Schizophrenic patients often experience auditory hallucinations (AHs) and visual hallucinations (VHs). However, brain and retinal alterations associated with combined AHs and VHs in schizophrenic patients are unknown. This study aimed o investigate brain and retinal alterations in first episode un-treated schizophrenic patients with combined AHs and VHs (FUSCHAV). FUSCHAV patients (n = 120), divided into four groups according to severity of AH and VH symptoms, were compared to healthy controls (n = 30). Gray matter volume (GMV) and global functional connectivity density (gFCD) were recorded to reflect brain structure and functional alterations. Total retinal thickness was acquired by optical coherence tomography to assess retinal impairment. The majority of FUSCHAV patients (85.8%) demonstrated both GMV reduction and gFCD increases along with retinal thinning compared to healthy controls. The severity of GMV reduction and gFCD increase differed between patient groups, ranked from highest to lowest severity as follows: severe AHs combined with severe VHs (FUSCHSASV, 20 patients), moderate AHs combined with severe VHs (FUSCHMASV, 23 patients), severe AHs combined with moderate VHs (FUSCHSAMV, 28 patients), and moderate AHs combined with moderate VHs (FUSCHMAMV, 26). Retinal impairment was similar among the four FUSCHAV groups. GMV reduction and gFCD increases in the frontal-parietal lobule show an inverted U-shaped pattern among FUSCHAV patients according to AH and VH severity, while retinal impairment remains stable among FUSCHAV groups. These findings indicate a reciprocal deterioration in auditory and visual disturbances among FUSCHAV patients.

精神分裂症患者经常经历听觉幻觉（AHs）和视觉幻觉（VHs）。然而，与精神分裂症患者的AHs和VHs组合相关的脑和视网膜改变尚不清楚。这项研究的目的是调查未经治疗的合并AHs和VHs（FUSCHAV）的精神分裂症首发患者的大脑和视网膜改变。将FUSCHAV患者（n  = 120）根据AH和VH症状的严重程度分为4组，与健康对照组（n = 30）。记录灰质体积（GMV）和整体功能连接密度（gFCD）以反映大脑结构和功能改变。通过光学相干断层扫描获取总视网膜厚度，以评估视网膜损伤。与健康对照组相比，大多数FUSCHAV患者（85.8％）表现出GMV降低和gFCD升高以及视网膜变薄。不同患者组之间的GMV降低和gFCD增加的严重程度不同，从最高到最低的严重程度如下：严重AH合并严重VH（FUSCHSASV，20例患者），中度AH合并严重VH（FUSCHMASV，23例），严重AH合并中度VHs（FUSCHSAMV，28例患者）和中度AHs合并中度VHs（FUSCHMAMV，26）。四个FUSCHAV组之间的视网膜损伤相似。在FUSCHAV患者中，根据AH和VH严重程度，额叶顶叶小叶的GMV降低和gFCD增加呈倒U形模式，而FUSCHAV组中视网膜损害保持稳定。这些发现表明，FUSCHAV患者的听觉和视觉障碍互为恶化。