Ophthalmology: Retinal Changes Provide Clues About The Progression Of Schizophrenia

First Posted: Aug 18, 2015 08:21 AM EDT

The Mental Health Foundation estimates that schizophrenic disorders affect around 25 million worldwide, resulting in moderate or severe disability in about 60 percent of cases. Most types of schizophrenia are the result of a serious disorder of the mind and the brain, but are not untreatable with the help of antipsychotic medications and psycho-social therapies.

Though researchers are still discovering new information about schizophrenia, which is associated with both structural and functional alterations of the visual system, including specific structural changes in the eye, new findings published in the journal Schizophrenia Research: Cognition, show that tracking certain changes may provide new risk measures regarding the progression of the disease.

"Our analysis of many studies suggests that measuring retinal changes may help doctors in the future to adjust schizophrenia treatment for each patient," study co-author Richard B. Rosen, MD, Director of Ophthalmology Research, New York Eye and Ear Infirmary of Mount Sinai, and Professor of Ophthalmology, Icahn School of Medicine at Mount Sinai, in a news release. "More studies are needed to drive the understanding of the contribution of retinal and other ocular pathology to disturbances seen in these patients, and our results will help guide future research."

Individuals with schizophrenia may have difficulties visually identifying reality in social interactions, including abnormalities in the way the brain processes visual information. This would make tracking certain moving objects, depth perception, organization of visual elements into shape and facial expressions more difficult to understand. Though previous studies have connected a 62 percent link between adult patients with schizophrenia to experiencing visual distortions, there has been very little work regarding differences in the retina or other eye structures that contribute to these disturbances.

"The retina develops from the same tissue as the brain," added Dr. Rosen. "Thus retinal changes may parallel or mirror the integrity of brain structure and function. When present in children, these changes may suggest an increased risk for schizophrenia in later life. Additional research is needed to clarify these relationships, with the goals of better predicting emergence of schizophrenia, and of predicting relapse and treatment response and people diagnosed with the condition."

In this most recent study, researchers examined the results of approximately 170 existing studies and grouped the findings into multiple categories, including changes in the retina vs. other parts of the eye, and changes related to dopamine vs. other neurotransmitters, key brain chemicals associated with the disease.

Findings revealed multiple, replicated, indicators of eye abnormalities in patients with schizophrenia, including widening of small blood vessels in the eys and in young people at high risk of the disorder, chronic low oxygen supply to the brain, which may explain key vision changes and worsening symptoms of the disease. Researchers also noted thinning of the retinal nerve fiber layer in some schizophrenic patients, which typically noted an onset of hallucinations as well as visual acuity problems in patients with Parkinson's disease.

"...because it is much faster and less expensive to obtain data on retinal structure and function, compared to brain structure and function, measures of retinal and ocular structure and function may have an important role in both future research studies and the routine clinical care of people with schizophrenia," Steven M. Silverstein, PhD, Director of the Division of Schizophrenia Research at Rutgers University Behavioral Health Care, concluded.

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