Abstract
Purpose :
Retinal pathology has been shown in Alzheimer’s Disease (AD) and Parkinson’s Disease (PD). However, the clinical utility of these purported ocular biomarkers remains limited. Schizophrenia (SZ) is a severe brain disease that shares similar neurological features with AD and PD including cognitive impairment and dopamine dysregulation, respectively. Notably, SZ has an earlier age of onset and retinal studies may provide clues to a more complete understanding of age-related neurodegeneration. The purpose of this study was to evaluate SZ patients for retinal thickness changes and vascular pathology using optical coherence tomography (OCT) and OCT-Angiography (OCTA), respectively.
Methods :
We prospectively enrolled 39 SZ patients (mean age: 38.2 ± 12.1 years) and 27 age-matched healthy controls (mean age: 39.0 ± 15.2 years; p = 0.7). The thicknesses of the retinal nerve fiber layer (RNFL), ganglion cell-inner plexiform layer (GC-IPL), and outer retinal layers comprising the photoreceptor complex (PRC) were measured and compared between the two cohorts using OCT. Density maps of the superficial capillary plexus (SCP) at the peripapillary and macular regions were measured using 3x3-mm OCTA scans. Mann-Whitney U test and multivariable mixed modeling adjusted for age, race, and gender were used for statistical analysis.
Results :
The RNFL was markedly thinner in SZ and most pronounced in the temporal quadrant (9.1% reduction; p < 0.04). There was no significant difference in GC-IPL thickness (p > 0.05). The PRC was significantly thinner in SZ, specifically in the superior-temporal (4% reduction; p < 0.05), inferior-temporal (4.5% reduction; p < 0.01), and inferior quadrants (3% reduction; p < 0.01). Peripapillary perfusion density was significantly decreased temporally (3.8% reduction; p < 0.02), while vessel density of the central macula was significantly greater in SZ relative to controls (17.6% increase; p = 0.04).
Conclusions :
Our retinal thickness findings and the associated vascular changes found in schizophrenia patients may provide important insight into neurodegenerative processes in this disease. The value of OCT and OCTA as non-invasive research tools for schizophrenia pathophysiology should be further investigated.
This is a 2020 ARVO Annual Meeting abstract.