Department of Psychiatry, Tohoku University Hospital, Sendai, Japan.
Department of Psychiatry, Graduate School of Medicine, Tohoku University, Sendai, Japan.
Mol Psychiatry. 2022 Sep;27(9):3592-3616. doi: 10.1038/s41380-022-01591-x. Epub 2022 May 2.
The retina shares structural and functional similarities with the brain. Furthermore, structural changes in the retina have been observed in patients with schizophrenia spectrum disorders (SSDs). This systematic review and meta-analysis investigated retinal abnormalities and their association with clinical factors for SSD.
Studies related to retinal layers in SSD patients were retrieved from PubMed, Scopus, Web of Science, Cochrane Controlled Register of Trials, International Clinical Trials Registry Platform, and PSYNDEX databases from inception to March 31, 2021. We screened and assessed the eligibility of the identified studies. EZR ver.1.54 and the metafor package in R were used for the meta-analysis and a random-effects or fixed-effects model was used to report standardized mean differences (SMDs).
Twenty-three studies (2079 eyes of patients and 1571 eyes of controls) were included in the systematic review and meta-analysis. The average peripapillary retinal nerve fiber layer (pRNFL) thickness, average macular thickness (MT), and macular ganglion cell layer-inner plexiform layer (GCL-IPL) thickness were significantly lower in patients than in controls (n = 14, 6, and 3, respectively; SMD = -0.33, -0.49, and -0.43, respectively). Patients also had significantly reduced macular volume (MV) compared to controls (n = 7; SMD = -0.53). The optic cup volume (OCV) was significantly larger in patients than in controls (n = 3; SMD = 0.28). The meta-regression analysis indicated an association between several clinical factors, such as duration of illness and the effect size of the pRNFL, macular GCL-IPL, MT, and MV.
Thinning of the pRNFL, macular GCL-IPL, MT, and MV and enlargement of the OCV in SSD were observed. Retinal abnormalities may be applicable as state/trait markers in SSDs. The accumulated evidence was mainly cross-sectional and requires verification by longitudinal studies to characterize the relationship between OCT findings and clinical factors.
视网膜在结构和功能上与大脑相似。此外，在精神分裂症谱系障碍（SSDs）患者中已经观察到视网膜结构的变化。本系统评价和荟萃分析调查了 SSD 患者的视网膜异常及其与临床因素的关系。
从 PubMed、Scopus、Web of Science、Cochrane 对照试验注册中心、国际临床试验注册平台和 PSYNDEX 数据库中检索到与 SSD 患者视网膜层相关的研究，检索时间从成立到 2021 年 3 月 31 日。我们筛选并评估了确定研究的资格。使用 EZR ver.1.54 和 R 中的 metafor 包进行荟萃分析，并使用固定效应或随机效应模型报告标准化均数差（SMD）。
共有 23 项研究（2079 只患者眼和 1571 只对照眼）被纳入系统评价和荟萃分析。与对照组相比，患者的视盘周围视网膜神经纤维层（pRNFL）平均厚度、平均黄斑厚度（MT）和黄斑神经节细胞层-内丛状层（GCL-IPL）平均厚度明显较低（分别为 n=14、6 和 3；SMD=-0.33、-0.49 和-0.43）。与对照组相比，患者的黄斑体积（MV）也明显减少（n=7；SMD=-0.53）。与对照组相比，患者的视杯容积（OCV）明显更大（n=3；SMD=0.28）。meta 回归分析表明，几种临床因素，如疾病持续时间和 pRNFL、黄斑 GCL-IPL、MT 和 MV 的效应大小之间存在关联。
在 SSD 中观察到 pRNFL、黄斑 GCL-IPL、MT 和 MV 变薄以及 OCV 增大。视网膜异常可能作为 SSD 的状态/特征标志物。已有的证据主要是横断面的，需要通过纵向研究来验证，以描述 OCT 发现与临床因素之间的关系。
