{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T14:53:37Z","timestamp":1767624817361,"version":"3.48.0"},"reference-count":46,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,28]],"date-time":"2025-12-28T00:00:00Z","timestamp":1766880000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NIH","award":["R01EY031731"],"award-info":[{"award-number":["R01EY031731"]}]},{"name":"NIH","award":["R01MH133812"],"award-info":[{"award-number":["R01MH133812"]}]},{"name":"NIH","award":["R01MH116948"],"award-info":[{"award-number":["R01MH116948"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>The purpose of this research is to determine whether retinal vasculatures differ between participants with schizophrenia spectrum disorder (SSD) and controls. Ninety participants (51 SSD, mean age 35.8 \u00b1 13.5, and 39 controls, mean age 35.5 \u00b1 11.4) underwent 3 \u00d7 3 mm2 macular and 6 \u00d7 6 mm2 optic nerve head (ONH) optical coherence tomography angiography (OCTA) scans. En face macula and ONH region images were divided into quadrants, binarized, and then skeletonized. Skeletonized vessel densities were compared between our two groups. Additionally, the foveal avascular zone (FAZ) size and acircularity index were compared between the two groups. There was significantly decreased vessel density in the temporal region of the ONH in the SSD group compared to controls (p = 0.033). Interestingly, the decreased vessel density was already present in patients with SSD in younger adulthood as compared to the controls (p = 0.006). There were no significant group differences in vessel density in any other region of the ONH, the ONH overall, any region of the macula, or the macula overall. There were also no significant group differences in the FAZ size or acircularity index. These data suggest there may be abnormal peripapillary retinal vasculature in patients with SSD. Whether this is a specific ocular vascular deficit or related to more systemic vascular abnormalities in SSD remains to be determined.<\/jats:p>","DOI":"10.3390\/bioengineering13010035","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T06:25:51Z","timestamp":1766989551000},"page":"35","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Retinal Vasculature in Schizophrenia Spectrum Disorder"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8569-996X","authenticated-orcid":false,"given":"Caroline Simon","family":"Sherman","sequence":"first","affiliation":[{"name":"University of Maryland School of Medicine, Baltimore, MD 21201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik","family":"Gunnarsson","sequence":"additional","affiliation":[{"name":"University of Maryland School of Medicine, Baltimore, MD 21201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nycole","family":"Hidalgo","sequence":"additional","affiliation":[{"name":"University of Maryland School of Medicine, Baltimore, MD 21201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2074-6876","authenticated-orcid":false,"given":"Kevin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pathology, Johns Hopkins University, Baltimore, MD 21218, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuo","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Bioinformatics, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD 21201, USA"},{"name":"Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hwiyoung","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Biostatistics and Bioinformatics, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD 21201, USA"},{"name":"Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hugh","family":"O\u2019Neill","sequence":"additional","affiliation":[{"name":"Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. Elliot","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Psychiatry & Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX 77054, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3082-4604","authenticated-orcid":false,"given":"Osamah","family":"Saeedi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, Baltimore, MD 21201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,28]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2025, December 22). Schizophrenia. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/schizophrenia."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1001\/jamapsychiatry.2015.1737","article-title":"premature mortality among adults with schizophrenia in the United States","volume":"72","author":"Olfson","year":"2015","journal-title":"JAMA Psychiatry"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Saiga, R., Uesugi, M., Takeuchi, A., Uesugi, K., Suzuki, Y., Takekoshi, S., Inomoto, C., Nakamura, N., Torii, Y., and Kushima, I. (2021). Brain capillary structures of schizophrenia cases and controls show a correlation with their neuron structures. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-91233-z"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.1001\/jamapsychiatry.2014.1314","article-title":"Cardiometabolic risk in patients with first-episode schizophrenia spectrum disorders baseline results from the RAISE-ETP study","volume":"71","author":"Correll","year":"2014","journal-title":"JAMA Psychiatry"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Vetter, M.W., Martin, B.-J., Fung, M., Pajevic, M., Anderson, T.J., and Raedler, T.J. (2015). Microvascular dysfunction in schizophrenia: A case\u2013control study. NPJ Schizophr., 1.","DOI":"10.1038\/npjschz.2015.23"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Hanson, D.R., and Gottesman, I.I. (2005). Theories of schizophrenia: A genetic-inflammatory-vascular synthesis. BMC Med. Genet., 6.","DOI":"10.1186\/1471-2350-6-7"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Moises, H.W., Wollschl\u00e4ger, D., and Binder, H. (2015). Functional genomics indicate that schizophrenia may be an adult vascular-ischemic disorder. Psychiatry, 5.","DOI":"10.1038\/tp.2015.103"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1038\/mp.2011.183","article-title":"An environmental analysis of genes associated with schizophrenia: Hypoxia and vascular factors as interacting elements in the neurodevelopmental model","volume":"17","author":"Esquivel","year":"2012","journal-title":"Mol. Psychiatry"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.neubiorev.2017.04.003","article-title":"Microvascular anomaly conditions in psychiatric disease. Schizophrenia\u2014Angiogenesis connection","volume":"77","author":"Katsel","year":"2017","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"7785","DOI":"10.1167\/iovs.13-12534","article-title":"Retinal nerve fiber layer structure abnormalities in schizophrenia and its relationship to disease state: Evidence from optical coherence tomography","volume":"54","author":"Lee","year":"2013","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Asanad, S., O\u2019NEill, H., Addis, H., Chen, S., Wang, J., Goldwaser, E., Kochunov, P., Hong, L.E., and Saeedi, O.J. (2021). Neuroretinal biomarkers for schizophrenia spectrum disorders. Transl. Vis. Sci. Technol., 10.","DOI":"10.1167\/tvst.10.4.29"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.pscychresns.2011.08.011","article-title":"A window into the brain: An in vivo study of the retina in schizophrenia using optical coherence tomography","volume":"203","author":"Chu","year":"2012","journal-title":"Psychiatry Res. Neuroimaging"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.schres.2019.12.034","article-title":"An investigation of retinal layer thicknesses in unaffected first-degree relatives of schizophrenia patients","volume":"218","author":"Kurtulmus","year":"2020","journal-title":"Schizophr. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1111\/bdi.12779","article-title":"Retinal vascular abnormalities in schizophrenia and bipolar disorder: A window to the brain","volume":"21","author":"Appaji","year":"2019","journal-title":"Bipolar Disord."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.jad.2019.08.061","article-title":"Retinal vascular fractal dimension in bipolar disorder and schizophrenia","volume":"259","author":"Appaji","year":"2019","journal-title":"J. Affect. Disord."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.schres.2019.08.020","article-title":"Retinal vascular tortuosity in schizophrenia and bipolar disorder","volume":"212","author":"Appaji","year":"2019","journal-title":"Schizophr. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1093\/schbul\/sbab111","article-title":"Quantifying Retinal Microvascular Morphology in Schizophrenia Using Swept-Source Optical Coherence Tomography Angiography","volume":"48","author":"Bannai","year":"2022","journal-title":"Schizophr. Bull."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1080\/08164622.2021.1878816","article-title":"Retinal nerve fibre layer and peripapillary vascular density by optical coherence tomography angiography in schizophrenia","volume":"104","author":"Budakoglu","year":"2021","journal-title":"Clin. Exp. Optom."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Koman-Wierdak, E., R\u00f3g, J., Brzozowska, A., Toro, M.D., Bonfiglio, V., Za\u0142uska-Ogryzek, K., Karaku\u0142a-Juchnowicz, H., Rejdak, R., and Nowomiejska, K. (2021). Analysis of the peripapillary and macular regions using OCT angiography in patients with schizophrenia and bipolar disorder. J. Clin. Med., 10.","DOI":"10.3390\/jcm10184131"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Korann, V., Appaji, A., Jacob, A., Devi, P., Nagendra, B., Chako, D.M., Padmanabha, A., Thonse, U., Bharath, R.D., and Kumar, V. (2021). Association between retinal vascular caliber and brain structure in schizophrenia. Asian J. Psychiatry, 61.","DOI":"10.1016\/j.ajp.2021.102707"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1176\/appi.ajp.2013.13020234","article-title":"Microvascular Abnormality in Schizophrenia as Shown by Retinal Imaging","volume":"170","author":"Meier","year":"2013","journal-title":"Am. J. Psychiatry"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"205","DOI":"10.2147\/EB.S317186","article-title":"Retinal microvasculature in schizophrenia","volume":"13","author":"Silverstein","year":"2021","journal-title":"Eye Brain"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Korann, V., Suhas, S., Appaji, A., Nagendra, B., Padmanabha, A., Jacob, A., Devi, P., Bharath, R.D., Kumar, V., and Varambally, S. (2022). Association between retinal vascular measures and brain white matter lesions in schizophrenia. Asian J. Psychiatry, 70.","DOI":"10.1016\/j.ajp.2022.103042"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1167\/iovs.18-25864","article-title":"Age-related alterations in retinal tissue perfusion and volumetric vessel density","volume":"60","author":"Lin","year":"2019","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"5780","DOI":"10.1167\/iovs.16-20045","article-title":"Retinal capillary density and foveal avascular zone area are age-dependent: Quantitative analysis using optical coherence tomography angiography","volume":"57","author":"Iafe","year":"2016","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1001\/jamaophthalmol.2020.5730","article-title":"Characterization of Retinal Microvascular and Choroidal Structural Changes in Parkinson Disease","volume":"139","author":"Robbins","year":"2021","journal-title":"JAMA Ophthalmol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2285","DOI":"10.1167\/iovs.06-1029","article-title":"Retinal Abnormalities in Early Alzheimer\u2019s Disease","volume":"48","author":"Berisha","year":"2007","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Wang, X., Zhao, Q., Tao, R., Lu, H., Xiao, Z., Zheng, L., Ding, D., Ding, S., Ma, Y., and Lu, Z. (2021). Decreased Retinal Vascular Density in Alzheimer\u2019s Disease (AD) and Mild Cognitive Impairment (MCI): An Optical Coherence Tomography Angiography (OCTA) Study. Front. Aging Neurosci., 12.","DOI":"10.3389\/fnagi.2020.572484"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Tang, F.Y., Ng, D.S., Lam, A., Luk, F., Wong, R., Chan, C., Mohamed, S., Fong, A., Lok, J., and Tso, T. (2017). Determinants of Quantitative Optical Coherence Tomography Angiography Metrics in Patients with Diabetes. Sci. Rep., 7.","DOI":"10.1038\/s41598-017-02767-0"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Yang, J., Yuan, M., Wang, E., and Chen, Y. (2019). Comparison of the Repeatability of Macular Vascular Density Measurements Using Four Optical Coherence Tomography Angiography Systems. J. Ophthalmol., 2019.","DOI":"10.1155\/2019\/4372580"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Zhang, Y.S., Zhou, N., Knoll, B.M., Samra, S., Ward, M.R., Weintraub, S., and A Fawzi, A. (2019). Parafoveal vessel loss and correlation between peripapillary vessel density and cognitive performance in amnestic mild cognitive impairment and early Alzheimer\u2019s Disease on optical coherence tomography angiography. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0214685"},{"key":"ref_32","first-page":"157","article-title":"Optical coherence tomography angiography in preclinical Alzheimer\u2019s disease","volume":"104","author":"Nguyen","year":"2019","journal-title":"Br. J. Ophthalmol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1097\/WNO.0000000000000580","article-title":"Altered macular microvasculature in mild cognitive impairment and alzheimer disease","volume":"38","author":"Jiang","year":"2018","journal-title":"J. Neuro-Ophthalmol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1007\/s00417-017-3640-y","article-title":"Quantification of changes in foveal capillary architecture caused by idiopathic epiretinal membrane using OCT angiography","volume":"255","author":"Nelis","year":"2017","journal-title":"Graefe\u2019s Arch. Clin. Exp. Ophthalmol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"260","DOI":"10.4103\/jovr.jovr_173_17","article-title":"Foveal avascular zone and vessel density in healthy subjects: An optical coherence tomography angiography study","volume":"13","author":"Falavarjani","year":"2018","journal-title":"J. Ophthalmic Vis. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1097\/IAE.0000000000002413","article-title":"VESSEL DENSITY OF SUPERFICIAL, INTERMEDIATE, AND DEEP CAPILLARY PLEXUSES USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY","volume":"39","author":"Lavia","year":"2019","journal-title":"Retina"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Yeo, J.H., Oh, R., Lee, J.Y., Kim, J.-G., Yoon, Y.H., and Kim, Y.J. (2020). Optical coherence tomography angiographic findings of lamellar macular hole: Comparisons between tractional and degenerative subtypes. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-70254-0"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.3928\/23258160-20161031-05","article-title":"Comparison of optical coherence tomography angiography and fluorescein angiography for the identification of retinal vascular changes in eyes with diabetic macular edema","volume":"47","author":"Peres","year":"2016","journal-title":"Ophthalmic Surg. Lasers Imaging Retin."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1097\/IAE.0000000000001972","article-title":"Foveal avascular zone area analysis using optical coherence tomography angiography before and after idiopathic epiretinal membrane surgery","volume":"39","author":"Kitagawa","year":"2019","journal-title":"Retina"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"9257","DOI":"10.1167\/iovs.11-8481","article-title":"Disruption of the retinal parafoveal capillary network in type 2 diabetes before the onset of diabetic retinopathy","volume":"52","author":"Tam","year":"2011","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Bin Lim, H., Kim, Y.W., Kim, J.M., Jo, Y.J., and Kim, J.Y. (2018). The Importance of Signal Strength in Quantitative Assessment of Retinal Vessel Density Using Optical Coherence Tomography Angiography. Sci. Rep., 8.","DOI":"10.1038\/s41598-018-31321-9"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"3065","DOI":"10.1167\/iovs.17-21551","article-title":"Axial length variation impacts on superficial retinal vessel density and foveal avascular zone area measurements using optical coherence tomography angiography","volume":"58","author":"Sampson","year":"2017","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Linderman, R., Salmon, A.E., Strampe, M., Russillo, M., Khan, J., and Carroll, J. (2017). Assessing the accuracy of foveal avascular zone measurements using optical coherence tomography angiography: Segmentation and scaling. Transl. Vis. Sci. Technol., 6.","DOI":"10.1167\/tvst.6.3.16"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Romo, J.S.A., Linderman, R.E., Pinhas, A., Carroll, J., Rosen, R.B., and Chui, T.Y.P. (2019). novel development of parafoveal capillary density deviation mapping using an age-group and eccentricity matched normative OCT angiography database. Transl. Vis. Sci. Technol., 8.","DOI":"10.1167\/tvst.8.3.1"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"3043","DOI":"10.1007\/s10792-020-01488-0","article-title":"Ethnic differences in normal retinal capillary density and foveal avascular zone measurements","volume":"40","author":"Gazeau","year":"2020","journal-title":"Int. Ophthalmol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"3804","DOI":"10.1167\/iovs.17-21460","article-title":"Age-related alterations in the retinal microvasculature, microcirculation, and microstructure","volume":"58","author":"Wei","year":"2017","journal-title":"Investig. Ophthalmol. Vis. Sci."}],"container-title":["Bioengineering"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2306-5354\/13\/1\/35\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T11:20:14Z","timestamp":1767612014000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2306-5354\/13\/1\/35"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,28]]},"references-count":46,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["bioengineering13010035"],"URL":"https:\/\/doi.org\/10.3390\/bioengineering13010035","relation":{},"ISSN":["2306-5354"],"issn-type":[{"type":"electronic","value":"2306-5354"}],"subject":[],"published":{"date-parts":[[2025,12,28]]}}}