Optical coherence tomography: a window into the brain of schizophrenic patients

Abstract

Purpose Our study aims to assess peripapillary retinal nerve fiber layer (RNFL) thickness, macular thickness and volume, and optic nerve head (ONH) measurements in patients affected by schizophrenia Methods 30 schizophrenic patients (mean age 44.5 +/‐ 10.9 years) were enrolled. They were compared with 30 age‐matched controls. In all subjects, peripapillary RNFL thickness, ONH measurements, macular thickness and volume were measured by optical coherence tomography (OCT). The eye studied was the right eye Results Schizophrenic patients showed an statistically significant reduction of the overall peripapillary RNFL thickness (95.1+/‐ 13.4 µm) compared with those values observed in control eyes (103.3+/‐9.0 µm) (p=0.008, Student t test). We also observed reduced peripapillary RNFL thickness in superior quadrant in schizophrenic patients (114.7+/‐18.0 µm) when compared with controls (127.3+/‐ 14.4 µm) (p=0.004, Student t test). Cup/disk area ratio (cases: 0.45 +/‐ 0.31; controls: 0.26 +/‐ 0.27 p=0.002, Mann‐Whitney U test), cup/disk horizontal ratio (cases: 0.67 +/‐ 0.22; controls: 0.48 +/‐ 0.23 p=0.003, Student t test), cup/disk vertical ratio (cases: 0.60 +/‐ 0.24; controls: 0.44 +/‐ 0.23 p=0.003, Mann‐Whitney U test) and cup area (cases: 1.32 +/‐ 1.09; controls: 0.73 +/‐ 0.82 p=0.001, Mann‐Whitney U test) were statistically increased in schizophrenic patients. Conclusion Schizophrenia patients showed a reduction in peripapillary RNFL thickness evaluated by OCT and an increase in some measurements of ONH. These findings suggest that as previously observed in neurodegenerative disorders, neuronal degeneration could be present in the

Ophthalmology Issues in Schizophrenia

“…They found that these measurements were reduced in schizophrenia patients, suggesting that SD-OCT could be a useful tool for schizophrenia diagnosis and monitoring [26••]. These results agree with the study by Cabezon et al [30] who showed significant average and superior peripapillary RNFL thinning in 30 schizophrenia patients. Ascaso et al [31] found a significant difference between RNFL thickness in schizophrenia patients compared to healthy subjects in the nasal quadrant.…”

Retinal Nerve Fiber Layer Structure Abnormalities in Schizophrenia and Its Relationship to Disease State: Evidence From Optical Coherence Tomography

“…38 Another study by Chu et al 39 showed that there was no difference in the RNFL thickness and macula volume in 38 schizophrenic patients compared to healthy controls. This finding was disagreed with by Cabezon et al, 40 who showed significant overall and superior peripapillary RNFL thinning in his 30 schizophrenic patients. Chu et al 39 suggested that unmyelinated axons in schizophrenic patients remained unaffected by the disease process.…”

“…However, it must be pointed out that the study of Chu et al 39 used the Stratus OCT with lower resolution that may be inadequate to detect the subtle abnormalities. On the other hand, Cabezon et al 40 found an overall peripapillary RNFL thinning in the schizophrenic patients without any statistically significant thinning in the macula region. This contradicted our findings of significant overall peripapillary RNFL thinning with corresponding macula fiber thinning, supporting a generalized structural RNFL loss in schizophrenic patients.…”

Retinal correlates of psychiatric disorders

“…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. 74,79 The Ascaso study (n = 60) found no correlation between duration and retinal abnormalities; however, the finding of macular thinning in patients with nonrecent illness episodes suggests that changes in retinal structures may be conditional as opposed to progressive. 75 Similarly, Chu and colleagues reported no significant retinal changes between early stage schizophrenia patients and schizoaffective disorder to age and gender-matched controls.…”