Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA.
Schizophr Bull. 2022 Jan 21;48(1):80-89. doi: 10.1093/schbul/sbab111.
Retinovascular changes are reported on fundus imaging in schizophrenia (SZ). This is the first study to use swept-source optical coherence tomography angiography (OCT-A) to comprehensively examine retinal microvascular changes in SZ.
This study included 30 patients with SZ/schizoaffective disorder (8 early and 15 chronic) and 22 healthy controls (HCs). All assessments were performed at Beth Israel Deaconess Medical Center and Massachusetts Eye and Ear. All participants underwent swept-source OCT-A of right (oculus dextrus [OD]) and left (oculus sinister [OS]) eye, clinical, and cognitive assessments. Macular OCT-A images (6 × 6 mm) were collected with the DRI Topcon Triton for superficial, deep, and choriocapillaris vascular regions. Microvasculature was quantified using vessel density (VD), skeletonized vessel density (SVD), fractal dimension (FD), and vessel diameter index (VDI).
Twenty-one HCs and 26 SZ subjects were included. Compared to HCs, SZ patients demonstrated higher overall OD superficial SVD, OD choriocapillaris VD, and OD choriocapillaris SVD, which were primarily observed in the central, central and outer superior, and central and outer inferior/superior, respectively. Early-course SZ subjects had significantly higher OD superficial VD, OD choriocapillaris SVD, and OD choriocapillaris FD compared to matched HCs. Higher bilateral (OU) superficial VD correlated with lower Positive and Negative Syndrome Scale (PANSS) positive scores, and higher OU deep VDI was associated with higher PANSS negative scores.
These results suggest the presence of microvascular dysfunction associated with early-stage SZ. Clinical associations with microvascular alterations further implicate this hypothesis, with higher measures being associated with worse symptom severity and functioning in early stages and with lower symptom severity and better functioning in later stages.
视网膜血管变化在精神分裂症（SZ）的眼底成像中已有报道。这是第一项使用扫频源光相干断层扫描血管造影术（OCT-A）全面检查 SZ 视网膜微血管变化的研究。
这项研究包括 30 名 SZ/分裂情感障碍患者（8 名早期和 15 名慢性）和 22 名健康对照者（HCs）。所有评估均在 Beth Israel Deaconess Medical Center 和 Massachusetts Eye and Ear 进行。所有参与者均接受右眼（oculus dextrus [OD]）和左眼（oculus sinister [OS]）的扫频源 OCT-A、临床和认知评估。使用 DRI Topcon Triton 采集黄斑 OCT-A 图像（6×6mm），用于浅层、深层和脉络膜毛细血管血管区域。使用血管密度（VD）、骨架化血管密度（SVD）、分形维数（FD）和血管直径指数（VDI）量化微血管。
共纳入 21 名 HCs 和 26 名 SZ 患者。与 HCs 相比，SZ 患者的 OD 浅层 SVD、OD 脉络膜毛细血管 VD 和 OD 脉络膜毛细血管 SVD 总体较高，主要见于中央、中央和外上方以及中央和外下方/上方。早期 SZ 患者的 OD 浅层 VD、OD 脉络膜毛细血管 SVD 和 OD 脉络膜毛细血管 FD 明显高于匹配的 HCs。双侧（OU）浅层 VD 越高，阳性和阴性综合征量表（PANSS）阳性评分越低，OU 深层 VDI 越高，PANSS 阴性评分越高。
这些结果表明存在与早期 SZ 相关的微血管功能障碍。微血管改变的临床相关性进一步证实了这一假说，较高的指标与早期阶段更严重的症状严重程度和功能障碍以及后期阶段更轻的症状严重程度和更好的功能相关。
