Dry Eye Disease in Patients With Schizophrenia: A Case-Control Study

Area of Science:

• Ophthalmology
• Psychiatry
• Immunology

Background:

• Dry eye disease (DED) is a common ocular surface condition.
• Schizophrenia is a complex psychiatric disorder with potential systemic implications.
• The relationship between schizophrenia and DED, particularly regarding tear inflammatory markers, requires further investigation.

Purpose of the Study:

• To investigate the clinical features of DED in patients with schizophrenia.
• To analyze the profile of inflammatory cytokines in the tears of individuals with schizophrenia.

Main Methods:

• A case-control study comparing schizophrenic patients (n=40) and healthy controls (n=20).
• Assessment of DED symptoms using the Ocular Surface Disease Index (OSDI) and clinical signs including tear break-up time (TBUT), meibomian gland loss (MGL), and lipid layer thickness (LLT).
• Tear samples were analyzed for a panel of inflammatory cytokines using multiplex ELISA Quantibody array.

Main Results:

• Schizophrenic patients exhibited significantly lower OSDI and TBUT, and increased MGL compared to controls.
• Elevated levels of pro-inflammatory cytokines (e.g., IL-1α, IL-6, IL-17A), chemokines, MMP-9, and ICAM-1 were found in the tears of schizophrenic patients.
• Decreased concentrations of IL-1Ra, TIMP-1, and TIMP-2 were observed in the schizophrenia group.
• Correlations were found between specific cytokines (CCL2, TIMP-1, IL-5, ICAM-1, IL-8) and DED clinical parameters (OSDI, LLT, PBR, Schirmer I-test).

Conclusions:

• Patients with schizophrenia are prone to developing DED, often presenting with mild symptoms but significant clinical signs.
• Distinct patterns of tear inflammatory cytokines characterize DED in schizophrenia, suggesting an underlying inflammatory component.
• These findings highlight the importance of ophthalmological screening in schizophrenia patients.