TY - JOUR
T1 - Examination of retinal vascular trajectory in schizophrenia and bipolar disorder
AU - Appaji, Abhishek
AU - Nagendra, Bhargavi
AU - Chako, Dona M.
AU - Padmanabha, Ananth
AU - Jacob, Arpitha
AU - Hiremath, Chaitra V.
AU - Varambally, Shivarama
AU - Kesavan, Muralidharan
AU - Venkatasubramanian, Ganesan
AU - Rao, Shyam V.
AU - Webers, Carroll A. B.
AU - Berendschot, Tos T. J. M.
AU - Rao, Naren P.
PY - 2019/12
Y1 - 2019/12
N2 - Aim Evidence suggests microvascular dysfunction (wider retinal venules and narrower arterioles) in schizophrenia (SCZ) and bipolar disorder (BD). The vascular development is synchronous with neuronal development in the retina and brain. The retinal vessel trajectory is related to retinal nerve fiber layer thinning and cerebrovascular abnormalities in SCZ and BD and has not yet been examined. Hence, in this study we examined the retinal vascular trajectory in SCZ and BD in comparison with healthy volunteers (HV). Methods Retinal images were acquired from 100 HV, SCZ patients, and BD patients, respectively, with a non-mydriatic fundus camera. Images were quantified to obtain the retinal arterial and venous trajectories using a validated, semiautomated algorithm. Analysis of covariance and regression analyses were conducted to examine group differences. A supervised machine-learning ensemble of bagged-trees method was used for automated classification of trajectory values. Results There was a significant difference among groups in both the retinal venous trajectory (HV: 0.17 +/- 0.08; SCZ: 0.25 +/- 0.17; BD: 0.27 +/- 0.20; P <0.001) and the arterial trajectory (HV: 0.34 +/- 0.15; SCZ: 0.29 +/- 0.10; BD: 0.29 +/- 0.11; P = 0.003) even after adjusting for age and sex (P <0.001). On post-hoc analysis, the SCZ and BD groups differed from the HV on retinal venous and arterial trajectories, but there was no difference between SCZ and BD patients. The machine learning showed an accuracy of 86% and 73% for classifying HV versus SCZ and BD, respectively. Conclusion Smaller trajectories of retinal arteries indicate wider and flatter curves in SCZ and BD. Considering the relation between retinal/cerebral vasculatures and retinal nerve fiber layer thinness, the retinal vascular trajectory is a potential marker for SCZ and BD. As a relatively affordable investigation, retinal fundus photography should be further explored in SCZ and BD as a potential screening measure.
AB - Aim Evidence suggests microvascular dysfunction (wider retinal venules and narrower arterioles) in schizophrenia (SCZ) and bipolar disorder (BD). The vascular development is synchronous with neuronal development in the retina and brain. The retinal vessel trajectory is related to retinal nerve fiber layer thinning and cerebrovascular abnormalities in SCZ and BD and has not yet been examined. Hence, in this study we examined the retinal vascular trajectory in SCZ and BD in comparison with healthy volunteers (HV). Methods Retinal images were acquired from 100 HV, SCZ patients, and BD patients, respectively, with a non-mydriatic fundus camera. Images were quantified to obtain the retinal arterial and venous trajectories using a validated, semiautomated algorithm. Analysis of covariance and regression analyses were conducted to examine group differences. A supervised machine-learning ensemble of bagged-trees method was used for automated classification of trajectory values. Results There was a significant difference among groups in both the retinal venous trajectory (HV: 0.17 +/- 0.08; SCZ: 0.25 +/- 0.17; BD: 0.27 +/- 0.20; P <0.001) and the arterial trajectory (HV: 0.34 +/- 0.15; SCZ: 0.29 +/- 0.10; BD: 0.29 +/- 0.11; P = 0.003) even after adjusting for age and sex (P <0.001). On post-hoc analysis, the SCZ and BD groups differed from the HV on retinal venous and arterial trajectories, but there was no difference between SCZ and BD patients. The machine learning showed an accuracy of 86% and 73% for classifying HV versus SCZ and BD, respectively. Conclusion Smaller trajectories of retinal arteries indicate wider and flatter curves in SCZ and BD. Considering the relation between retinal/cerebral vasculatures and retinal nerve fiber layer thinness, the retinal vascular trajectory is a potential marker for SCZ and BD. As a relatively affordable investigation, retinal fundus photography should be further explored in SCZ and BD as a potential screening measure.
KW - bipolar disorder
KW - machine learning
KW - retinal nerve fiber layer
KW - retinal vascular trajectory
KW - schizophrenia
KW - NERVE-FIBER LAYER
KW - OPTICAL COHERENCE TOMOGRAPHY
KW - THICKNESS MEASUREMENT
KW - DIABETIC-RETINOPATHY
KW - RATING-SCALE
KW - BRAIN
KW - DISEASE
KW - RELIABILITY
KW - METAANALYSIS
KW - ASSOCIATION
U2 - 10.1111/pcn.12921
DO - 10.1111/pcn.12921
M3 - Article
C2 - 31400288
SN - 1323-1316
VL - 73
SP - 738
EP - 744
JO - Psychiatry and Clinical Neurosciences
JF - Psychiatry and Clinical Neurosciences
IS - 12
ER -