Sex-Specific Changes in Choroid Vasculature Among Patients with Schizophrenia and Bipolar Disorder

Abstract

While structural changes within the retina of psychosis patients have been established, no detailed studies of choroidal microvasculature in these patients have been performed. Given evidence of microvascular disruption in psychosis patients, this study sought to determine whether there exists evidence of microvascular disruption in the choroids in these patients. Methods: Fifty-six subjects (20 controls and 36 psychosis patients) were recruited from April 2018 to February 2020. Five were excluded due to imaging artifact or missing demographic information. Swept-source optical coherence tomography angiography (SS-OCTA) images were obtained. Choroid vascular enface images (12 mm × 9mm) were exported every 2.6 μm from Bruch's membrane to the choroid-scleral interface from Topcon to ImageJ. The images were binarized using Otsu's method, signal from the optic disk and retinal vasculature was removed, and average choroid vascular density (CVD) was calculated as the average of percent area occupied by choroidal vasculature across images in the stack. Choroid vascular volume (CVV) was calculated as the CVD multiplied by maximum CT and image area. During image analysis, study staff were blinded to the phenotype of the study subjects. Results: Compared with same-sex controls, male psychiatric patients had significantly lower CVD. Compared with same-sex controls, female psychiatric patients had significantly lower maximum CT with correspondingly decreased CVV, after adjusting for age. When all psychiatric patients were compared with all healthy controls, no significant differences in CT, CVD, or CVV were noted. Conclusion: These results suggest that the pathogenesis of psychotic illness affects choroidal microvasculature in a sex-specific manner.

Optic nerve head and macular neurovasculature in psychosis

“…Li et al [9] 2022 No significant difference was observed in choroidal thickness in psychotic patients with healthy controls.…”

Choroid plexuses at the interface of peripheral immunity and tissue repair in multiple sclerosis

“…Adjusting for this metric is therefore recommended to minimize segmentation and atrophy biases, particularly in diseases with a neurodegenerative component. Several additional parameters have been identified as modulators of ChPs size: sex -the enlargement being greater in females in healthy controls, psychiatric disorders and pediatric MS [35,36 && ] -aging [37], adiposity and obesity [36 && ,38]. The pathophysiological correlates of ChP size changes in humans remain enigmatic and may involve various processes, including perfusion changes, inflammatory infiltrates, BCSFB dysfunction.…”

“…Adjusting for this metric is therefore recommended to minimize segmentation and atrophy biases, particularly in diseases with a neurodegenerative component. Several additional parameters have been identified as modulators of ChPs size: sex – the enlargement being greater in females in healthy controls, psychiatric disorders and pediatric MS [35,36 ▪▪ ] – aging [37], adiposity and obesity [36 ▪▪ ,38].…”