{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T04:20:16Z","timestamp":1793334016391,"version":"4.5.0"},"reference-count":75,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Psychiatry"],"published-print":{"date-parts":[[2023,5,1]]},"abstract":"Importance<\/jats:title>The potential association of schizophrenia with distinct retinal changes is of clinical interest but has been challenging to investigate because of a lack of sufficiently large and detailed cohorts.<\/jats:p><\/jats:sec>Objective<\/jats:title>To investigate the association between retinal biomarkers from multimodal imaging (oculomics) and schizophrenia in a large real-world population.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This cross-sectional analysis used data from a retrospective cohort of 154\u202f830 patients 40 years and older from the AlzEye study, which linked ophthalmic data with hospital admission data across England. Patients attended Moorfields Eye Hospital, a secondary care ophthalmic hospital with a principal central site, 4 district hubs, and 5 satellite clinics in and around London, United Kingdom, and had retinal imaging during the study period (January 2008 and April 2018). Data were analyzed from January 2022 to July 2022.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Retinovascular and optic nerve indices were computed from color fundus photography. Macular retinal nerve fiber layer (RNFL) and ganglion cell\u2013inner plexiform layer (mGC-IPL) thicknesses were extracted from optical coherence tomography. Linear mixed-effects models were used to examine the association between schizophrenia and retinal biomarkers.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 485 individuals (747 eyes) with schizophrenia (mean [SD] age, 64.9 years [12.2]; 258 [53.2%] female) and 100\u202f931 individuals (165\u202f400 eyes) without schizophrenia (mean age, 65.9 years [13.7]; 53\u202f253 [52.8%] female) were included after images underwent quality control and potentially confounding conditions were excluded. Individuals with schizophrenia were more likely to have hypertension (407 [83.9%] vs 49\u202f971 [48.0%]) and diabetes (364 [75.1%] vs 28\u202f762 [27.6%]). The schizophrenia group had thinner mGC-IPL (\u22124.05 \u03bcm, 95% CI, \u22125.40 to \u22122.69; P<\/jats:italic>\u2009=\u20095.4\u2009\u00d7\u200910\u22129<\/jats:sup>), which persisted when investigating only patients without diabetes (\u22123.99 \u03bcm; 95% CI, \u22126.67 to \u22121.30; P<\/jats:italic>\u2009=\u2009.004) or just those 55 years and younger (\u22122.90 \u03bcm; 95% CI, \u22125.55 to \u22120.24; P<\/jats:italic>\u2009=\u2009.03). On adjusted analysis, retinal fractal dimension among vascular variables was reduced in individuals with schizophrenia (\u22120.14 units; 95% CI, \u22120.22 to \u22120.05; P<\/jats:italic>\u2009=\u2009.001), although this was not present when excluding patients with diabetes.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this study, patients with schizophrenia had measurable differences in neural and vascular integrity of the retina. Differences in retinal vasculature were mostly secondary to the higher prevalence of diabetes and hypertension in patients with schizophrenia. The role of retinal features as adjunct outcomes in patients with schizophrenia warrants further investigation.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamapsychiatry.2023.0171","type":"journal-article","created":{"date-parts":[[2023,3,22]],"date-time":"2023-03-22T15:12:14Z","timestamp":1679497934000},"page":"478","source":"Crossref","is-referenced-by-count":59,"title":["Association Between Retinal Features From Multimodal Imaging and Schizophrenia"],"prefix":"10.1001","volume":"80","author":[{"given":"Siegfried K.","family":"Wagner","sequence":"first","affiliation":[{"name":"NIHR Moorfields Biomedical Research Centre, London, United Kingdom"},{"name":"Institute of Ophthalmology, University College London, London, United Kingdom"},{"name":"Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Cortina-Borja","sequence":"additional","affiliation":[{"name":"Great Ormond Street Institute of Child Health, University College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven M.","family":"Silverstein","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Rochester Medical Center, Rochester, New York"},{"name":"Department of Ophthalmology, University of Rochester Medical Center, Rochester, New York"},{"name":"Department of Neuroscience, University of Rochester Medical Center, Rochester, New York"},{"name":"Center for Visual Science, University of Rochester, Rochester, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukun","family":"Zhou","sequence":"additional","affiliation":[{"name":"NIHR Moorfields Biomedical Research Centre, London, United Kingdom"},{"name":"Institute of Ophthalmology, University College London, London, United Kingdom"},{"name":"Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Romero-Bascones","sequence":"additional","affiliation":[{"name":"Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom"},{"name":"Biomedical Engineering Department, Faculty of Engineering (MU-ENG), Mondragon Unibertsitatea, Mondrag\u00f3n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robbert R.","family":"Struyven","sequence":"additional","affiliation":[{"name":"NIHR Moorfields Biomedical Research Centre, London, United Kingdom"},{"name":"Institute of Ophthalmology, University College London, London, United Kingdom"},{"name":"Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom"},{"name":"Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"Trucco","sequence":"additional","affiliation":[{"name":"VAMPIRE Project, School of Science and Engineering, University of Dundee, Dundee, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muthu R. 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