Search

Purpose: While structural changes within the retina of psychosis patients have been established, no detailed studies of choroidal microvasculature in these patients have been performed. Given evidence of microvascular disruption in psychosis patients, this study sought to determine whether there exists evidence of microvascular disruption in the choroids in these patients., Methods: Fifty-six subjects (20 controls and 36 psychosis patients) were recruited from April 2018 to February 2020. Five were excluded due to imaging artifact or missing demographic information. Swept-source optical coherence tomography angiography (SS-OCTA) images were obtained. Choroid vascular enface images (12 mm × 9mm) were exported every 2.6 μm from Bruch's membrane to the choroid-scleral interface from Topcon to ImageJ. The images were binarized using Otsu's method, signal from the optic disk and retinal vasculature was removed, and average choroid vascular density (CVD) was calculated as the average of percent area occupied by choroidal vasculature across images in the stack. Choroid vascular volume (CVV) was calculated as the CVD multiplied by maximum CT and image area. During image analysis, study staff were blinded to the phenotype of the study subjects., Results: Compared with same-sex controls, male psychiatric patients had significantly lower CVD. Compared with same-sex controls, female psychiatric patients had significantly lower maximum CT with correspondingly decreased CVV, after adjusting for age. When all psychiatric patients were compared with all healthy controls, no significant differences in CT, CVD, or CVV were noted., Conclusion: These results suggest that the pathogenesis of psychotic illness affects choroidal microvasculature in a sex-specific manner., Competing Interests: P.L., D.B., and M. Keshavan. were supported in part by the Harvard Medical School Dupont Warren Fellowship and Livingston Grant; Sydney R. Baer Jr Foundation; National Institute of Health Harvard Catalyst [grant number 1KL2TR002542]; National Institute of Mental Health [grant number R01 MH078113]; and National Institute of Mental Health [grant number R01 MH077945]. We would like to thank the following B-SNIP2 principal investigators (Carol Tamminga, Brett Clementz, Elliot Gershon, and Godfrey Pearlson) for their input and support of this study.L.A.K. has received financial support from the National Eye Institute and CureVac AG and has financial arrangement with Pykus Therapeutics.J.B.M. is a consultant for Alcon, Allergan, Carl Zeiss, Sunovion, Topcon and Genentech.C.Y.L., I.G., M. Kasetty, R.K., I.A., K.D., and J.C.W. have no conflicts of interest to report., (© 2022 Li et al.)