Retinal layers and associated clinical factors in schizophrenia spectrum disorders: a systematic review and meta-analysis
Introduction The retina shares structural and functional similarities with the brain. Furthermore, structural changes in the retina have been observed in patients with schizophrenia spectrum disorders (SSDs). This systematic review and meta-analysis investigated retinal abnormalities and their assoc...
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| Veröffentlicht in: | Molecular psychiatry 2022-09, Vol.27 (9), p.3592-3616 |
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| creator | Komatsu, Hiroshi Onoguchi, Goh Jerotic, Stefan Kanahara, Nobuhisa Kakuto, Yoshihisa Ono, Takashi Funakoshi, Shunichi Yabana, Takeshi Nakazawa, Toru Tomita, Hiroaki |
| description | Introduction
The retina shares structural and functional similarities with the brain. Furthermore, structural changes in the retina have been observed in patients with schizophrenia spectrum disorders (SSDs). This systematic review and meta-analysis investigated retinal abnormalities and their association with clinical factors for SSD.
Methods
Studies related to retinal layers in SSD patients were retrieved from PubMed, Scopus, Web of Science, Cochrane Controlled Register of Trials, International Clinical Trials Registry Platform, and PSYNDEX databases from inception to March 31, 2021. We screened and assessed the eligibility of the identified studies. EZR ver.1.54 and the metafor package in R were used for the meta-analysis and a random-effects or fixed-effects model was used to report standardized mean differences (SMDs).
Results
Twenty-three studies (2079 eyes of patients and 1571 eyes of controls) were included in the systematic review and meta-analysis. The average peripapillary retinal nerve fiber layer (pRNFL) thickness, average macular thickness (MT), and macular ganglion cell layer-inner plexiform layer (GCL-IPL) thickness were significantly lower in patients than in controls (
n
= 14, 6, and 3, respectively; SMD = −0.33, −0.49, and −0.43, respectively). Patients also had significantly reduced macular volume (MV) compared to controls (
n
= 7; SMD = −0.53). The optic cup volume (OCV) was significantly larger in patients than in controls (
n
= 3; SMD = 0.28). The meta-regression analysis indicated an association between several clinical factors, such as duration of illness and the effect size of the pRNFL, macular GCL-IPL, MT, and MV.
Conclusion
Thinning of the pRNFL, macular GCL-IPL, MT, and MV and enlargement of the OCV in SSD were observed. Retinal abnormalities may be applicable as state/trait markers in SSDs. The accumulated evidence was mainly cross-sectional and requires verification by longitudinal studies to characterize the relationship between OCT findings and clinical factors. |
| doi_str_mv | 10.1038/s41380-022-01591-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2659228593</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2741144394</sourcerecordid><originalsourceid>FETCH-LOGICAL-c441t-e9ad859fae1c3364be9df8c907974a30b065431ac8f0056fb19de144542dde483</originalsourceid><addsrcrecordid>eNp9kUuLFTEQhYMozkP_gAsJuHETTTpJd8edDDoKA4LoOuQm1U6GflxT6XHaX2_N3FHBhasUOV-dU3AYe6bkKyV1_xqN0r0UsmmEVNYpcfOAHSvTtcLarn9Is7ZOGNWbI3aCeCXlrWgfsyNtLc2yO2bbZ6h5DiMfwwYFeZgTD4hLzKFC4nHMc44kDyHWhfQ8c4yX-eeyvyww58BxD7GWdeIp41ISebzh9LthhSnUHHmB6ww_7ownqEEEStsw4xP2aAgjwtP795R9ff_uy9kHcfHp_OPZ2wsRjVFVgAupt24IoKLWrdmBS0MfnexcZ4KWO9lao1WI_SClbYedcgmUMdY0KYHp9Sl7efDdl-X7Clj9lDHCOIYZlhV901rXNBShCX3xD3q1rIXuJaozily1M0Q1ByqWBbHA4PclT6FsXkl_W4w_FOOpGH9XjL-hpef31utugvRn5XcTBOgDgCTN36D8zf6P7S_rtptB</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2741144394</pqid></control><display><type>article</type><title>Retinal layers and associated clinical factors in schizophrenia spectrum disorders: a systematic review and meta-analysis</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Komatsu, Hiroshi ; Onoguchi, Goh ; Jerotic, Stefan ; Kanahara, Nobuhisa ; Kakuto, Yoshihisa ; Ono, Takashi ; Funakoshi, Shunichi ; Yabana, Takeshi ; Nakazawa, Toru ; Tomita, Hiroaki</creator><creatorcontrib>Komatsu, Hiroshi ; Onoguchi, Goh ; Jerotic, Stefan ; Kanahara, Nobuhisa ; Kakuto, Yoshihisa ; Ono, Takashi ; Funakoshi, Shunichi ; Yabana, Takeshi ; Nakazawa, Toru ; Tomita, Hiroaki</creatorcontrib><description>Introduction
The retina shares structural and functional similarities with the brain. Furthermore, structural changes in the retina have been observed in patients with schizophrenia spectrum disorders (SSDs). This systematic review and meta-analysis investigated retinal abnormalities and their association with clinical factors for SSD.
Methods
Studies related to retinal layers in SSD patients were retrieved from PubMed, Scopus, Web of Science, Cochrane Controlled Register of Trials, International Clinical Trials Registry Platform, and PSYNDEX databases from inception to March 31, 2021. We screened and assessed the eligibility of the identified studies. EZR ver.1.54 and the metafor package in R were used for the meta-analysis and a random-effects or fixed-effects model was used to report standardized mean differences (SMDs).
Results
Twenty-three studies (2079 eyes of patients and 1571 eyes of controls) were included in the systematic review and meta-analysis. The average peripapillary retinal nerve fiber layer (pRNFL) thickness, average macular thickness (MT), and macular ganglion cell layer-inner plexiform layer (GCL-IPL) thickness were significantly lower in patients than in controls (
n
= 14, 6, and 3, respectively; SMD = −0.33, −0.49, and −0.43, respectively). Patients also had significantly reduced macular volume (MV) compared to controls (
n
= 7; SMD = −0.53). The optic cup volume (OCV) was significantly larger in patients than in controls (
n
= 3; SMD = 0.28). The meta-regression analysis indicated an association between several clinical factors, such as duration of illness and the effect size of the pRNFL, macular GCL-IPL, MT, and MV.
Conclusion
Thinning of the pRNFL, macular GCL-IPL, MT, and MV and enlargement of the OCV in SSD were observed. Retinal abnormalities may be applicable as state/trait markers in SSDs. The accumulated evidence was mainly cross-sectional and requires verification by longitudinal studies to characterize the relationship between OCT findings and clinical factors.</description><identifier>ISSN: 1359-4184</identifier><identifier>EISSN: 1476-5578</identifier><identifier>DOI: 10.1038/s41380-022-01591-x</identifier><identifier>PMID: 35501407</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/53/2422 ; 692/699/476/1799 ; Behavioral Sciences ; Biological Psychology ; Clinical trials ; Cross-Sectional Studies ; Humans ; Medicine ; Medicine & Public Health ; Mental disorders ; Meta-analysis ; Nerve Fibers ; Neurosciences ; Patients ; Pharmacotherapy ; Psychiatry ; Retina ; Retinal Ganglion Cells ; Review Article ; Schizophrenia ; Structure-function relationships ; Systematic review ; Tomography, Optical Coherence</subject><ispartof>Molecular psychiatry, 2022-09, Vol.27 (9), p.3592-3616</ispartof><rights>The Author(s), under exclusive licence to Springer Nature Limited 2022. corrected publication 2022. corrected publication 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2022. The Author(s), under exclusive licence to Springer Nature Limited.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-e9ad859fae1c3364be9df8c907974a30b065431ac8f0056fb19de144542dde483</citedby><cites>FETCH-LOGICAL-c441t-e9ad859fae1c3364be9df8c907974a30b065431ac8f0056fb19de144542dde483</cites><orcidid>0000-0001-8550-8003</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/s41380-022-01591-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/s41380-022-01591-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35501407$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Komatsu, Hiroshi</creatorcontrib><creatorcontrib>Onoguchi, Goh</creatorcontrib><creatorcontrib>Jerotic, Stefan</creatorcontrib><creatorcontrib>Kanahara, Nobuhisa</creatorcontrib><creatorcontrib>Kakuto, Yoshihisa</creatorcontrib><creatorcontrib>Ono, Takashi</creatorcontrib><creatorcontrib>Funakoshi, Shunichi</creatorcontrib><creatorcontrib>Yabana, Takeshi</creatorcontrib><creatorcontrib>Nakazawa, Toru</creatorcontrib><creatorcontrib>Tomita, Hiroaki</creatorcontrib><title>Retinal layers and associated clinical factors in schizophrenia spectrum disorders: a systematic review and meta-analysis</title><title>Molecular psychiatry</title><addtitle>Mol Psychiatry</addtitle><addtitle>Mol Psychiatry</addtitle><description>Introduction
The retina shares structural and functional similarities with the brain. Furthermore, structural changes in the retina have been observed in patients with schizophrenia spectrum disorders (SSDs). This systematic review and meta-analysis investigated retinal abnormalities and their association with clinical factors for SSD.
Methods
Studies related to retinal layers in SSD patients were retrieved from PubMed, Scopus, Web of Science, Cochrane Controlled Register of Trials, International Clinical Trials Registry Platform, and PSYNDEX databases from inception to March 31, 2021. We screened and assessed the eligibility of the identified studies. EZR ver.1.54 and the metafor package in R were used for the meta-analysis and a random-effects or fixed-effects model was used to report standardized mean differences (SMDs).
Results
Twenty-three studies (2079 eyes of patients and 1571 eyes of controls) were included in the systematic review and meta-analysis. The average peripapillary retinal nerve fiber layer (pRNFL) thickness, average macular thickness (MT), and macular ganglion cell layer-inner plexiform layer (GCL-IPL) thickness were significantly lower in patients than in controls (
n
= 14, 6, and 3, respectively; SMD = −0.33, −0.49, and −0.43, respectively). Patients also had significantly reduced macular volume (MV) compared to controls (
n
= 7; SMD = −0.53). The optic cup volume (OCV) was significantly larger in patients than in controls (
n
= 3; SMD = 0.28). The meta-regression analysis indicated an association between several clinical factors, such as duration of illness and the effect size of the pRNFL, macular GCL-IPL, MT, and MV.
Conclusion
Thinning of the pRNFL, macular GCL-IPL, MT, and MV and enlargement of the OCV in SSD were observed. Retinal abnormalities may be applicable as state/trait markers in SSDs. The accumulated evidence was mainly cross-sectional and requires verification by longitudinal studies to characterize the relationship between OCT findings and clinical factors.</description><subject>692/53/2422</subject><subject>692/699/476/1799</subject><subject>Behavioral Sciences</subject><subject>Biological Psychology</subject><subject>Clinical trials</subject><subject>Cross-Sectional Studies</subject><subject>Humans</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mental disorders</subject><subject>Meta-analysis</subject><subject>Nerve Fibers</subject><subject>Neurosciences</subject><subject>Patients</subject><subject>Pharmacotherapy</subject><subject>Psychiatry</subject><subject>Retina</subject><subject>Retinal Ganglion Cells</subject><subject>Review Article</subject><subject>Schizophrenia</subject><subject>Structure-function relationships</subject><subject>Systematic review</subject><subject>Tomography, Optical Coherence</subject><issn>1359-4184</issn><issn>1476-5578</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kUuLFTEQhYMozkP_gAsJuHETTTpJd8edDDoKA4LoOuQm1U6GflxT6XHaX2_N3FHBhasUOV-dU3AYe6bkKyV1_xqN0r0UsmmEVNYpcfOAHSvTtcLarn9Is7ZOGNWbI3aCeCXlrWgfsyNtLc2yO2bbZ6h5DiMfwwYFeZgTD4hLzKFC4nHMc44kDyHWhfQ8c4yX-eeyvyww58BxD7GWdeIp41ISebzh9LthhSnUHHmB6ww_7ownqEEEStsw4xP2aAgjwtP795R9ff_uy9kHcfHp_OPZ2wsRjVFVgAupt24IoKLWrdmBS0MfnexcZ4KWO9lao1WI_SClbYedcgmUMdY0KYHp9Sl7efDdl-X7Clj9lDHCOIYZlhV901rXNBShCX3xD3q1rIXuJaozily1M0Q1ByqWBbHA4PclT6FsXkl_W4w_FOOpGH9XjL-hpef31utugvRn5XcTBOgDgCTN36D8zf6P7S_rtptB</recordid><startdate>20220901</startdate><enddate>20220901</enddate><creator>Komatsu, Hiroshi</creator><creator>Onoguchi, Goh</creator><creator>Jerotic, Stefan</creator><creator>Kanahara, Nobuhisa</creator><creator>Kakuto, Yoshihisa</creator><creator>Ono, Takashi</creator><creator>Funakoshi, Shunichi</creator><creator>Yabana, Takeshi</creator><creator>Nakazawa, Toru</creator><creator>Tomita, Hiroaki</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8550-8003</orcidid></search><sort><creationdate>20220901</creationdate><title>Retinal layers and associated clinical factors in schizophrenia spectrum disorders: a systematic review and meta-analysis</title><author>Komatsu, Hiroshi ; Onoguchi, Goh ; Jerotic, Stefan ; Kanahara, Nobuhisa ; Kakuto, Yoshihisa ; Ono, Takashi ; Funakoshi, Shunichi ; Yabana, Takeshi ; Nakazawa, Toru ; Tomita, Hiroaki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-e9ad859fae1c3364be9df8c907974a30b065431ac8f0056fb19de144542dde483</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>692/53/2422</topic><topic>692/699/476/1799</topic><topic>Behavioral Sciences</topic><topic>Biological Psychology</topic><topic>Clinical trials</topic><topic>Cross-Sectional Studies</topic><topic>Humans</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mental disorders</topic><topic>Meta-analysis</topic><topic>Nerve Fibers</topic><topic>Neurosciences</topic><topic>Patients</topic><topic>Pharmacotherapy</topic><topic>Psychiatry</topic><topic>Retina</topic><topic>Retinal Ganglion Cells</topic><topic>Review Article</topic><topic>Schizophrenia</topic><topic>Structure-function relationships</topic><topic>Systematic review</topic><topic>Tomography, Optical Coherence</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Komatsu, Hiroshi</creatorcontrib><creatorcontrib>Onoguchi, Goh</creatorcontrib><creatorcontrib>Jerotic, Stefan</creatorcontrib><creatorcontrib>Kanahara, Nobuhisa</creatorcontrib><creatorcontrib>Kakuto, Yoshihisa</creatorcontrib><creatorcontrib>Ono, Takashi</creatorcontrib><creatorcontrib>Funakoshi, Shunichi</creatorcontrib><creatorcontrib>Yabana, Takeshi</creatorcontrib><creatorcontrib>Nakazawa, Toru</creatorcontrib><creatorcontrib>Tomita, Hiroaki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Molecular psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Komatsu, Hiroshi</au><au>Onoguchi, Goh</au><au>Jerotic, Stefan</au><au>Kanahara, Nobuhisa</au><au>Kakuto, Yoshihisa</au><au>Ono, Takashi</au><au>Funakoshi, Shunichi</au><au>Yabana, Takeshi</au><au>Nakazawa, Toru</au><au>Tomita, Hiroaki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Retinal layers and associated clinical factors in schizophrenia spectrum disorders: a systematic review and meta-analysis</atitle><jtitle>Molecular psychiatry</jtitle><stitle>Mol Psychiatry</stitle><addtitle>Mol Psychiatry</addtitle><date>2022-09-01</date><risdate>2022</risdate><volume>27</volume><issue>9</issue><spage>3592</spage><epage>3616</epage><pages>3592-3616</pages><issn>1359-4184</issn><eissn>1476-5578</eissn><abstract>Introduction
The retina shares structural and functional similarities with the brain. Furthermore, structural changes in the retina have been observed in patients with schizophrenia spectrum disorders (SSDs). This systematic review and meta-analysis investigated retinal abnormalities and their association with clinical factors for SSD.
Methods
Studies related to retinal layers in SSD patients were retrieved from PubMed, Scopus, Web of Science, Cochrane Controlled Register of Trials, International Clinical Trials Registry Platform, and PSYNDEX databases from inception to March 31, 2021. We screened and assessed the eligibility of the identified studies. EZR ver.1.54 and the metafor package in R were used for the meta-analysis and a random-effects or fixed-effects model was used to report standardized mean differences (SMDs).
Results
Twenty-three studies (2079 eyes of patients and 1571 eyes of controls) were included in the systematic review and meta-analysis. The average peripapillary retinal nerve fiber layer (pRNFL) thickness, average macular thickness (MT), and macular ganglion cell layer-inner plexiform layer (GCL-IPL) thickness were significantly lower in patients than in controls (
n
= 14, 6, and 3, respectively; SMD = −0.33, −0.49, and −0.43, respectively). Patients also had significantly reduced macular volume (MV) compared to controls (
n
= 7; SMD = −0.53). The optic cup volume (OCV) was significantly larger in patients than in controls (
n
= 3; SMD = 0.28). The meta-regression analysis indicated an association between several clinical factors, such as duration of illness and the effect size of the pRNFL, macular GCL-IPL, MT, and MV.
Conclusion
Thinning of the pRNFL, macular GCL-IPL, MT, and MV and enlargement of the OCV in SSD were observed. Retinal abnormalities may be applicable as state/trait markers in SSDs. The accumulated evidence was mainly cross-sectional and requires verification by longitudinal studies to characterize the relationship between OCT findings and clinical factors.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>35501407</pmid><doi>10.1038/s41380-022-01591-x</doi><tpages>25</tpages><orcidid>https://orcid.org/0000-0001-8550-8003</orcidid></addata></record> |
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| subjects | 692/53/2422 692/699/476/1799 Behavioral Sciences Biological Psychology Clinical trials Cross-Sectional Studies Humans Medicine Medicine & Public Health Mental disorders Meta-analysis Nerve Fibers Neurosciences Patients Pharmacotherapy Psychiatry Retina Retinal Ganglion Cells Review Article Schizophrenia Structure-function relationships Systematic review Tomography, Optical Coherence |
| title | Retinal layers and associated clinical factors in schizophrenia spectrum disorders: a systematic review and meta-analysis |
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