Case-ControlJournal of autism and developmental disorders2024

Retinal Thinning in Adults with Autism Spectrum Disorder.

Evelyn B N Friedel, Ludger Tebartz van Elst, Mirjam Schäfer and 10 others

PMID 36550331

WHAT IT FOUND

Adults with autism had thinner outer retina and maculae than neurotypical peers, but their optic nerve fibers were the same thickness.

Greater social impairment correlated with thinner outer retina. This is a structural finding, not a diagnostic test or a functional vision loss.

Key findings

01Autistic adults showed significantly reduced total macular thickness and volume compared to neurotypical controls.

02The reduction was localized to the outer nuclear layer, while the peripapillary retinal nerve fiber layer showed no significant difference between groups.

03Higher scores on the Social Responsiveness Scale, indicating greater social impairment, were significantly correlated with thinner maculae and outer nuclear layers.

STILL TO COME

How it was doneWhat they found

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What it does not show

The cross-sectional design cannot determine if these retinal changes are present from birth (trait) or develop over time (state). The sample size was relatively small, and the results require replication in larger cohorts. The autistic group had significantly higher rates of comorbid depression and childhood ADHD symptoms than the control group, though subsample analyses suggested the retinal thinning persisted in those without these comorbidities. The study relied on self-report or clinician-rated scales for symptom severity, which may not fully capture the heterogeneity of autism. No functional visual assessments (like contrast sensitivity or color vision) were reported alongside the structural OCT data in this specific summary, limiting the interpretation of clinical impact.

Declared interests

The study was funded by the Universitätsklinikum Freiburg. The authors declared no other conflicts of interest.

The easy way to misread this

Do not interpret the retinal thinning as a cause of functional visual impairment or as a diagnostic biomarker for autism. The study found no differences in the optic nerve fiber layer, and the correlation with social impairment is an association, not a proof of causality or a standalone test result.

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The study

Participants
34 autistic adults and 31 neurotypical adults
Certainty of evidence
Low

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    Cite

    Evelyn B N Friedel, Ludger Tebartz van Elst, Mirjam Schäfer, et al. Retinal Thinning in Adults with Autism Spectrum Disorder. Journal of autism and developmental disorders. 2024.

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