Microvascular Abnormality in Schizophrenia as Shown by Retinal Imaging

作者:Meier Madeline H; Shalev Idan; Moffitt Terrie E*; Kapur Shitij; Keefe Richard S E; Wong Tien Y; Belsky Daniel W; Harrington Honalee; Hogan Sean; Houts Renate; Caspi Avshalom; Poulton Richie
来源:American Journal of Psychiatry, 2013, 170(12): 1451-1459.
DOI:10.1176/appi.ajp.2013.13020234

摘要

Objective: Retinal and cerebral microvessels are structurally and functionally homologous, but unlike cerebral microvessels, retinal microvessels can be non-invasively measured in vivo by retinal imaging. The authors tested the hypothesis that individuals with schizophrenia exhibit microvascular abnormality and evaluated the utility of retinal imaging as a tool for schizophrenia research. Method: Participants were members of the Dunedin Study; a population-representative cohort followed from birth with 95% retention. Study members underwent retinal imaging at age 38. The authors assessed retinal arteriolar and venular caliber for all members of the cohort, including individuals who developed schizophrenia: Results: Study members who developed schizophrenia were distinguished by wider retinal venules, suggesting Microvascular abnormality reflective of insufficient brain oxygen supply. Analyses that controlled for confounding health conditions suggested that wider retinal venules are not simply an artifact of co-occurring health problems in schizophrenia patients. Wider venules were also associated with a dimensional measure of adult psychosis symptoms and with psychosis symptoms reported in childhood. Conclusions: The findings provide initial support for the hypothesis that individuals with schizophrenia show microvascular abnormality. Moreover, the results suggest that the same vascular mechanisms underlie subthreshold symptoms and clinical disorder and that these associations may begin early in life. These findings highlight the promise of retinal imaging as a tool for understanding the pathogenesis of schizophrenia.

  • 出版日期2013-12