BACKGROUND: Neurodegeneration plays an important role in the pathophysiology of schizophrenia. Conventional imaging has limited sensitivity in identifying early degenerative changes in the brain. Optical Coherence Tomography (OCT) is a noninvasive method for assessing retinal changes, providing a window into the central nervous system. METHODOLOGY: Thirty-six schizophrenia patients and 31 healthy controls aged 18-45 were included. OCT was used to measure macular thickness and volume across nine retinal regions. Comparative analyses were conducted using t-tests, and the association between retinal changes and clinical characteristics was explored. RESULTS: Patients exhibited increased macular thickness in the central subfield (right: p = 0.006
left p = 0.009) and outer superior quadrant (left p <
0.001). Significant thinning was observed in the right outer temporal(p <
0.001) and right inner temporal(p = 0.024), left inner inferior(p = 0.013) and left outer nasal quadrants (p ≤ 0.001). Macular volume was lower in the patients but not statistically significant. CONCLUSIONS: Schizophrenia can present with a mixed pattern of changes in the structure of the macula. This pattern could suggest inflammatory changes in the macular structures. Future studies need to focus on the etiopathogenesis of these inflammatory changes, which will help in a better understanding of schizophrenia.