Background Retinovascular changes are reported on fundus imaging in schizophrenia (SZ). This is the first study to use swept-source optical coherence tomography angiography (OCT-A) to comprehensively examine retinal microvascular changes in SZ. Methods This study included 30 patients with SZ/schizoaffective disorder (8 early and 15 chronic) and 22 healthy controls (HCs). All assessments were performed at Beth Israel Deaconess Medical Center and Massachusetts Eye and Ear. All participants underwent swept-source OCT-A of right (oculus dextrus [OD]) and left (oculus sinister [OS]) eye, clinical, and cognitive assessments. Macular OCT-A images (6 × 6 mm) were collected with the DRI Topcon Triton for superficial, deep, and choriocapillaris vascular regions. Microvasculature was quantified using vessel density (VD), skeletonized vessel density (SVD), fractal dimension (FD), and vessel diameter index (VDI). Results Twenty-one HCs and 26 SZ subjects were included. Compared to HCs, SZ patients demonstrated higher overall OD superficial SVD, OD choriocapillaris VD, and OD choriocapillaris SVD, which were primarily observed in the central, central and outer superior, and central and outer inferior/superior, respectively. Early-course SZ subjects had significantly higher OD superficial VD, OD choriocapillaris SVD, and OD choriocapillaris FD compared to matched HCs. Higher bilateral (OU) superficial VD correlated with lower Positive and Negative Syndrome Scale (PANSS) positive scores, and higher OU deep VDI was associated with higher PANSS negative scores. Conclusions and Relevance These results suggest the presence of microvascular dysfunction associated with early-stage SZ. Clinical associations with microvascular alterations further implicate this hypothesis, with higher measures being associated with worse symptom severity and functioning in early stages and with lower symptom severity and better functioning in later stages.

中文翻译：

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使用扫描源光学相干断层扫描血管造影量化精神分裂症的视网膜微血管形态


背景 精神分裂症（SZ）的眼底成像显示视网膜血管变化。这是第一项利用扫频光学相干断层扫描血管造影（OCT-A）全面检查 SZ 视网膜微血管变化的研究。方法 这项研究包括 30 名精神分裂症/分裂情感障碍患者（8 名早期患者和 15 名慢性患者）和 22 名健康对照者 (HC)。所有评估均在贝斯以色列女执事医疗中心和马萨诸塞州眼耳科进行。所有参与者均接受了右眼（右眼 [OD]）和左眼（左眼 [OS]）扫源 OCT-A、临床和认知评估。使用 DRI Topcon Triton 收集浅表、深层和脉络膜毛细血管区域的黄斑 OCT-A 图像 (6 × 6 mm)。使用血管密度（VD）、骨架化血管密度（SVD）、分形维数（FD）和血管直径指数（VDI）对微脉管系统进行量化。结果 21 名 HC 受试者和 26 名 SZ 受试者被纳入。与 HC 相比，SZ 患者表现出更高的总体 OD 浅表 SVD、OD 脉络膜毛细血管 VD 和 OD 脉络膜毛细血管 SVD，分别主要在中央、中央和外上以及中央和外下/上观察到。与匹配的 HC 相比，早期病程 SZ 受试者的 OD 浅表 VD、OD 脉络膜毛细血管 SVD 和 OD 脉络膜毛细血管 FD 显着较高。较高的双侧 (OU) 浅表 VD 与较低的阳性和阴性综合征量表 (PANSS) 阳性评分相关，较高的 OU 深部 VDI 与较高的 PANSS 阴性评分相关。结论和相关性 这些结果表明存在与早期 SZ 相关的微血管功能障碍。 与微血管改变的临床关联进一步暗示了这一假设，较高的测量值与早期症状严重程度和功能较差相关，而在后期阶段与症状严重程度较低和功能较好相关。