Rutgers University Behavioral Health Care, United States; Rutgers University, Robert Wood Johnson Medical School, Departments of Psychiatry and Ophthalmology, United States.
Rutgers University, Department of Psychology, United States.
Schizophr Res. 2020 May;219:84-94. doi: 10.1016/j.schres.2019.09.016. Epub 2019 Nov 7.
Differences between people with schizophrenia and psychiatrically healthy controls have been consistently demonstrated on measures of retinal function such as electroretinography (ERG), and measures of retinal structure such as optical coherence tomography (OCT). Since our 2015 review of this literature, multiple new studies have been published using these techniques. At the same time, the accumulation of data has highlighted the "fault lines" in these fields, suggesting methodological considerations that need greater attention in future studies.
We reviewed studies of ERG and OCT in schizophrenia, as well as data from studies whose findings are relevant to interpreting these papers, such as those on effects of the following on ERG and OCT data: comorbid medical conditions that are over-represented in schizophrenia, smoking, antipsychotic medication, substance abuse, sex and gender, obesity, attention, motivation, and influences of brain activity on retinal function.
Recent ERG and OCT studies continue to support the hypothesis of retinal structural and functional abnormalities in schizophrenia, and suggest that these are relevant to understanding broader aspects of pathophysiology, neurodevelopment, and neurodegeneration in this disorder. However, there are differences in findings which suggest that the effects of multiple variables on ERG and OCT data need further clarification.
The retina, as the only component of the CNS that can be imaged directly in live humans, has potential to clarify important aspects of schizophrenia. With greater attention to specific methodological issues, the true potential of ERG and OCT as biomarkers for important clinical phenomena in schizophrenia should become apparent.
在视网膜功能的测量方面，如视网膜电图（ERG），以及视网膜结构的测量方面，如光学相干断层扫描（OCT），精神分裂症患者与精神健康对照组之间存在差异，这一点已得到一致证实。自我们 2015 年对该文献进行审查以来，已经使用这些技术发表了多项新的研究。与此同时，数据的积累突出了这些领域的“断层线”，这表明需要在未来的研究中更加关注方法学方面的考虑因素。
我们对精神分裂症的 ERG 和 OCT 研究进行了综述，以及对那些对解释这些论文有重要意义的研究数据进行了综述，例如，以下因素对 ERG 和 OCT 数据的影响：在精神分裂症中过度表现的合并医学疾病、吸烟、抗精神病药物、物质滥用、性别、肥胖、注意力、动机，以及大脑活动对视网膜功能的影响。
最近的 ERG 和 OCT 研究继续支持精神分裂症视网膜结构和功能异常的假说，并表明这些与理解该疾病更广泛的病理生理学、神经发育和神经退行性变方面有关。然而，研究结果存在差异，这表明有多个变量对 ERG 和 OCT 数据的影响需要进一步澄清。
视网膜作为唯一可以在活体人类中直接成像的中枢神经系统组成部分，有可能阐明精神分裂症的重要方面。通过更加关注特定的方法学问题，ERG 和 OCT 作为精神分裂症重要临床现象的生物标志物的真正潜力应该会变得明显。
