The Effect of Transcranial Magnetic Stimulation Treatment on Microvasculature Stracture of the Retina and the Choroid

Inclusion Criteria: * Diagnosed with Major Depressive Disorder according to DSM-5 TR. * Lack of response to treatment after being administered at least two different antidepressants and anti-obsessive agents at effective doses and durations. * The clinical condition cannot be better explained by a metabolic or organic disorder. * Routine electroencephalography (EEG) findings before TMS do not indicate electrical activity consistent with an epileptic focus. * Routine blood tests before TMS show no conditions that could affect treatment levels, particularly thyroid issues, vitamin deficiencies, or inflammation parameters that might cause depression or cognitive impairment (consultation with relevant departments if necessary). * No history of hearing loss identified during routine evaluations (if a history of hearing loss exists, consultation will be requested; if none, the process will proceed accordingly). Exclusion Criteria: * According to the pre-TMS risk assessment form, there is a contraindication for treatment, * Epileptic focus is detected in the pre-TMS electroencephalography findings, * Previous head trauma, loss of consciousness and intra-cerebral surgery, * A metal particle caused by an aneurysm clip, connection tongs or explosive substances that will affect the electromagnetic field in the brain, * A significant disorder in the thyroid hormone profile in routine blood checks before TMS, * A significant increase in inflammation markers in routine checks before TMS…