Optical coherence tomography reveals retinal thinning in schizophrenia spectrum disorders

Abstract

Background Schizophrenia spectrum disorders (SSDs) are presumed to be associated with retinal thinning. However, evidence is lacking as to whether these retinal alterations reflect a disease-specific process or are rather a consequence of comorbid diseases or concomitant microvascular impairment. Methods The study included 126 eyes of 65 patients with SSDs and 143 eyes of 72 healthy controls. We examined macula and optic disc measures by optical coherence tomography (OCT) and OCT angiography (OCT-A). Additive mixed models were used to assess the impact of SSDs on retinal thickness and perfusion and to explore the association of retinal and clinical disease-related parameters by controlling for several ocular and systemic covariates (age, sex, spherical equivalent, intraocular pressure, body mass index, diabetes, hypertension, smoking status, and OCT signal strength). Results OCT revealed significantly lower parafoveal macular, macular ganglion cell–inner plexiform layer (GCIPL), and macular retinal nerve fiber layer (RNFL) thickness and thinner mean and superior peripapillary RNFL in SSDs. In contrast, the applied OCT-A investigations, which included macular and peripapillary perfusion density, macular vessel density, and size of the foveal avascular zone, did not reveal any significant between-group differences. Finally, a longer duration of illness and higher chlorpromazine equivalent doses were associated with lower parafoveal macular and macular RNFL thickness. Conclusions This study strengthens the evidence for disease-related retinal thinning in SSDs.

The multimodal Munich Clinical Deep Phenotyping study to bridge the translational gap in severe mental illness treatment research

“…As mentioned above, so far only preliminary retinal data from the CDP cohort have been published (119) because the sample size is not large enough to obtain sound results for all the variables examined. Of note, similar to the data in the initial OCT paper (119), we plan to make published data available to enable open research exchange. However, the fact that no further preliminary findings have been published is a limitation of the current status of the CDP study.…”

“…As a preliminary finding from the CDP study, we recently published OCT findings in 65 patients with an SSD and 72 HC that provided evidence of thinner inner retinal layers and thinner total macular thickness in SSDs (119). These changes could not be explained by comorbidities such as hypertension, diabetes, or higher body mass index (BMI), all of which also affect retinal thickness and are enriched in patients with SSD.…”

Age of Onset Moderates the Association Between Total Antioxi-Dant Capacity and Cognitive Deficits in Patients With Drug-Naïve Schizophrenia

“…impairment, which severely negatively impacts the overall functioning of the patient and hinders the recovery process [12]. As the three main characteristics of schizophrenia, positive symptoms, negative symptoms and cognitive deficits are closely correlated [13]. Studies have shown that the severity of negative and cognitive symptoms is associated with impairments in semantic memory, verbal memory and executive functioning, whereas positive symptoms are associated with semantic memory [14].…”

Genetic susceptibility to schizophrenia through neuroinflammatory pathways is associated with retinal thinning: Findings from the UK-Biobank

“…1 Recent studies using optical coherence tomography have provided evidence of retinal thinning in individuals with schizophrenia, suggesting that illness pathophysiology may be detected in the most distal and hence readily accessible part of the central nervous system. [2][3][4][5][6][7][8] These studies have shown inner retinal atrophy, thinning of peripapillary retinal nerve fiber layers and macular ganglion cell and inner plexiform layers, as well as an enlarged cup-disc ratio. This was also confirmed in a large and well-characterized cohort, 9 where individuals with schizophrenia showed an enlargement in cup disc ratio and a decrease in inner retinal thickness compared to healthy controls, beyond what could be attributed to the presence of hypertension and diabetes.…”