Retinal correlates of psychiatric disorders

Almonte, Melanie; Capellàn, Pamela; Yap, Timothy E.; Cordeiro, M. Francesca

doi:10.1177/2040622320905215

Cited by 35 publications

(29 citation statements)

References 215 publications

(286 reference statements)

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“…In addition, some of the visual distortions reported by people with schizophrenia resemble those seen in cases of retinal disease (18,24,25). There is also emerging evidence that glaucoma is a neurodegenerative condition whose occurrence precedes a range of neurodegenerative disorders [e.g., Alzheimer's disease (81) and mild cognitive impairment (82), as well as indirect evidence for glaucoma-like changes in schizophrenia, including an enlarged cup-to-disc ratio (83) and abnormalities in frequency doubling perimetry reviewed in Almonte et al (84)]. Recent findings also indicate that glaucoma often precedes a diagnosis of schizophrenia, bipolar disorder, or major depression by several years (85).…”

Section: Syndromes Of Visual Hallucinationsmentioning

confidence: 92%

The Phenomenology and Neurobiology of Visual Distortions and Hallucinations in Schizophrenia: An Update

Silverstein

Lai

2021

Front. Psychiatry

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Schizophrenia is characterized by visual distortions in ~60% of cases, and visual hallucinations (VH) in ~25–50% of cases, depending on the sample. These symptoms have received relatively little attention in the literature, perhaps due to the higher rate of auditory vs. visual hallucinations in psychotic disorders, which is the reverse of what is found in other neuropsychiatric conditions. Given the clinical significance of these perceptual disturbances, our aim is to help address this gap by updating and expanding upon prior reviews. Specifically, we: (1) present findings on the nature and frequency of VH and distortions in schizophrenia; (2) review proposed syndromes of VH in neuro-ophthalmology and neuropsychiatry, and discuss the extent to which these characterize VH in schizophrenia; (3) review potential cortical mechanisms of VH in schizophrenia; (4) review retinal changes that could contribute to VH in schizophrenia; (5) discuss relationships between findings from laboratory measures of visual processing and VH in schizophrenia; and (6) integrate findings across biological and psychological levels to propose an updated model of VH mechanisms, including how their content is determined, and how they may reflect vulnerabilities in the maintenance of a sense of self. In particular, we emphasize the potential role of alterations at multiple points in the visual pathway, including the retina, the roles of multiple neurotransmitters, and the role of a combination of disinhibited default mode network activity and enhanced state-related apical/contextual drive in determining the onset and content of VH. In short, our goal is to cast a fresh light on the under-studied symptoms of VH and visual distortions in schizophrenia for the purposes of informing future work on mechanisms and the development of targeted therapeutic interventions.

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Section: Syndromes Of Visual Hallucinationsmentioning

confidence: 92%

The Phenomenology and Neurobiology of Visual Distortions and Hallucinations in Schizophrenia: An Update

Silverstein

Lai

2021

Front. Psychiatry

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“…Undoubtedly, the eye's microarchitectural information can be used as a valuable structural model to study psychiatric disorders to improve the non‐invasive identification of high‐risk individuals 9–11 . Therefore, structural biomarkers remain an increasingly popular topic in clinical applications.…”

Section: Uncovering the Evidence: The Eye And The Brainmentioning

confidence: 99%

Recent updates of eye movement abnormalities in patients with schizophrenia: A scoping review

Wolf

Ueda

Hirano

2021

Psychiatry Clin Neurosci

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Aim Although eye‐tracking technology expands beyond capturing eye data just for the sole purpose of ensuring participants maintain their gaze at the presented fixation cross, gaze technology remains of less importance in clinical research. Recently, impairments in visual information encoding processes indexed by novel gaze metrics have been frequently reported in patients with schizophrenia. This work undertakes a scoping review of research on saccadic dysfunctions and exploratory eye movement deficits among patients with schizophrenia. It gathers promising pieces of evidence of eye movement abnormalities in attention‐demanding tasks on the schizophrenia spectrum that have mounted in recent years and their outcomes as potential biological markers. Methods The protocol was drafted based on PRISMA for scoping review guidelines. Electronic databases were systematically searched to identify articles published between 2010 and 2020 that examined visual processing in patients with schizophrenia and reported eye movement characteristics as potential biomarkers for this mental illness. Results The use of modern eye‐tracking instrumentation has been reported by numerous neuroscientific studies to successfully and non‐invasively improve the detection of visual information processing impairments among the screened population at risk of and identified with schizophrenia. Conclusions Eye‐tracking technology has the potential to contribute to the process of early intervention and more apparent separation of the diagnostic entities, being put together by the syndrome‐based approach to the diagnosis of schizophrenia. However, context‐processing paradigms should be conducted and reported in equally accessible publications to build comprehensive models.

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“…As an ontogenetic part of the brain, the retina exhibits high levels of many neurotransmitters of the central nervous system, including dopamine (1). Since the retina represents a more accessible structure than the brain itself for related measurements, it recently gained increasing attention in other, non-ophthalmological research fields, such as neurology or psychiatry (2).…”

Section: Introductionmentioning

confidence: 99%

Replication of Reduced Pattern Electroretinogram Amplitudes in Depression With Improved Recording Parameters

Friedel

Elst

Schmelz³

et al. 2021

Front. Med.

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Background: The retina has gained increasing attention in non-ophthalmological research in recent years. The pattern electroretinogram (PERG), a method to evaluate retinal ganglion cell function, has been used to identify objective correlates of the essentially subjective state of depression. A reduction in the PERG contrast gain was demonstrated in patients with depression compared to healthy controls with normalization after remission. PERG responses are not only modulated by stimulus contrast, but also by check size and stimulation frequency. Therefore, the rationale was to evaluate potentially more feasible procedures for PERG recordings in daily diagnostics in psychiatry.Methods: Twenty-four participants (12 patients with major depression (MDD) and 12 age- and sex-matched healthy controls) were examined in this pilot study. We investigated PERG amplitudes for two steady-state pattern reversal frequencies (12.5/18.75 rps) and four sizes of a checkerboard stimulus (0.8°, 1.6°, 3.2°, and 16°) to optimize the PERG recordings in MDD patients.Results: Smaller PERG amplitudes in MDD patients were observed for all parameters, whereby the extent of the reduction appeared to be stimulus-specific. The most pronounced decline in the PERG of MDD patients was observed at the higher stimulation frequency and the finest pattern, whilst responses for the largest check size were less affected. Following the PERG ratio protocol for early glaucoma, where similar stimulus dependent modulations have been reported, we calculated PERG ratios (0.8°/16°) for all participants. At the higher frequency (18.75 rps), significantly reduced ratios were observed in MDD patients.Conclusion: The “normalization” of the PERG responses—via building a ratio—appears to be a very promising approach with regard to the development of an objective biomarker of the depressive state, facilitating inter-individual assessments of PERG recordings in patients with psychiatric disorders.

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Retinal correlates of psychiatric disorders

Cited by 35 publications

References 215 publications

The Phenomenology and Neurobiology of Visual Distortions and Hallucinations in Schizophrenia: An Update

The Phenomenology and Neurobiology of Visual Distortions and Hallucinations in Schizophrenia: An Update

Recent updates of eye movement abnormalities in patients with schizophrenia: A scoping review

Replication of Reduced Pattern Electroretinogram Amplitudes in Depression With Improved Recording Parameters

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