Hamadan University of Medical Sciences. Department of Ophthalmology, Hamadan, Iran.
Hamadan University of Medical Sciences. Research Center for Behavioral Disorders and Substances Abuse. Hamadan, Iran.
J Psychiatr Res. 2021 Sep;141:81-91. doi: 10.1016/j.jpsychires.2021.06.007. Epub 2021 Jun 7.
Schizophrenia Spectrum Disorder (SSD) is a chronic psychiatric disorder with modest treatment outcomes. Changes in neuronal morphology may be associated with the symptomatology of SSD. In the present study, we compared the retinal nerve fibre layer thickness (RNFLT) of typically developed adults with that of individuals with SSD in both acute and chronic stages.
Fifteen healthy adult males (mean age: 36.40 years) and 30 individuals with SSD (mean age: 37.9 years) took part in the study. Among the latter, 15 had a chronic mean SSD for 15.33 years, while 15 were in an acute psychotic phase with a mean illness duration of 12.20 years. Experts rated positive and negative symptoms of SSD. Retinal nerve fibre layer thickness (RNFLT) of all participants was measured with optical coherence tomography (OCT).
Compared to healthy controls, individuals with acute SSD had the lowest macula thickness in the right eye. For nerve fiber layer atrophy, participants with acute SSD showed the largest atrophy (right eye, inferior quadrant). For retinal thickness and macular volume cube, compared to healthy controls, participants with acute SSD had the lowest thickness in the subfield of the right eye. Non-linear associations were observed between RNFL and positive and negative symptoms: e.g., for macula central and subfoveal thickness (left and right eye) and for participants with both acute and chronic SSD, exclusively positive and exclusively negative symptoms (as opposed to prevalently negative with some positive symptoms or prevalently positive with some negative symptoms) were associated with lower volumes. In participants with acute SSD, a longer disease duration was associated with thicker RNFL, while in participants with a chronic SSD a longer disease duration was associated with a thinner RNFL.
The present results confirm previous findings that specific neuronal morphological abnormalities can be observed among individuals with SSD. The non-linear associations between neuronal alterations and positive and negative symptomatology suggested that higher pronounced SSD severity appears to be particularly related to morphological changes. Disease duration and RNFL thickness were linearly associated, though, in opposite directions depending on the chronic or acute state.
精神分裂症谱系障碍（SSD）是一种慢性精神疾病，治疗效果不甚理想。神经元形态的变化可能与 SSD 的症状有关。本研究比较了急性期和慢性期 SSD 患者的视网膜神经纤维层厚度（RNFLT）与正常发育成人的差异。
15 名健康成年男性（平均年龄：36.40 岁）和 30 名 SSD 患者（平均年龄：37.9 岁）参与了本研究。后者中，15 名患者 SSD 慢性期 15.33 年，15 名患者处于急性精神病期，平均病程 12.20 年。专家对 SSD 的阳性和阴性症状进行了评分。所有参与者均接受了光学相干断层扫描（OCT）测量视网膜神经纤维层厚度（RNFLT）。
与健康对照组相比，急性期 SSD 患者右眼黄斑最薄。对于神经纤维层萎缩，急性期 SSD 患者萎缩最大（右眼下象限）。对于视网膜厚度和黄斑体积立方，与健康对照组相比，急性期 SSD 患者右眼各子域厚度最低。RNFL 与阳性和阴性症状之间存在非线性关联：例如，对于黄斑中心和中心凹下厚度（左眼和右眼），以及对于急性期和慢性期 SSD 患者，仅阳性症状或仅阴性症状（与阳性症状为主但有一些阴性症状或阴性症状为主但有一些阳性症状相比）与体积降低相关。在急性期 SSD 患者中，疾病持续时间越长，RNFL 越厚，而在慢性期 SSD 患者中，疾病持续时间越长，RNFL 越薄。
本研究结果证实了之前的发现，即在 SSD 患者中可以观察到特定的神经元形态异常。神经元改变与阳性和阴性症状之间的非线性关联表明，较高的 SSD 严重程度似乎与形态变化特别相关。然而，疾病持续时间和 RNFL 厚度呈线性相关，但方向相反，取决于慢性或急性状态。
