Retinal Layer Abnormalities as Biomarkers of Schizophrenia

Samani, Niraj N; Proudlock, Frank A; Siram, Vasantha; Suraweera, Chathurie; Hutchinson, Claire V.; Nelson, Christopher P.; Al-Uzri, Mohammed; Gottlob, Irène

doi:10.1093/schbul/sbx130

Cited by 68 publications

(53 citation statements)

References 43 publications

(56 reference statements)

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“…40 One study found significant thinning of the nasal parafoveal RNFL in SZ compared to HC, but not in the overall or temporal region. 41 While our meta-analysis consisted of a mix of acutely and chronically impaired patients recruited from both inpatient and outpatient settings, we did not identify an effect of disease duration on RNFL thickness. We could not perform a meta-regression of acute vs chronic states since many of the studies combined acute and chronic course.…”

Section: Rnfl Findingsmentioning

confidence: 88%

A Meta-analysis of Retinal Cytoarchitectural Abnormalities in Schizophrenia and Bipolar Disorder

Lizano

Bannai

Lutz

et al. 2019

Schizophrenia Bulletin

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Background Schizophrenia (SZ) and bipolar disorder (BD) are characterized by reductions in gray matter and white matter. Limitations in brain imaging have led researchers to use optical coherence tomography (OCT) to explore retinal imaging biomarkers of brain pathology. We examine the retinal layers that may be associated with SZ or BD. Methods Articles identified using PubMed, Web of Science, Cochrane Database. Twelve studies met inclusion for acutely/chronically ill patients. We used fixed or random effects meta-analysis for probands (SZ and BD), SZ or BD eyes vs healthy control (HC) eyes. We adjusted for sources of bias, cross-validated results, and report standardized mean differences (SMD). Statistical analysis performed using meta package in R. Results Data from 820 proband eyes (SZ = 541, BD = 279) and 904 HC eyes were suitable for meta-analysis. The peripapillary retinal nerve fiber layer (RNFL) showed significant thinning in SZ and BD eyes compared to HC eyes (n = 12, SMD = −0.74, −0.51, −1.06, respectively). RNFL thinning was greatest in the nasal, temporal, and superior regions. The combined peripapillary ganglion cell layer and inner plexiform layer (GCL-IPL) showed significant thinning in SZ and BD eyes compared to HC eyes (n = 4, SMD = −0.39, −0.44, −0.28, respectively). No statistically significant differences were identified in other retinal or choroidal regions. Clinical variables were unrelated to the RNFL or GCL-IPL thickness by meta-regression. Conclusion The observed retinal layer thinning is consistent with the classic gray- and white-matter atrophy observed on neuroimaging in SZ and BD patients. OCT may be a useful biomarker tool in studying the neurobiology of psychosis.

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Section: Rnfl Findingsmentioning

confidence: 88%

A Meta-analysis of Retinal Cytoarchitectural Abnormalities in Schizophrenia and Bipolar Disorder

Lizano

Bannai

Lutz

et al. 2019

Schizophrenia Bulletin

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“…Significant inverse correlations have been reported between duration of disease and thickness of the RNFL, temporal parafoveal ISL and temporal parafoveal ONL, as well as macular thinning and volume. 61,62 These correlations with macula thickness and volume suggest progressive neurodegeneration seen in parallel with MRI changes of grey matter volume loss. 123 However, studies containing similar numbers of patients and controls have reported no significant correlation between RNFL thickness or macular thickness with duration of illness.…”

Section: Severity and Duration Of Schizophreniamentioning

confidence: 91%

“…Macular thinning and reduced MV are another reported, yet debated, finding in patients with schizophrenia compared with age-matched controls. Whereas several studies observed overall macular thinning in patients compared with age-matched controls, 61,62,75,79,80 one study observed macular thinning isolated to the nasal and inferior outer macular regions. 81 In contrast, Silverstein and colleagues reported no difference in macular thinning between schizophrenia patients and age-matched controls.…”

Section: Oct In Schizophreniamentioning

confidence: 97%

“…82 On examination of the individual layers of the macula with OCT, one comprehensive study by Samani and colleagues found that total retinal thickness was significantly reduced in the foveal, nasal parafoveal, and temporal parafoveal regions, with all three zones having outer nuclear layer (ONL) and inner segment layer (ISL) thinning in common. 61 Furthermore, thinning was observed to affect the parafoveal ganglion cell layer (GCL) temporally, and the inner plexiform layer (IPL) and retinal nerve fibre layer (RNFL) nasally. 61 Of relevance to treatment potential in schizophrenia, lower macular volumes have been observed in treatment-refractory patients compared with treatment-responsive patients, possibly reflecting the duration of disease, but also with potential as a prognostic biomarker.…”

Section: Oct In Schizophreniamentioning

confidence: 99%

“…126 Only one study we reviewed actively assessed the role of antipsychotics on OCT abnormalities, and found no significant correlation with treatment. 61 The relationship between the severity of symptoms and retinal abnormalities is also unclear. Thinning of the RNFL, GCL and IPL have been found to significantly correlate with disease severity, measured by the Positive and Negative Symptom Scale (PANSS).…”

Section: Severity and Duration Of Schizophreniamentioning

confidence: 99%

See 2 more Smart Citations

Retinal correlates of psychiatric disorders

Almonte

Capellàn

Yap

et al. 2020

Therapeutic Advances in Chronic Disease

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Diagnosis and monitoring of psychiatric disorders rely heavily on subjective selfreports of clinical symptoms, which are complicated by the varying consistency of accounts reported by patients with an impaired mental state. Hence, more objective and quantifiable measures have been sought to provide clinicians with more robust methods to evaluate symptomology and track progression of disease in response to treatments. Owing to the shared origins of the retina and the brain, it has been suggested that changes in the retina may correlate with structural and functional changes in the brain. Vast improvements in retinal imaging, namely optical coherence tomography (OCT) and electrodiagnostic technology, have made it possible to investigate the eye at a microscopic level, allowing for the investigation of potential biomarkers in vivo. This review provides a summary of retinal biomarkers associated with schizophrenia, bipolar disorder and major depression, demonstrating how retinal biomarkers may be used to complement existing methods and provide structural markers of pathophysiological mechanisms that underpin brain dysfunction in psychiatric disorders.

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