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Title: Retinal layer abnormalities as biomarkers of schizophrenia
Authors: Samani, Niraj N.
Proudlock, Frank A.
Siram, Vasantha
Suraweera, Chathurie
Hutchinson, Claire
Nelson, Christopher P.
Al-Uzri, Mohammed
Gottlob, Irene
First Published: 19-Dec-2017
Publisher: Oxford University Press (OUP) for Maryland Psychiatric Research Center
Citation: Schizophrenia Bulletin, 2018, 44 (4), pp.876-885
Abstract: Objective Schizophrenia is associated with several brain deficits, as well as visual processing deficits, but clinically-useful biomarkers are elusive. We hypothesised that retinal layer changes, non-invasively visualized using spectral-domain optical coherence tomography (SD-OCT), may represent a possible “window” to these abnormalities. Methods A Leica EnvisuTM SD-OCT device was used to obtain high-resolution central foveal B-scans in both eyes of 35 patients with schizophrenia and 50 demographically-matched controls. Manual retinal layer segmentation was performed to acquire individual and combined layer thickness measurements in three macular regions. Contrast sensitivity was measured at three spatial frequencies in a sub-group of each cohort. Differences were compared using adjusted linear models and significantly different layer measures in patients underwent Spearman Rank correlations with contrast sensitivity, quantified symptoms severity, disease duration and antipsychotic medication dose. Results Total retinal and photoreceptor complex thickness was reduced in all regions in patients (P<0.0001). Segmentation revealed consistent thinning of the outer nuclear layer (P<0.001) and inner segment layer (P<0.05), as well as a pattern of parafoveal ganglion cell changes. Low spatial frequency contrast sensitivity was reduced in patients (P=0.002) and correlated with temporal parafoveal ganglion cell complex thinning (R=0.48, P=0.01). Negative symptom severity was inversely correlated with foveal photoreceptor complex thickness (R=-0.54, P=0.001) and outer nuclear layer thickness (R=-0.47, P=0.005). Samani et al. 4 Conclusions Our novel findings demonstrate considerable retinal layer abnormalities in schizophrenia that are related to clinical features and visual function. With time, SD-OCT could provide easily-measurable biomarkers to facilitate clinical assessment and further our understanding of the disease.
DOI Link: 10.1093/schbul/sbx130
ISSN: 0586-7614
eISSN: 1745-1701
Version: Published (publisher PDF)
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © 2017, the authors. published by Oxford University Press (OUP) for Maryland Psychiatric Research Center. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-commercial License (, which permits unrestricted use, distribution, and reproduction in any medium non-commercially, provided the original author and source are credited.
Appears in Collections:Published Articles, Dept. of Neuroscience, Psychology and Behaviour

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