Emanuel Boudriot1, Benedikt Schworm2, Christoph Kern2, Elias Wagner1, Florian J Raabe3,4, Lenka Slapakova1,5, Katharina Hanken1, Iris Jäger1, Marius Stephan1,5, Vanessa Gabriel1, Georgios Ioannou1, Julian Melcher1, Genc Hasanaj1, Mattia Campana1, Joanna Moussiopoulou1, Lisa Löhrs1, Alkomiet Hasan6, Peter Falkai1,7, Oliver Pogarell1, Siegfried Priglinger2, Daniel Keeser1,8,9. 1. Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nußbaumstraße 7, 80336, Munich, Germany. 2. Department of Ophthalmology, University Hospital, LMU Munich, 80336, Munich, Germany. 3. Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Nußbaumstraße 7, 80336, Munich, Germany. florian.raabe@med.uni-muenchen.de. 4. International Max Planck Research School for Translational Psychiatry (IMPRS-TP), 80804, Munich, Germany. florian.raabe@med.uni-muenchen.de. 5. International Max Planck Research School for Translational Psychiatry (IMPRS-TP), 80804, Munich, Germany. 6. Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, 86156, Augsburg, Germany. 7. Max Planck Institute of Psychiatry, 80804, Munich, Germany. 8. NeuroImaging Core Unit Munich (NICUM), University Hospital, LMU Munich, 80336, Munich, Germany. 9. Munich Center for Neurosciences (MCN), LMU Munich, 82152, Planegg-Martinsried, Germany.
Abstract
BACKGROUND: Schizophrenia spectrum disorders (SSDs) are presumed to be associated with retinal thinning. However, evidence is lacking as to whether these retinal alterations reflect a disease-specific process or are rather a consequence of comorbid diseases or concomitant microvascular impairment. METHODS: The study included 126 eyes of 65 patients with SSDs and 143 eyes of 72 healthy controls. We examined macula and optic disc measures by optical coherence tomography (OCT) and OCT angiography (OCT-A). Additive mixed models were used to assess the impact of SSDs on retinal thickness and perfusion and to explore the association of retinal and clinical disease-related parameters by controlling for several ocular and systemic covariates (age, sex, spherical equivalent, intraocular pressure, body mass index, diabetes, hypertension, smoking status, and OCT signal strength). RESULTS: OCT revealed significantly lower parafoveal macular, macular ganglion cell-inner plexiform layer (GCIPL), and macular retinal nerve fiber layer (RNFL) thickness and thinner mean and superior peripapillary RNFL in SSDs. In contrast, the applied OCT-A investigations, which included macular and peripapillary perfusion density, macular vessel density, and size of the foveal avascular zone, did not reveal any significant between-group differences. Finally, a longer duration of illness and higher chlorpromazine equivalent doses were associated with lower parafoveal macular and macular RNFL thickness. CONCLUSIONS: This study strengthens the evidence for disease-related retinal thinning in SSDs.
BACKGROUND: Schizophrenia spectrum disorders (SSDs) are presumed to be associated with retinal thinning. However, evidence is lacking as to whether these retinal alterations reflect a disease-specific process or are rather a consequence of comorbid diseases or concomitant microvascular impairment. METHODS: The study included 126 eyes of 65 patients with SSDs and 143 eyes of 72 healthy controls. We examined macula and optic disc measures by optical coherence tomography (OCT) and OCT angiography (OCT-A). Additive mixed models were used to assess the impact of SSDs on retinal thickness and perfusion and to explore the association of retinal and clinical disease-related parameters by controlling for several ocular and systemic covariates (age, sex, spherical equivalent, intraocular pressure, body mass index, diabetes, hypertension, smoking status, and OCT signal strength). RESULTS: OCT revealed significantly lower parafoveal macular, macular ganglion cell-inner plexiform layer (GCIPL), and macular retinal nerve fiber layer (RNFL) thickness and thinner mean and superior peripapillary RNFL in SSDs. In contrast, the applied OCT-A investigations, which included macular and peripapillary perfusion density, macular vessel density, and size of the foveal avascular zone, did not reveal any significant between-group differences. Finally, a longer duration of illness and higher chlorpromazine equivalent doses were associated with lower parafoveal macular and macular RNFL thickness. CONCLUSIONS: This study strengthens the evidence for disease-related retinal thinning in SSDs.
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