Quantitative Retinal Microvascular Analysis in Schizophrenia with Swept Source Optical Coherence Tomography Angiography

Deepthi Bannai, MS

Beth Israel Deaconess Medical Center
Quantitative Retinal Microvascular Analysis in Schizophrenia with Swept Source Optical Coherence Tomography Angiography

Scientific Abstract

Background: Ophthalmologic studies in schizophrenia have reported changes in retinal arterial/venule diameter and tortuosity. We used optical swept-source coherence tomography angiography (SS-OCTA) to analyze retinal microvasculature in schizophrenia and their correlations to clinical measures.

Methods: Matched schizophrenia (n=26) and healthy controls (HC, n=21) were recruited. Macular angiography images were collected with the DRI Topcon Triton for the superficial, deep, and choriocapillaris complexes. Quadrant data was extracted by superimposing the ETDRS grid. Microvasculature was quantified using vessel density (VD), skeletal density (SD), fractal dimension (FD), and vessel diameter index (VDI). PANSS ratings was collected for all participants. Statistical analyses were performed in R.

Results: Kruskal-Wallis tests demonstrated no significant differences between HC and schizophrenia in overall microvascular measures. For quadrant measures, central superficial VD and SD, and outer superior choriocapillaris SD were significantly increased in schizophrenia compared to HC (d=0.62, p=0.032; d=0.76, p=0.002; d=0.82, p=0.018, respectively). Deep and choriocapillaris inner superior FD were significantly reduced in schizophrenia (d=-0.85, p=0.005; d=-1.04, p=0.001). Superficial FD was associated with overall psychosis symptoms (r=-0.41, p=0.041). Higher positive symptom scores were correlated with higher choriocapillaris SD and FD (r=0.40, p=0.041; r=0.40, p=0.041). Negative symptoms were positively correlated with deep measures (VD: r=0.51, p=0.009; SD: r=0.52, p=.007; VDI: r=0.51, p=0.008; FD: r=0.52, p=0.007).

Conclusion: While no significant group differences were found in overall measures, our findings suggest schizophrenia-associated microvascular changes may be reflected in quadrant measures. Finally, we have found that vascular measures are associated with PANSS scores and be a marker for symptom severity in SZ.

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research Areas


Deepthi Bannai, MS, Iniya Adhan, MS, Megan Kasetty, MD, Leo A. Kim, MD, PhD, Scot Hill, PhD, Carol Tamminga, MD, Elliot Gershon, MD, Sarah Keedy, Ph.D, Godfrey Pearlson, MA, MBBS, Matcheri Keshavan, MD, John B. Miller, MD, Paulo Lizano, MD, PhD

Principal Investigator

Paulo Lizano, MD, PhD

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