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Investigating the association between schizophrenia and distance visual acuity: Mendelian randomisation study

Shoham, Natalie; Dunca, Diana; Cooper, Claudia; Hayes, Joseph F; McQuillin, Andrew; Bass, Nick; Lewis, Gemma; (2023) Investigating the association between schizophrenia and distance visual acuity: Mendelian randomisation study. BJPsych Open , 9 (2) , Article e33. 10.1192/bjo.2023.6. Green open access

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Abstract

BACKGROUND: Increased rates of visual impairment are observed in people with schizophrenia. AIMS: We assessed whether genetically predicted poor distance acuity is causally associated with schizophrenia, and whether genetically predicted schizophrenia is causally associated with poorer visual acuity. METHOD: We used bidirectional, two-sample Mendelian randomisation to assess the effect of poor distance acuity on schizophrenia risk, poorer visual acuity on schizophrenia risk and schizophrenia on visual acuity, in European and East Asian ancestry samples ranging from approximately 14 000 to 500 000 participants. Genetic instrumental variables were obtained from the largest available summary statistics: for schizophrenia, from the Psychiatric Genomics Consortium; for visual acuity, from the UK Biobank; and for poor distance acuity, from a meta-analysis of case-control samples. We used the inverse variance-weighted method and sensitivity analyses to test validity of results. RESULTS: We found little evidence that poor distance acuity was causally associated with schizophrenia (odds ratio 1.00, 95% CI 0.91-1.10). Genetically predicted schizophrenia was associated with poorer visual acuity (mean difference in logMAR score: 0.024, 95% CI 0.014-0.033) in European ancestry samples, with a similar but less precise effect that in smaller East Asian ancestry samples (mean difference: 0.186, 95% CI -0.008 to 0.379). CONCLUSIONS: Genetic evidence supports schizophrenia being a causal risk factor for poorer visual acuity, but not the converse. This highlights the importance of visual care for people with psychosis and refutes previous hypotheses that visual impairment is a potential target for prevention of schizophrenia.

Type: Article
Title: Investigating the association between schizophrenia and distance visual acuity: Mendelian randomisation study
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1192/bjo.2023.6
Publisher version: https://doi.org/10.1192/bjo.2023.6
Language: English
Additional information: © The Author(s) 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/).
Keywords: Mendelian randomisation, Psychiatric epidemiology, psychosis, schizophrenia, visual impairment
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry > Epidemiology and Applied Clinical Research
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry > Mental Health Neuroscience
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10164654
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