Evaluation of Structural Changes in the Retina of Patients with Schizophrenia

Abstract

Aim: To understand the potential of evaluating the thickness of the retinal nerve fiber layer (RNFL) and macular volume in patients with schizophrenia, using Optical Coherence Tomography (OCT), and its possible application to monitor this disorder. Study Design and Participants: Cross-sectional study that included two groups, one with 20 patients diagnosed with schizophrenia and a control group with 20 healthy volunteers. Patients with schizophrenia were divided into two subgroups, one with less than 5 years of illness duration and the other with more than 5 years. Both groups underwent OCT. The study was conducted between April 2014 and July 2014, with the collaboration of the Ophthalmology and Psychiatry departments. Results: Schizophrenic patients showed a significant decrease in all measurements of the macula, volume and thickness, when compared to the control group (p<0.05). No differences were found between groups regarding RNFL thickness, although there was a correlation between disease duration and decreased overall RNFL thickness (r=-0.338; p=0.033). Comparison between the group with schizophrenia for less than five years and the group with more than 5 years, revealed statistically significant differences in volume (p=0.021) and thickness (p=0.018) of the temporal outer ring of the macula. Conclusion: Results suggest that there are differences in the retina in patients with schizophrenia. These data support the hypothesis of a neurodegenerative component of the disorder. OCT is a noninvasive exam that, although non-specific, can be useful either to diagnose or monitor disease progression.