Optical coherence tomography indices of structural retinal pathology in schizophrenia

Silverstein, Steven M.; Paterno, Danielle; Cherneski, Lindsay; Green, Stuart

doi:10.1017/s0033291717003555

Cited by 70 publications

(45 citation statements)

References 77 publications

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“…However, 5 studies reported a significant negative relationship between RNFL thickness and disease duration, 25,26,30,33,34 while 6 others did not observe a relationship. 23,24,27,29,31,32 Additionally, RNFL thinning was associated with worse clinical symptom severity in one study, 33 no association in 7 studies [24][25][26][27]29,32,34 and when stratified by recent illness episode vs non-recent illness episode or by treatment responsive vs refractory, there were no differences in RNFL thickness for the recent illness vs controls or between treatment response groups. 23,24 In order to explain these findings, Ascaso hypothesized that neuro-inflammation, which can occur during acute episodes, may increase RNFL thickness, thus masking thinning in RNFL that are seen in chronic SZ and BD patients.…”

Section: Rnfl Findingsmentioning

confidence: 95%

“…Twelve studies were eligible for quantitative analysis, which included 521 patients (SZ = 315 and BD = 206) and 496 HC (table 1). [23][24][25][26][27][28][29][30][31][32][33][34] Differences in Peripapillary RNFL Thickness Twelve studies were analyzed for overall peripapillary RNFL thickness with a total of 820 eyes from probands (541 SZ and 279 BD) and 904 eyes from HC (575 in SZ and 329 in BD studies). Compared to HC eyes, the overall peripapillary RNFL was thinner in probands Seven studies included the superior and inferior peripapillary RNFL thickness, and the sample consisted of 460 patient eyes (320 SZ and 140 BD) and 514 HC eyes (374 in SZ and 140 in BD studies).…”

Section: Studies Selectionmentioning

confidence: 99%

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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: 95%

Section: Studies Selectionmentioning

confidence: 99%

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

Lizano

Bannai

Lutz

et al. 2019

Schizophrenia Bulletin

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“…Moreover, it is unknown how RNFL thinning relates to atrophy of specific regions of the brain in schizophrenia and MD. 78 In particular, if occipital atrophy does occur, knowing when it occurs in relation to RNFL thinning could help explain why some studies have found no difference in RNFL thickness between patients with schizophrenia and controls despite visual symptomology. 82 Lessons may be learned from a similar finding of absent retinal thinning with visual disturbances in anti-NMDA receptor encephalitis, pointing, instead, to potential dysfunction in the anterior and posterior visual pathways and thus demonstrating deeper cortical and subcortical processing impairments in the brain.…”

Section: Resultsmentioning

confidence: 99%

“…61,62,[72][73][74] Specifically, peripapillary RNFL thinning has been observed in the nasal, inferior and, predominately, in the superior quadrants ( Figure 2). [74][75][76][77] In contrast, Silverstein and colleagues reported no difference in RNFL thickness between schizophrenia patients and controls, 78 and Ascaso and colleagues found these significant differences only amongst right eyes, the clinical relevance of which remains unclear ( Table 1). Macular thinning and reduced MV are another reported, yet debated, finding in patients with schizophrenia compared with age-matched controls.…”

Section: Oct In Schizophreniamentioning

confidence: 99%

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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“…They have demonstrated that reduced macular volume was related to an increased expression of positive symptoms In their studies, schizophrenic patients and controls did not differ significantly in RNFL or macula parameters, when age and medical comorbidity adjustments were made. Besides this, hypertension and diabetes, which often co-occur with schizophrenia and are commonly inadequately managed, can independently cause retinal thinning (Silverstein et al 2017). It has also been proposed that acute psychosis is in correlation with inflammation and tissue swelling, which can disable the detection of retinal atrophy (Ascaso et al 2015).…”

Section: Structural and Functional Considerations Of The Retinamentioning

confidence: 99%

New Insights Into Schizophrenia: A Look at the Eye and Related Structures

et al. 2020

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Background: Schizophrenia is a multifactorial neurodevelopmental disorder associated with cognitive dysfunction and changes in primary sensory processing. This article aims to explore the current insights into the relationship between schizophrenia and different visual disturbances.Methods: To provide a literature review of visual impairments in schizophrenia, we performed a PubMed/MEDLINE and Scopus search to identify all articles in English on the topic up to the end of 2018.Results: Multiple retinal functional and structural abnormalities are found in patients with schizophrenia. Wider retinal venules suggest chronically insufficient brain supply of oxygen and this could contribute to the occurrence of psychotic symptoms. Optical coherence tomography studies showed that retinal nerve fiber layer, macular thickness, and macular volume were significantly lowered in the chronic phase of schizophrenia. Results from electroretinogram recordings have demonstrated different declinations such as abnormalities of a -wave activity in the photoreceptors or b -wave activity in the bipolar and Muller cells. Abnormalities in eye movements, such as a notable decrease in saccades and smooth pursuit eye movements, are one of the most reliable and reproducible impairments associated with schizophrenia. Disrupted visual processing of the magnocellular pathway may result in a decrease of contrast sensitivity, sensory processing, orientation discrimination, visual integration, trajectory and spatial localization, backward masking and motion tracking. Visual perceptual abnormalities occur in more than 60% of schizophrenic patients and these are visual hallucinations, perceptual distortion of colors, shapes and light intensity, decrease in contour integration and surround suppression. Other, frequently present eye disorders include impaired visual acuity, strabismus and nystagmus.Conclusion: Visual impairments are one of the most important features of schizophrenia, which could help in defining the disease state and assigning appropriate treatment.

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Optical coherence tomography indices of structural retinal pathology in schizophrenia

Cited by 70 publications

References 77 publications

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

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

Retinal correlates of psychiatric disorders

New Insights Into Schizophrenia: A Look at the Eye and Related Structures

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