J.ophthalmol.(Ukraine).2020;4:38-44.

http://doi.org/10.31288/oftalmolzh202043844

Received: 24 April 2020; Published on-line: 27 August 2020


A structural and functional study of the retina in patients with schizophrenia

K.E. Kozub1,2,Iu.E. Shelepin1,A.N. Chomskii3,E.A. Sharybin3, E.A. Ivanova4

1 Pavlov Institute for Physiology, Russian Academy of Sciences; St. Petersburg (Russia)

2 Modern Medical Technologies Clinic; St. Petersburg (Russia)

3 Bekhterev Institute of Human Brain, Russian Academy of Sciences; St. Petersburg (Russia)

4 Kashchenko Hospital; St. Petersburg (Russia)

E-mail: kulikopp@mail.ru

TO CITE THIS ARTICLE: Kozub KE, Shelepin IuE, Chomskii AN, Sharybin EA, Shabanova EA. A structural and functional study of the retina in patients with schizophrenia. J.ophthalmol.(Ukraine).2020;4:38-44. http://doi.org/10.31288/oftalmolzh202043844


Purpose: To examine the relationship between retinal structural parameters and visual perception function in patients with schizophrenia.

Material and Methods: Twenty-four subjects (48 eyes) were included in the study. Group 1 (the schizophrenia group) comprised 11 patients with paranoid schizophrenia and one with schizotypical personality disorder, and Group 2 (the control group) comprised 12 mentally healthy subjects. Group 1 was subdivided into Subgroup A (disease duration of > 5 years) Subgroup B (disease duration of < 5 years). Subjects underwent a routine eye examination, assessment of contrast sensitivity threshold using Ergotest 3.0 software, and optical coherence tomography (OCT) of the retina using a Topcon 3D OCT 2000 apparatus in 3D Macula, Radial Macula and 3D Disc modes.

Results: Compared to the control group, the patients with schizophrenia exhibited significantly (p < 0.05) lower contrast sensitivity threshold values at high spatial frequencies. The contrast sensitivity threshold at high spatial frequencies was negatively correlated with disease duration (p=0.046, r=-0.585). OCT-based macular parameters and the diameter of the foveola in these patients tended to increase compared with controls, but only differences in the macular volume (p = 0.035), superior inner retinal thickness (p = 0.022) and nasal inner retinal thickness (p = 0.003) for both eyes were significant.

Conclusion: Our findings in patients with schizophrenia confirm previously reported evidence of dysfunction of the parvocellular visual channels in the early disease stages. In addition, they confirm the hypothesis that there is an association of an acute psychotic episode with neuroinflammation and subclinical retinal edema in the macula.

Keywords:  schizophrenia, optical coherence tomography, macular volume, retinal contrast sensitivity

 

References

1.Cohen J D, Servan-Schreiber D. Context, cortex, and dopamine: a connectionist approach to behavior and biology in schizophrenia. Psychol Rev.  1992 Jan;99(1):45-77.  

Crossref   PubMed 

2.Shamshinova AM. [Changes in the visual system during treatment of patients with schizophrenia with phenothiazine neuroleptics (chlorpromazine, triftazine)]. [Abstract of a Thesis for the Degree of Cand Sc (Med)]. Moscow: Moscow Helmholtz Research Institute for Eye Diseases; 1972. Russian.

3.Goldovskaia IL. [Psychotropic therapy and the visual system]. [Abstract of a Dissertation for the Degree of Dr Sc (Med)]. Moscow: Moscow Helmholtz Research Institute for Eye Diseases; 1989. Russian.

4.Murav'eva SV, Pronina MV, Moiseenko GA, Pnevskaya AN, Polyakov YuI, Kropotov YuD, et al. [A study on visual cognitive impairment in early schizophrenia and correcting it through the use of interactive virtual media]. Fiziol Cheloveka. 2017; 43 (6): 24–36. Russian. 

Crossref   

5.Shoshina II, Shelepin YE. [The mechanisms of global and local analysis of visual information in schizophrenia]. St Petersburg: VVM; 2016. Russian.

6.Ferrari L, Huang SC, Magnani G, Ambrosi A, Comi G, Leocani L. Optical coherence tomography reveals retinal neuroaxonal thinning in frontotemporal dementia as in Alzheimer’s disease. J Alzheimer’s Dis. 2017;56(3):1101–7. 

Crossref   PubMed

7.Akopyan VS, Boiko AN, Davydovskaya MV, Semenova NS, Filonenko IV, Fomin AV, Tsysar MA. [Retinal neuro-architecture in multiple sclerosis (MS): Optical coherence tomography diagnostic features]. Оftalmologiia. 2011;8(1):32–6. Russian.

8.Kovalenko AV, Boiko EV, Bisaga GN, Krasnoshchekova IeIe. [The role of optical coherence tomography in the diagnosis and treatment of demyelinating diseases]. Oftalmologicheskie vedomosti. 2010;3(1):4–10. Russian.

9.Gordon-Lipkin E, Chodkowski B, Reich DS, Smith SA, Pulicken M, Balcer LJ. Retinal nerve fiber layer is associated with brain atrophy in multiple sclerosis. Neurology. 2007 Oct 16;69(16):1603-9.  

Crossref   PubMed 

10.Ong YT, Hilal S, Venketasubramanian N, Niessen WJ, Vrooman H. Retinal neurodegeneration on optical coherence tomography and cerebral atrophy. Neurosci Lett. 2015 Jan 1;584:12-6. 

Crossref   PubMed 

11.Tiganov AS, Akopyan VS, Gavrilova SI, Semenova NS, Fedorova YaB, Gurova EV, Filonenko IV. [Thinning of the retinal ganglion cell layer in patients with Alzheimer's disease and mild cognitive decline: the diagnostic significance of spectral optical coherence tomography]. Vestnik OGU. 2013;153(4):263-6. Russian.

12.Lee JY, Ahn J, Kim TW, Jeon BS. Optical coherence tomography in Parkinson’s disease: is the retina a biomarker. J Parkinson’s Dis. 2014;4(2):197-204.  

Crossref   PubMed  

13.Moiseenko GA, Vakhrameeva OA, Lamminpiia AM, Pronin SV, Maltsev DS, Sukhinin MV, et al. [A study on the relationship between the size of foveola and visual perception characteristics]. Fiziol Cheloveka. 2018 Sep;44(5):22-9. Russian. 

Crossref   

14.Mollon JD, Astell S, Reffin JP. A minimalist test of colour vision. Colour Vision Deficiencies.  In: Drum B, Moreland JD, Serra A, editors. Colour Vision Deficiencies XI. Norwell, MA: Kluwer Academic Publishers; 1991. p. 59–67.

Crossref  

15.Tiganov AS, Snezhnevskii AV, Orlovskaia DD. [Manual of Psychiatry]. 2 volumes. Vol. 1. Moscow: Meditsina; 1999. Russian.

16.Pan J, Zhou Y, Xiang Y, Yu J. Retinal nerve fiber layer thickness changes in Schizophrenia. Psychiatry Res. 2018 Dec;270:786-791.  

Crossref   PubMed  

17.Ascaso FJ, Rodriguez-Jimenez R, Cabezon L, Lopez-Anton R,  Santabarbara J, De La Camara C. Retinal nerve fiber layer  and macular thickness in patients with schizophrenia: influence of recent illness episodes. Psychiatry Res. 2015 Sep 30;229(1-2):230-6.  

Crossref   PubMed  

18.Lee WW, Tajunisah I, Sharmilla K, Peyman M, Subrayan V. Retinal nerve fiber layer structure abnormalities in schizophrenia and its relationship to disease state: evidence from optical coherence tomography. Invest Ophthalmol Vis Sci. 2013 Nov 21;54(12):7785-92. 

Crossref   PubMed  

19.Yilmaz U, Kucuk E, Ulgen A, Ozkose A, Demircan S, Ulusoy DM. Retinal nerve fiber layer and macular thickness measurement in patients with schizophrenia. Eur J Ophthalmol. 2015;26:375–378. 

Crossref   PubMed  

20.Pantaleo Fornaro, Giovanni Calabria, Guido Corallo, Giovanni B Picotti. Pathogenesis of Degenerative Retinopathies Induced by Thioridazine and Other Antipsychotics: A Dopamine Hypothesis. Doc Ophthalmol. 2002 Jul;105(1):41-9. 

Crossref   PubMed 

21.Silverstein S, Paterno D, Cherneski L, Green S. Optical coherence tomography indices of structural retinal pathology in schizophrenia. Psychol Med. 2018 Sep;48(12):2023-2033. 

Crossref   PubMed

22.Machekhin V.A. [Retinal tomography studies of the optic disc in health and glaucoma]. Moscow: Оftalmologiia; 2011. Russian.

 

The authors certify that they have no conflicts of interest in the subject matter or materials discussed in this manuscript.