Retinal Origins of Aberrant Salience in Schizophrenia: The Perceptual Theory
Biological Psychiatry Global Open Science June 4, 2026 Petr Adámek, Veronika Rudolfová, Kristýna Malenínská et al.
A proposed framework, the Perceptual Theory of Schizophrenia (PerTh), contends that instability in retinal dopamine signaling may initiate a subset of schizophrenia cases. Retinal dopamine normally controls visual gain and spatial frequency processing; genetic liabilities for schizophrenia are argued to converge on retinal dopamine homeostasis, producing corrupted sensory input. This noisy signal is proposed to cascade through thalamocortical pathways, disrupting salience formation and driving compensatory synaptic changes that leave weak connections vulnerable to pruning. The theory aims to explain symptom timing, the predominance of auditory over visual hallucinations, and heterogeneity, without replacing existing models, and generates testable predictions about retinal function in psychosis.