Risk of retinal disease and visual impairment in individuals with psychiatric disorders

Individuals with a psychiatric disease have been reported to have structural variations in the retina, but how this affects retinal disease risk and vision loss is poorly understood. This study evaluated the risk of retinal disease and visual impairment in individuals with psychiatric disorders.

An exploratory retrospective cohort study was conducted through a federated health research network that aggregates de-identified EHR data of over 95 million individuals across 50 healthcare organizations. Individuals ages 50-89 were identified for schizophrenia, bipolar disorder (BD), major depressive disorder (MDD), retinal disease, and visual impairment defined by vision loss or blindness using ICD-10 codes. Individuals were propensity score matched (PSM) on age, sex, race, ethnicity, hypertension, diabetes, and dyslipidaemias. Risk ratio calculation and statistical analyses were conducted through the network's analytics tool utilizing 95% confidence intervals.

After PSM, the schizophrenia cohort had 160,414 matched individuals (average age 65), 391,440 in the BD cohort (64), and 1,962,380 in the MDD cohort (67). A recorded diagnosis of schizophrenia was associated with a decreased likelihood of having a retinal disease diagnosis, while recorded diagnoses of BD and MDD were associated with an increased likelihood. Across all psychiatric disorders, individuals with a retinal disease diagnosis had an increased risk of visual impairment compared to individuals with a retinal disease alone.

Recorded diagnoses of BD and MDD were associated with an increased likelihood of having a retinal disease diagnosis. Across all psychiatric disorders, individuals with a concurrent retinal disease were more likely to have a visual impairment diagnosis.