Relation between retinal vascular abnormalities and working memory impairment in patients with schizophrenia and bipolar disorder

Abhishek Appaji*, Bhargavi Nagendra, Dona Maria Chako, Ananth Padmanabha, Arpitha Jacob, Chaitra V Hiremath, Shivarama Varambally, Muralidharan Kesavan, Ganesan Venkatasubramanian, Shyam Vasudeva Rao, Carroll A B Webers, Tos T J M Berendschot, Naren P Rao

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Emerging evidence indicates abnormal retinal micro-vasculature in schizophrenia (SCZ) and bipolar disorder (BD) and its relation to cognitive functions. However, the association of these abnormalities with the cognitive deficits in these disorders has not been examined till date. Hence, we explored this aspect in patients with SCZ, BD, and healthy volunteers (HV). We examined 34 with SCZ, 39 with BD, and 45 HV. Retinal images were acquired using nonmydriatic fundus camera. The retinal images were analyzed, and average diameters of retinal arterioles and venules were calculated. Working memory was assessed using computerized one-back test from Cogstate® battery. There was significant difference between groups in retinal venules and arterioles caliber (p < 0.001). Both SCZ and BD patients had wider venules and narrower arterioles. They had significantly lower working memory accuracy (p = 0.008) and higher log mean speed (p < 0.001). There was significant positive correlation between one-back test accuracy and retinal arteriolar caliber (r = 0.22; p = 0.01) and between log mean speed score and retinal venular caliber (r = 0.20; p = 0.02). Findings suggest association between working memory and retinal vascular caliber, a potential pointer towards understanding the vascular pathology in cognitive deficits in SCZ and BD. Future studies need to examine whether retinal vascular could be a biomarker for SCZ and BD.

Original languageEnglish
Article number101942
Number of pages5
JournalAsian Journal of Psychiatry
Early online date10 Feb 2020
Publication statusPublished - Mar 2020


  • Bipolar disorder
  • Cerebrovascular disorder
  • Cognitive impairment
  • Fundus
  • Retinal vasculature
  • Schizophrenia


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