Automatic Diagnosis of Bipolar Disorder Using Optical Coherence Tomography Data and Artificial Intelligence.

Eva M Sánchez-Morla,Miguel Ortiz,Juan M Miguel-Jiménez,María Satue,Elena Garcia-Martin,Juan L Fuentes,Elvira Orduna,Luciano Boquete

doi:10.3390/jpm11080803

Abstract

Background: The aim of this study is to explore an objective approach that aids the diagnosis of bipolar disorder (BD), based on optical coherence tomography (OCT) data which are analyzed using artificial intelligence. Methods: Structural analyses of nine layers of the retina were analyzed in 17 type I BD patients and 42 controls, according to the areas defined by the Early Treatment Diabetic Retinopathy Study (ETDRS) chart. The most discriminating variables made up the feature vector of several automatic classifiers: Gaussian Naive Bayes, K-nearest neighbors and support vector machines. Results: BD patients presented retinal thinning affecting most layers, compared to controls. The retinal thickness of the parafoveolar area showed a high capacity to discriminate BD subjects from healthy individuals, specifically for the ganglion cell (area under the curve (AUC) = 0.82) and internal plexiform (AUC = 0.83) layers. The best classifier showed an accuracy of 0.95 for classifying BD versus controls, using as variables of the feature vector the IPL (inner nasal region) and the INL (outer nasal and inner inferior regions) thickness. Conclusions: Our patients with BD present structural alterations in the retina, and artificial intelligence seem to be a useful tool in BD diagnosis, but larger studies are needed to confirm our findings.

Highlights

Bipolar disorder (BD) is a severe mental disorder that has a chronic or recurrent course characterized by high variability affecting its clinical manifestations, course, degree of functional deficit, and its neurobiological basis [1]
All procedures adhered to the tenets of the Declaration of Helsinki, which has been approved by the ethics committee, and all participants gave written informed consent to participate in the study
It was found that the retinal thickness in patients diagnosed with bipolar disorder presents abnormalities in comparison with healthy volunteers

Summary

Introduction

Bipolar disorder (BD) is a severe mental disorder that has a chronic or recurrent course characterized by high variability affecting its clinical manifestations, course, degree of functional deficit, and its neurobiological basis [1] It is, a difficult disorder to diagnose, especially in the early stages of the disease, often resulting in delays in the initiation of adequate treatment [2,3]. The innermost layer of the retina is the retinal nerve fiber layer (RNFL), formed by the axons of the ganglion cells, which converge to form the optic nerve The axons of these cells are not myelinated, so it is possible to study individual axons using imaging techniques such as optical coherence tomography (OCT) [5]. Conclusions: Our patients with BD present structural alterations in the retina, and artificial intelligence seem to be a useful tool in BD diagnosis, but larger studies are needed to confirm our findings

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