Eye and Brain (Jul 2021)
Retinal Microvasculature in Schizophrenia
Abstract
Steven M Silverstein,1– 4 Adriann Lai,1 Kyle M Green,3 Christen Crosta,5 Samantha I Fradkin,6 Rajeev S Ramchandran3,7 1Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA; 2Department of Neuroscience, University of Rochester Medical Center, Rochester, NY, USA; 3Department of Ophthalmology, University of Rochester Medical Center, Rochester, NY, USA; 4Center for Visual Science, University of Rochester, Rochester, NY, USA; 5Department of Cell Biology and Neuroscience, Rutgers University, Piscataway, NJ, USA; 6Department of Psychology, University of Rochester, Rochester, NY, USA; 7Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USACorrespondence: Steven M SilversteinDepartment of Psychiatry, University of Rochester Medical Center, 300 Crittenden Boulevard, Rochester, NY, 14642, USATel +1 585 275-6742Fax +1 585 276-2094Email [email protected]: 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.Keywords: schizophrenia, retina, OCT angiography, OCTA, venule, arteriole
