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. 2022 Nov 18;48(6):1194-1205.
doi: 10.1093/schbul/sbac085.

Mapping Retinal Abnormalities in Psychosis: Meta-analytical Evidence for Focal Peripapillary and Macular Reductions

Jairo M Gonzalez-Diaz  1   2   3 , Joaquim Radua  4   5   6 , Bernardo Sanchez-Dalmau  7   8   1 , Anna Camos-Carreras  7   8 , Diana C Zamora  2 , Miquel Bernardo  9   10   11   12
Affiliations

Mapping Retinal Abnormalities in Psychosis: Meta-analytical Evidence for Focal Peripapillary and Macular Reductions

Jairo M Gonzalez-Diaz et al. Schizophr Bull. .

Abstract

Background: Several studies have suggested that the retina structure is affected in schizophrenia spectrum disorders (SSD). We aimed to investigate the location and size of the potential differences between patients and healthy controls (HC) in several thickness and volume measures across the retina.

Study design: We included cross-sectional studies comparing peripapillary retinal nerve fiber layer (pRNFL) thickness, macular volume, macular thickness (MT), foveal thickness, ganglion cell and inner plexiform layer thickness (GCL+IPL), cup volume, and cup/disc ratio (C/D) in the right and/or left eyes and/or the pRNFL and MT quadrants between patients with SSD and HC. Search databases were MEDLINE, Web of Science, PsycINFO, Cochrane Central, and medrxiv.org. Risk of bias was assessed with the Newcastle-Ottawa Scale. Standardized mean differences (SMD), subgroup analysis, and meta-regression with several variables were computed using the dmetar package in R. PROSPERO: CRD42021287873.

Study results: Data from 22 reports (942 patients, 742 HC) were included. We found a retinal thinning in pRNFL (-0.30; 95% CI: -0.46, -0.14), macula (-0.37; 95% CI: -0.61, -0.13), and GCL+IPL (-0.33; 95% CI: -0.57, -0.10). The retinal thinning was especially pronounced in the superior and inferior quadrants of the inner ring of the macula. We also observed a decrease of macular volume (-0.44; 95% CI: -0.68, -0.20) and an increase in C/D ratio (0.35; 95% CI: 0.03, 0.67).

Conclusions: Current evidence demonstrates retinal thinning in SSD, affecting both axonal and cellular structures, specially focused in the inner ring of the macula.

Keywords: optical coherence/early diagnosis; retina; schizophrenia spectrum and other psychotic disorders; tomography.

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Figures

Fig. 1.
Fig. 1.
Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) flowchart. HC, healthy controls; OCT, optical coherence tomography; SSD, schizophrenia spectrum disorders.
Fig. 2.
Fig. 2.
Effect size map for both eyes of pRNFL thickness and Macular thickness. *P < .05. †I2 > 50%. ††I2 ≥ 80%. pRNFL, peripapillary retinal nerve fiber layer; T, temporal; N, nasal. A colored version of this figure is available online.
See this image and copyright information in PMC

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