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Original Investigation
January 2017

Association Between Regular Cannabis Use and Ganglion Cell Dysfunction

Author Affiliations
  • 1Pôle Hospitalo-Universitaire de Psychiatrie du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, France
  • 2EA7298 Interactions gènes-risques environnementaux et effets sur la santé, Université de Lorraine, Vandœuvre-lès-Nancy, Nancy, France
  • 3Institut National de la Santé et de la Recherche Médicale U1114, Fédération de Médecine Translationnelle de Strasbourg, Département de Psychiatrie, Centre Hospitalier Régional Universitaire de Strasbourg, Strasbourg, France
  • 4Maison des Addictions, Centre Hospitalier Régional Universitaire Nancy, Nancy, France
  • 5Pôle S2R, PARC, ESPRI-BIOBASE, Centre Hospitalier Régional Universitaire Nancy, Vandoeuvre lès Nancy, Nancy, France
  • 6Université de Lorraine, Faculté de Médecine, SPI-EAO, Vandoeuvre-lès-Nancy, Nancy, France
  • 7Centre National de la Recherche Scientifique, Institut Elie Cartan de Lorraine, Unité Mixte de Recherche 7502, Vandoeuvre-lès-Nancy, Nancy, France
  • 8Service d’Ophtalmologie, Centre Hospitalier Régional Universitaire Nancy, Nancy, France
JAMA Ophthalmol. 2017;135(1):54-60. doi:10.1001/jamaophthalmol.2016.4761
Key Points

Question  What is the effect of regular cannabis use on the function of retinal ganglion cells?

Findings  In this case-control study of 28 individuals who regularly used cannabis and 24 controls, a large delay in retinal information processing was found in regular cannabis users compared with controls based on an increase in N95 implicit time on results of pattern electroretinography.

Meaning  Although this study is preliminary and not designed to determine cause and effect, the findings suggest that retinal function might be used as a marker of brain neurotransmission abnormalities in cannabis users.

Abstract

Importance  Because cannabis use is a major public health concern and cannabis is known to act on central neurotransmission, studying the retinal ganglion cells in individuals who regularly use cannabis is of interest.

Objective  To determine whether the regular use of cannabis could alter the function of retinal ganglion cells in humans.

Design, Setting, and Participants  For this case-control study, individuals who regularly use cannabis, as well as healthy controls, were recruited, and data were collected from February 11 to October 28, 2014. Retinal function was used as a direct marker of brain neurotransmission abnormalities in complex mental phenomena.

Main Outcomes and Measures  Amplitude and implicit time of the N95 wave on results of pattern electroretinography.

Results  Twenty-eight of the 52 participants were regular cannabis users (24 men and 4 women; median age, 22 years [95% CI, 21-24 years]), and the remaining 24 were controls (20 men and 4 women; median age, 24 years [95% CI, 23-27 years]). There was no difference between groups in terms of age (P = .13) or sex (P = .81). After adjustment for the number of years of education and alcohol use, there was a significant increase for cannabis users of the N95 implicit time on results of pattern electroretinography (median, 98.6 milliseconds [95% CI, 93.4-99.5]) compared with controls (median, 88.4 milliseconds [95% CI, 85.0-91.1]), with 8.4 milliseconds as the median of the differences (95% CI, 4.9-11.5; P < .001, Wald logistic regression). A receiver operating characteristic curve analysis (area under the curve, 0.84 [95% CI, 0.73-0.95]; P < .001) revealed, for a cutoff value of 91.13 milliseconds, a sensitivity of 78.6% (95% CI, 60.5%-89.8%) and a specificity of 75.0% (95% CI, 55.1%-88.0%) for correctly classifying both cannabis users and controls in their corresponding group. The positive predictive value was 78.6% (95% CI, 60.5%-89.8%), and the negative predictive value was 75.0% (95% CI, 55.1%-88.0%).

Conclusions and Relevance  Our results demonstrate a delay in transmission of action potentials by the ganglion cells in regular cannabis users, which could support alterations in vision. Our findings may be important from a public health perspective since they could highlight the neurotoxic effects of cannabis use on the central nervous system as a result of how it affects retinal processing.

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