Retinal structure and its relationship with premorbid, clinical, and cognitive variables in young Spanish patients with early course schizophrenia spectrum disorders

Abstract

Retina; Schizophrenia spectrum; Tomography

Retina; Espectre de l'esquizofrènia; Tomografia

Retina; Espectro de la esquizofrenia; Tomografía

Emerging evidence suggests that retinal structural alterations are present in schizophrenia spectrum disorders (SSD), potentially reflecting broader neurodevelopmental and neurodegenerative processes. This cross-sectional study investigates retinal thickness and its clinical correlations in a sample of early-course SSD patients compared to healthy controls (HCs). One hundred-two eyes from 26 SSD cases and 25 age- and sex-matched HCs were included. Retinal structure was evaluated using Spectral-Domain Optical Coherence Tomography (SD-OCT), focusing on the peripapillary retinal nerve fiber layer (pRNFL), macular volume/thickness, and ganglion cell-inner plexiform layer (GCL+IPL) thickness. Although SSD cases showed increased peripapillary retinal nerve fiber layer (pRNFL) thickness in specific quadrants, most retinal parameters did not differ significantly between groups. Preliminary associations were observed between retinal measures, premorbid adjustment, DUP, and cognitive performance. These findings, while suggesting the potential of retinal imaging as a tool for early detection and monitoring of psychotic disorders, must be interpreted with caution. Further longitudinal and multimodal research is warranted to explore the association between these retinal changes and neuroinflammation, neurodegeneration, and overall brain health in SSD patients.

JMG is funded by Ministerio de Ciencia y Tecnología – Colombia (Grant 885/2020). SA thanks the support of the Spanish Ministry of Innovation and Science (PI24/00671), funded by the Instituto de Salud Carlos III and cofinanced by the European Union (FEDER) “Una manera de hacer Europa”. MFF received the support of a “Contratos predoctorales de formación en investigación en salud (PFIS22) (FI22/00185) from the Instituto de Salud Carlos III (ISCIII). CT would like to thank Instituto de Salud Carlos III (ISCIII), PI17/01066, PI20/00344, PI24/00407, and co-funded by the European Union.