June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Association between retinal fractal dimension and schizophrenia
Author Affiliations & Notes
  • Timing Liu
    Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
  • Siegfried Wagner
    University College London, London, London, United Kingdom
    Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
  • Mario Cortina-Borja
    Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
  • Emanuele Trucco
    University of Dundee, Dundee, Dundee, United Kingdom
  • Robbert Struyven
    University College London, London, London, United Kingdom
  • Muthu Rama Krishnan Mookiah
    University of Dundee, Dundee, Dundee, United Kingdom
  • Alastair K Denniston
    University Hospitals Birmingham NHS Foundation Trust, Birmingham, Birmingham, United Kingdom
  • Jugnoo Rahi
    University College London, London, London, United Kingdom
  • Axel Petzold
    University College London, London, London, United Kingdom
  • Pearse Andrew Keane
    University College London, London, London, United Kingdom
    Moorfields Eye Hospital NHS Foundation Trust, London, London, United Kingdom
  • Footnotes
    Commercial Relationships   Timing Liu None; Siegfried Wagner None; Mario Cortina-Borja None; Emanuele Trucco None; Robbert Struyven None; Muthu Rama Krishnan Mookiah None; Alastair Denniston None; Jugnoo Rahi None; Axel Petzold None; Pearse Keane None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 1057 – F0304. doi:
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      Timing Liu, Siegfried Wagner, Mario Cortina-Borja, Emanuele Trucco, Robbert Struyven, Muthu Rama Krishnan Mookiah, Alastair K Denniston, Jugnoo Rahi, Axel Petzold, Pearse Andrew Keane; Association between retinal fractal dimension and schizophrenia. Invest. Ophthalmol. Vis. Sci. 2022;63(7):1057 – F0304.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Psychotic disorders, such as schizophrenia, are associated with increased cardiovascular morbidity and, increasingly, neurovascular impairment. Retinal fractal dimension (FD) is a geometric index of complexity associated with neurovascular pathology. In this study, we sought to evaluate the association between schizophrenia and retinal FD and investigate the effect of other comorbidities on this association.

Methods : A hospital-based retrospective cohort study of 96,995 patients, of which 676 had schizophrenia, was run at a tertiary ophthalmic institution in London, United Kingdom. Retinal FD was extracted from macular-centered color fundus photographs using the Vascular Assessment and Measurement Platform for Images of the Retina. Multivariable linear regression evaluated the association between retinal FD and schizophrenia adjusting for age, sex, hypertension and diabetes mellitus.

Results : Patients with schizophrenia were younger (63.2 +/-12.4 versus 68.3 +/- 12.5 years of age, p<0.001) and more likely to be diabetic (73.5% versus 47.3%, p<0.001) but there was no significant difference in sex or hypertension distribution. Retinal FD was 1.51 +/- 0.03 for both patients with schizophrenia and without. When stratifying by diabetic status, retinal FD was not different (p=0.11) between diabetic patients with schizophrenia and those without. However, retinal FD was significantly reduced (p=0.004) in non-diabetic patients with schizophrenia. Adjusting for age, sex, hypertension and diabetes mellitus, schizophrenia remained associated with reduced retinal FD (beta coefficient= -0.0034, 95%CI: -0.0057, -0.0012, p=0.003). However the main effect was neutralized when incorporating interaction between DM and schizophrenia (schizophrenia p=0.41, interaction p=0.004).

Conclusions : Retinal FD is reduced in people with schizophrenia but this association was significant only for non-diabetic individuals. This indicates the compound effect of diabetes and schizophrenia on cerebral vasculature. The strong association between retinal FD and schizophrenia indicated the potential utility of using retinal FD as an economic and accessible marker for neurovascular impairment in non-diabetic patients with schizophrenia.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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