Retinal structural abnormalities in young adults with psychosis spectrum disorders

Jerotić, Stefan; Ristić, Ivan; Pejovic, Slobodanka; Mihaljević, Marina; Pavlović, Zorana; Britvić, Dubravka; Ignjatovic, Z.; Silverstein, Steven M.; Marić, Nadja P.

doi:10.1016/j.pnpbp.2019.109825

Cited by 22 publications

(13 citation statements)

References 27 publications

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“…They also reported correlation between GCL and IPL measurements and disease severity. GCL-IPL changes were also reported by Jerotic et al, 2020 (in addition to reduction in macular volume and macular thickness) (Jerotic et al, 2020).…”

Section: Discussion:-oct Studies In Schizophreniasupporting

confidence: 67%

Oct Studies in Schizophrenia: Current Evidence and Future Perspectives

Usman¹

2020

IJAR

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Background: Schizophrenia is a detrimental neurodevelopmental disorder that affects nearly 1 % of the population worldwide. Although schizophrenia ranks among the leading causes of global disease-related disability, definitive investigations do not exist for its diagnosis at present. Since the retina is derived from the same neural layer that the brain develops from, OCT imaging of retina can provide valuable information regarding underlying pathology of schizophrenia. Objectives: This review aims at describing the potential relevance of OCT studies 1) in understanding current insights into retinal structural changes in schizophrenia 2) in understanding the relationship between retinal structural alterations and disease progression and chronicity 3) and to determine the potential role of retinal changes as biomarkers of schizophrenia. Methodology: A comprehensive search of databases such as PubMed, Google Scholar and Medline was conducted using the keywords: schizophrenia, retina, OCT and RNFL changes. Relevant articles were identified and their key findings summarized in this review. Conclusion: OCT studies in schizophrenia patients conducted in recent years continue to provide evidence of retinal structural alterations associated with schizophrenia. However, the findings of these studies vary and there is a need to conduct further studies for clarification regarding the subject. The application of OCT and other neuroimaging techniques to correlate retinal structural alterations with schizophrenia may potentially help establish the role of retinal variables as biomarkers for the disease, and may open a gateway for better diagnostic investigations in schizophrenia.

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Section: Discussion:-oct Studies In Schizophreniasupporting

confidence: 67%

Oct Studies in Schizophrenia: Current Evidence and Future Perspectives

Usman¹

2020

IJAR

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“…There is now convincing data from a number of studies, published in different countries across multiple laboratories, demonstrating that there is thinning of multiple retinal layers in people with schizophrenia (145)(146)(147)(148)(149)(150)(151). These layers include the innermost layer, the retinal nerve fiber layer (RNFL), comprising the axons of the ganglion cells, which form the optic nerve that leaves the retina and synapses at the lateral geniculate nucleus (LGN) of the thalamus; the ganglion cell body and inner plexiform layers; and the vascular layers (e.g., choroid) that support the outermost neural layers (28,80).…”

Section: Potential Retinal Contributions To Vh and Visual Distortions In Schizophreniamentioning

confidence: 99%

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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“…Thus, we sought to characterize the retinal microvasculature in schizophrenia using OCTA. Because there is evidence from OCT that thinning of retinal layers in schizophrenia may not develop until several years after the first psychotic episode, [23][24][25][26] we investigated a sample that included both people recovering from a first episode of schizophrenia (eg, patients with a single hospitalization that had occurred no more than 2 years prior to testing), and people with a longer period of established illness (ie, who had experienced multiple hospitalizations for psychotic episodes, with greater than 2 years since their initial episode), in order to determine if any OCTA findings would follow this pattern. Of note, the OCTA data reported here were collected from the subject sample in one of our prior OCT studies.…”

Section: Introductionmentioning

confidence: 99%

Retinal Microvasculature in Schizophrenia

Silverstein¹,

Lai²,

Green³

et al. 2021

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Purpose: Schizophrenia is associated with alterations in neural structure and function of the retina that are similar to changes seen in the retina and brain in multiple neurodegenerative disorders. Preliminary evidence suggests that retinal microvasculature may also be compromised in schizophrenia. The goal of this study was to determine, using optical coherence tomography angiography (OCTA), whether 1) schizophrenia is associated with alterations in retinal microvasculature density; and 2) microvasculature reductions are associated with retinal neural layer thinning and performance on a measure of verbal IQ. Patients and Methods: Twenty-eight outpatients with schizophrenia or schizoaffective disorder and 37 psychiatrically healthy control subjects completed OCT and OCTA exams, and the Wechsler Test of Adult Reading. Results: Schizophrenia patients were characterized by retinal microvasculature density reductions, and enlarged foveal avascular zones, in both eyes. These microvascular abnormalities were generally associated with thinning of retinal neural (macular and peripapillary nerve fiber layer) tissue (but the data were stronger for the left than the right eye) and lower scores on a proxy measure of verbal IQ. First-and later-episode patients did not differ significantly on OCTA findings. Conclusion:The retinal microvasculature impairments seen in schizophrenia appear to be a biomarker of overall brain health, as is the case for multiple neurological conditions. Additional research is needed, however, to clarify contributions of social disadvantage and medical comorbidities to the findings.

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Retinal structural abnormalities in young adults with psychosis spectrum disorders

Cited by 22 publications

References 27 publications

Oct Studies in Schizophrenia: Current Evidence and Future Perspectives

Oct Studies in Schizophrenia: Current Evidence and Future Perspectives

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

Retinal Microvasculature in Schizophrenia

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