BACKGROUND Retinal assessment has indicated the presence of neuronal loss in neurodegenerative disorders, but its role in schizophrenia remains unclear. We sought to synthesize the available evidence considering 3 noninvasive modalities: optical coherence tomography, electroretinography, and fundus photography, and examine their diagnostic accuracy based on unpublished individual participant data, when provided by the primary study authors. METHODS We searched MEDLINE, SCOPUS, clinicaltrials.gov, PSYNDEX, Cochrane Controlled Register of Trials (CENTRAL), WHO International Clinical Trials Registry Platform, and Google Scholar, up to October 30, 2018. Authors were contacted and invited to share anonymized participant-level data. Aggregate data were pooled using random effects models. Diagnostic accuracy meta-analysis was based on multiple cutoffs logistic generalized linear mixed modeling. This study was registered with PROSPERO, number CRD42018109344. RESULTS Pooled mean differences of peripapillary retinal nerve fiber layer thickness in micrometer between 694 eyes of 432 schizophrenia patients and 609 eyes of 358 controls, from 11 case-control studies, with corresponding 95% confidence intervals (CIs) by quadrant were the following: -4.55, 95% CI: -8.28, -0.82 (superior); -6.25, 95% CI: -9.46, -3.04 (inferior); -3.18, 95% CI: -5.04, -1.31 (nasal); and -2.7, 95% CI: -4.35, -1.04 (temporal). Diagnostic accuracy, based on 4 studies, was fair to poor, unaffected by age and sex; macular area measurements performed slightly better. CONCLUSION The notion of structural and functional changes in retinal integrity of patients with schizophrenia is supported with current evidence, but diagnostic accuracy is limited. The potential prognostic, theranostic, and preventive role of retinal evaluation remains to be examined.

中文翻译：

---

精神分裂症的视网膜变化：基于个体参加者数据的系统评价和荟萃分析。

背景技术视网膜评估已经表明在神经退行性疾病中存在神经元丢失，但是其在精神分裂症中的作用仍不清楚。我们试图综合考虑3种非侵入性方式的可用证据：光学相干断层扫描，视网膜电图和眼底照相，并在未发表的个体参与者数据（主要研究作者提供）的基础上检查其诊断准确性。方法截至2018年10月30日，我们在MEDLINE，SCOPUS，clinicaltrials.gov，PSYNDEX，Cochrane对照试验注册中心（CENTRAL），WHO国际临床试验注册平台和Google学术搜索中进行了搜索。级别数据。使用随机效应模型汇总总数据。诊断准确性的荟萃分析基于多临界逻辑广义线性混合建模。该研究已在PROSPERO注册，编号为CRD42018109344。结果来自11个病例对照研究的432例精神分裂症患者的694眼和358例对照的609眼的乳头周围视网膜神经纤维层厚度的汇总平均差如下图所示-相应的95％置信区间（CI）： 4.55，95％CI：-8.28，-0.82（优）；-6.25，95％CI：-9.46，-3.04（劣等）；-3.18，95％CI：-5.04，-1.31（鼻）；-2.7、95％CI：-4.35，-1.04（时间）。根据4项研究，诊断准确性对穷人是公平的，不受年龄和性别的影响。黄斑区域的测量稍好一些。结论精神分裂症患者视网膜完整性的结构和功能改变的观点得到了当前证据的支持，但诊断准确性受到限制。视网膜评估的潜在预后，治疗和预防作用仍有待检查。