Retinal structure and its relationship with premorbid, clinical, and cognitive variables in young Spanish patients with early course schizophrenia spectrum disorders

Emerging evidence suggests that retinal structural alterations are present in schizophrenia spectrum disorders (SSD), potentially reflecting broader neurodevelopmental and neurodegenerative processes. This cross-sectional study investigates retinal thickness and its clinical correlations in a sample of early-course SSD patients compared to healthy controls (HCs). One hundred-two eyes from 26 SSD cases and 25 age- and sex-matched HCs were included. Retinal structure was evaluated using Spectral-Domain Optical Coherence Tomography (SD-OCT), focusing on the peripapillary retinal nerve fiber layer (pRNFL), macular volume/thickness, and ganglion cell-inner plexiform layer (GCL+IPL) thickness. Although SSD cases showed increased peripapillary retinal nerve fiber layer (pRNFL) thickness in specific quadrants, most retinal parameters did not differ significantly between groups. Preliminary associations were observed between retinal measures, premorbid adjustment, DUP, and cognitive performance. These findings, while suggesting the potential of retinal imaging as a tool for early detection and monitoring of psychotic disorders, must be interpreted with caution. Further longitudinal and multimodal research is warranted to explore the association between these retinal changes and neuroinflammation, neurodegeneration, and overall brain health in SSD patients.