Corneal endothelial changes in schizophrenic patients with long-term administration of major tranquilizers

To examine corneal endothelial changes in schizophrenic patients who underwent long-term administration of major tranquilizers.

We performed slit-lamp examination and endothelial specular microscopy on 100 eyes of 50 schizophrenic patients (range, 31 to 68 years old; mean, 54 years) who underwent long-term (12 to 44 years) treatment with major tranquilizers. We also studied 50 eyes of 25 patients (range, 31 to 65 years old; mean, 53 years) with no history of corneal disease, as a control group of similar age. Mean cell density, coefficient of variation, and percentage of hexagonal cells were calculated and statistically compared between patients and controls using an unpaired t-test.

Slit-lamp examination disclosed pigmentation of the cornea in nine eyes of five patients and pigmentation of the lens in 25 eyes (25%) of 35 patients. Corneal pigmentary changes were seen only in patients with lenticular changes. No eyes showed corneal edema. In contrast, no corneal abnormalities were seen in any control eye. Specular microscopic analysis showed mean cell density of 3,484.4 +/- 462.6 cells/mm2, coefficient of variation of 0.31 +/- 0.06 and percentage of hexagonal cells to be 60.2% +/- 7.5% in the patient group, and 3,291.3 +/- 384.4 cells/mm2, 0.32 +/- 0.07, and 60.6% +/- 7.0%, respectively, in the control subjects. There were no statistically significant differences between patient and control eyes in these three factors. The nine eyes with corneal pigmentation showed no significant differences in these three factors as compared with the control subjects.

These results indicate that long-term treatment with major tranquilizers is not associated with morphometric abnormalities of the corneal endothelium.