Analysis of the Thickness of the Outer Retinal Layer Using Optical Coherence Tomography – A Predictor of Visual Acuity in Schizophrenia

Abstract

Background The aim of this study was to evaluate the thickness of the outer retinal layer (ORL) together with macular thickness and changes in the retinal nerve fiber layer (RNFL) in patients with schizophrenia in comparison with healthy controls.

Methods This study included 114 eyes of 57 patients diagnosed with schizophrenia and 114 eyes of 57 healthy controls. Central foveal thickness (CFT), central macular thickness (CMT), and ORL thickness were measured in both groups via the images obtained by spectral-domain optical coherence tomography (SD-OCT). RNFL was also assessed in four quadrants (inferior, superior, temporal, nasal). CMT measurements were presented as the average thickness of the macula in the central 1 mm area on the Early Treatment Diabetic Retinopathy Study (ETDRS) grid. The ORL thickness was defined as the distance between the external limiting membrane and retinal pigment epithelium at the center of the foveal pit.

Results The mean age of 57 patients was 37 ± 10 years, of whom 34 (60%) were male and 23 (40%) female. No statistically significant difference was found between groups in terms of age and gender (p = 0.8 for age, p = 0.9 for gender). There was no statistically significant difference in the mean CMT between the two groups (p = 0.1). The mean ORL thickness in the two groups was 99.8 ± 8.3 and 103.7 ± 6.2, respectively, and was significantly decreased in the schizophrenia group (p = 0.005). RNFL analysis demonstrated significant thinning in the inferior and superior quadrants compared to healthy controls (p < 0.001 and p = 0.017, respectively).

Conclusions SD-OCT findings – especially ORL and RNFL thickness – may be related to the neurodegenerational changes in schizophrenia.

Zusammenfassung

Hintergrund Das Ziel dieser Studie war es, die Dicke der äußeren Netzhautschicht (ORL) zusammen mit der Makuladicke und Veränderungen in der retinalen Nervenfaserschicht (RNFL) bei Patienten mit Schizophrenie im Vergleich zur gesunden Kontrollgruppe zu bewerten.

Methoden Diese Studie umfasste 114 Augen von 57 Patienten mit diagnostizierter Schizophrenie und 114 Augen von 57 gesunden Kontrollpersonen. Die Dicke der zentralen Fovea (CFT), die Dicke der zentralen Makula (CMT) und die ORL-Dicke wurden in beiden Gruppen über die Bilder gemessen, die durch optische Kohärenztomografie im Spektralbereich (SD-OCT) erhalten wurden. RNFL wurde auch in 4 Quadranten (untere, obere, temporale, nasale) beurteilt. CMT-Messungen wurden als durchschnittliche Dicke der Makula im zentralen 1-mm-Bereich im Raster der Early Treatment Diabetic Retinopathy Study (ETDRS) dargestellt. Die ORL-Dicke wurde als der Abstand zwischen der äußeren Grenzmembran und dem retinalen Pigmentepithel im Zentrum der Foveagrube definiert.

Ergebnisse Das Durchschnittsalter von 57 Patienten betrug 37 ± 10 Jahre, davon waren 34 (60%) männlich und 23 (40%) weiblich. Es wurde kein statistisch signifikanter Unterschied zwischen den Gruppen in Bezug auf Alter und Geschlecht gefunden (p = 0,8 für Alter, p = 0,9 für Geschlecht). Es gab keinen statistisch signifikanten Unterschied in der mittleren CMT zwischen den beiden Gruppen (p = 0,1). Die mittlere ORL-Dicke in den beiden Gruppen betrug 99,8 ± 8,3 und 103,7 ± 6,2 und war in der Schizophreniegruppe signifikant verringert (p = 0,005). Die RNFL-Analyse zeigte eine signifikante Ausdünnung im unteren und oberen Quadranten im Vergleich zu gesunden Kontrollen (p < 0,001 bzw. p = 0,017).

Schlussfolgerungen Die SD-OCT-Befunde – insbesondere die ORL und RNFL-Dicke – können mit den neurodegenerativen Veränderungen bei Schizophrenie zusammenhängen.

Key words

schizophrenia - optical coherence tomography - outer retinal layer thickness

Schlüsselwörter

Schizophrenie - optische Kohärenztomografie - Dicke der äußeren Netzhautschicht

Publication History

Received: 03 October 2021

Accepted: 13 January 2022

Article published online:
23 March 2022

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