate whether the human retina can serve as a non-invasive mirror of emotional suffering, even in individuals with perfect vision. This study introduces the concept of the “Emotional Retina” and explores retinal vascular changes associated with emotional distress in healthy young adults using Optical Coherence Tomography Angiography (OCTA).
Methods:
This observational study included 150 asymptomatic participants aged 18–35 years. Emotional status was assessed using standardized psychological tools:
· DASS-21 (Depression, Anxiety, Stress Scale)
· PSQI (Pittsburgh Sleep Quality Index)
Each subject underwent:
· OCTA (3×3 and 6×6 mm scans): Assessments of superficial and deep capillary plexus vessel density, FAZ area, and perfusion symmetry
· IOLMaster 700: Used to control for biometric confounders (axial length, ACD, CCT)
A novel scoring model, the Emotional Retina Index (ERI), was created by combining vascular disruption metrics and psychological scores.
Results:
· Participants with moderate-to-severe depression showed a significant reduction in deep plexus vessel density and enlarged FAZ (p<0.001)
· Anxiety correlated with temporal perifoveal rarefaction and perfusion asymmetry
· Poor sleep quality predicted bilateral perfusion loss and higher ERI (p=0.002)
· An ERI ≥7 predicted emotional distress with 94% sensitivity and 88% specificity
· All subjects had 6/6 vision and normal fundus exams, confirming that retinal changes were subclinical and emotion-linked
