Examination of retinal vascular trajectory in schizophrenia and bipolar disorder

Abstract

Aim: Evidence suggests microvascular dysfunction (wider retinal venules and narrower arterioles) in schizophrenia (SCZ) and bipolar disorder (BD). The vascular development is synchronous with neuronal development in the retina and brain. The retinal vessel trajectory is related to retinal nerve fiber layer thinning and cerebrovascular abnormalities in SCZ and BD and has not yet been examined. Hence, in this study we examined the retinal vascular trajectory in SCZ and BD in comparison with healthy volunteers (HV).Methods: Retinal images were acquired from 100 HV, SCZ patients, and BD patients, respectively, with a non-mydriatic fundus camera. Images were quantified to obtain the retinal arterial and venous trajectories using a validated, semiautomated algorithm. Analysis of covariance and regression analyses were conducted to examine group differences. A supervised machine-learning ensemble of bagged-trees method was used for automated classification of trajectory values.Results: There was a significant difference among groups in both the retinal venous trajectory (HV: 0.17 AE 0.08; SCZ: 0.25 AE 0.17; BD: 0.27 AE 0.20; P < 0.001) and the arterial trajectory (HV: 0.34 AE 0.15; SCZ: 0.29 AE 0.10; BD: 0.29 AE 0.11; P = 0.003) even after adjusting for age and sex (P < 0.001). On post-hoc analysis, the SCZ and BD groups differed from the HV on retinal venous and arterial trajectories, but there was no difference between SCZ and BD patients. The machine learning showed an accuracy of 86% and 73% for classifying HV versus SCZ and BD, respectively.Conclusion: Smaller trajectories of retinal arteries indicate wider and flatter curves in SCZ and BD. Considering the relation between retinal/cerebral vasculatures and retinal nerve fiber layer thinness, the retinal vascular trajectory is a potential marker for SCZ and BD. As a relatively affordable investigation, retinal fundus photography should be further explored in SCZ and BD as a potential screening measure.

Lower Hippocampal Volume in Patients with Schizophrenia and Bipolar Disorder: A Quantitative MRI Study

“…Because SZ and BD share the biological basis of psychoses [1][2][3][4][5][6][7][8][9][10][11][51][52][53][54][55][56][57] and they sometimes present similar pathologies, detection of anatomical and functional biomarkers that differentiate SZ and BD patients is crucial for the optimization of pharmacological and psychosocial treatments for each condition. The results of our ROC analyses suggest that the right hippocampal volume is a potential marker for differentiation between SZ and BD.…”

Retinal fundus imaging in bipolar disorder: A pilot study

“…In BD, one study reported no significant difference between BD and HC, whereas another study reported narrowed arterioles and widened venules . Furthermore, another recent study reported that patients with BD had abnormal arteriolar or venular trajectories . Since metabolic problems are common in BD, current results might be confounded by metbolic abnormalities.…”

Telepsychiatry and the Role of Artificial Intelligence in Mental Health in Post-COVID-19 India: A Scoping Review on Opportunities

“…Studies show that telepsychiatry and AI can be effectively deployed for automated evaluation, namely imaging and behavior analysis, 47 evaluating biosignals, 48 assessing language use in mental disorders, 49 acoustic analysis, 50 knowledge-based methods, 51 and retinal examination. 52 – 56 Other potential uses include online information exchange and support services using social media and networking, 57 psychiatric consultation in primary care and emergency rooms, 58 and asynchronous psychotherapy. 59 Home care and related interventions for the geriatric population are also possible using technology.…”

“…Technological features include videoconference, telephone, and messaging systems, 61,62 web-based interactions, 63,64 mobile phone technologies, 65 networking via social media and group discussions, 66 simulated people and places, 67 and internet games. 68 The technology aspect of telepsychiatry has been experimented on a small scale in different cultural set- Retinal examination [52][53][54][55][56] Online information exchange and support services 57 Psychiatric consultation in primary care and emergency rooms 58 Asynchronous psychotherapy 59 Home care and related interventions 60 for ways to accommodate this online health-seeking behavior of their patients in their regular practice, beginning from the current pandemic, into the future.…”