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Peripapillary Retinal Nerve Fiber Layer Thickness and the Evolution of Cognitive Performance in an Elderly Population.

ABSTRACT: Retinal nerve fiber layer (RNFL) thickness is reduced in Alzheimer's patients. However, whether it is associated with early evolution of cognitive function is unknown. Within 427 participants from the Three-City-Alienor longitudinal population-based cohort, we explored the relationship between peripapillary RNFL thicknesses and the evolution of cognitive performance. RNFL was assessed at baseline by spectral domain optical coherence tomography; cognitive performances were assessed at baseline and at 2?years, with the Mini-Mental State Examination, the Isaacs' set test, and the Free and Cued Selective Reminding Test (FCSRT). Multivariate linear mixed models were performed. The RNFL was not associated with initial cognitive performance. Nevertheless, a thicker RNFL was significantly associated with a better cognitive evolution over time in the free delayed recall (p?=?0.0037) and free?+?cued delayed recall (p?=?0.0043) scores of the FCSRT, particularly in the temporal, superotemporal, and inferotemporal segments. No associations were found with other cognitive tests. The RNFL was associated with changes in scores that assess episodic memory. RNFL thickness could reflect a higher risk of developing cognitive impairment over time.

SUBMITTER: Mendez-Gomez JL

PROVIDER: S-EPMC5358525 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Peripapillary Retinal Nerve Fiber Layer Thickness and the Evolution of Cognitive Performance in an Elderly Population.

Méndez-Gómez Juan Luis JL Rougier Marie-Bénédicte MB Tellouck Laury L Korobelnik Jean-François JF Schweitzer Cédric C Delyfer Marie-Noëlle MN Amieva Hélène H Dartigues Jean-François JF Delcourt Cécile C Helmer Catherine C

Frontiers in neurology 20170321

Retinal nerve fiber layer (RNFL) thickness is reduced in Alzheimer's patients. However, whether it is associated with early evolution of cognitive function is unknown. Within 427 participants from the Three-City-Alienor longitudinal population-based cohort, we explored the relationship between peripapillary RNFL thicknesses and the evolution of cognitive performance. RNFL was assessed at baseline by spectral domain optical coherence tomography; cognitive performances were assessed at baseline an ...[more]

PMID: 28373855

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Project description:ImportanceType 2 diabetes is expected to accelerate age-related peripapillary retinal nerve fiber layer (pRNFL) loss, but limited information on the rate of reduction in pRNFL thicknesses in patients with type 2 diabetes is available.ObjectiveTo investigate longitudinal changes in pRNFL thickness in patients with type 2 diabetes, with or without diabetic retinopathy (DR).Design, setting, and participantsA total of 164 eyes of 63 healthy individuals and 101 patients with type 2 diabetes (49 patients without DR [non-DR group] and 52 patients with mild to moderate nonproliferative DR [NPDR group]) were enrolled in this prospective, longitudinal, observational study from January 2, 2013, through February 27, 2015. Participants were followed up for 3 years, and the peripapillary mean and sector RNFL thicknesses were measured at 1-year intervals. The mean rate of pRNFL loss was estimated using a linear mixed model and compared among the 3 groups. Follow-up was completed on March 16, 2018, and data were analyzed from April 2 through July 27, 2018.ExposureType 2 diabetes.Main outcomes and measuresThe rate of reduction in pRNFL thickness in patients with type 2 diabetes.ResultsA total of 164 participants (88 women [53.7%]; mean [SD] age, 58.2 [8.7] years) were included in the study analysis. The mean (SD) age of the control group was 56.5 (9.3) years (39 women [61.9%]); the non-DR group, 59.1 (9.4) years (26 women [53.1%]); and the NPDR group, 59.4 (11.0) years (23 women [44.2%]). Mean (SD) duration of type 2 diabetes was 7.1 (4.4) years in the non-DR group and 13.2 (8.4) years in the NPDR group. The baseline mean (SD) pRNFL thickness was 96.2 (11.0) μm in the control group, 93.5 (6.4) μm in the non-DR group, and 90.4 (7.9) μm in the NPDR group. During 3 years of follow-up, these values decreased to 95.0 (9.2) μm in the control group, 90.3 (6.4) in the non-DR group, and 86.6 (7.9) μm in the NPDR group. In a linear mixed model, the estimated mean pRNFL loss was -0.92 μm/y in the non-DR group (P < .001) and -1.16 μm/y in the NPDR group (P < .001), which was 2.9-fold (95% CI, 1.1-14.8; P = .003) and 3.3-fold (95% CI, 1.4-18.0; P < .001) greater, respectively, than that of the control group (-0.35 μm/y; P = .01).Conclusions and relevanceProgressive reduction of pRNFL thickness was observed in healthy controls and patients with type 2 diabetes without and with DR; however, type 2 diabetes was associated with a greater loss of pRNFL regardless of whether DR was present. These findings suggest that pRNFL loss may occur in people with type 2 diabetes even in the absence of DR progression.

Project description:ObjectiveThis study aimed to compare the peripapillary retinal nerve fiber layer (pRNFL) thickness and macular thickness (MT) between patients with non-diabetic chronic kidney disease (NDCKD) and controls, as well as between different stages of NDCKD. We also evaluated the correlation between pRNFL thickness and MT with duration of NDCKD.MethodsThis was a comparative cross-sectional study. Subjects were divided into NDCKD and control groups. Both pRNFL thickness and MT, including center subfield thickness (CST), average MT as well as average ganglion cell-inner plexiform layer (GC-IPL) were measured using spectral-domain optical coherence tomography. One-way ANCOVA test was used to compare the differences in pRNFL and MT between NDCKD and controls, as well as between the different stages of NDCKD. Spearman rank-order correlation coefficients were employed to determine the effects of NDCKD duration on pRNFL thickness and MT.ResultsA total of 132 subjects were recruited, 66 with NDCKD and 66 controls. There was a statistically significant difference in superior (110.74 ± 23.35 vs 117.36 ± 16.17 μm, p = 0.022), nasal (65.97 ± 12.90 vs 69.35 ± 10.17 μm, p = 0.006), inferior quadrant (117.44 ± 23.98 vs 126.15 ± 14.75 μm, p = 0.006), average pRNFL (90.36 ± 14.93 vs 95.42 ± 9.87 μm, p = 0.005), CST (231.89 ± 26.72 vs 243.30 ± 21.05 μm, p = 0.006), average MT (268.88 ± 20.21 vs 274.92 ± 12.79 μm, p = 0.020) and average GC-IPL (75.48 ± 12.44 vs 81.56 ± 6.48, p = 0.001) values between the NDCKD group and controls. The superior quadrant (p = 0.007), nasal quadrant (p = 0.030), inferior quadrant (p = 0.047), average pRNFL (p = 0.006), average MT (p = 0.001) and average GC-IPL (p = 0.001) differed significantly between different stages of NDCKD. There was no correlation between pRNFL thickness and MT with duration of NDCKD.ConclusionCST, average MT, average GC-IPL thickness, average pRNFL and all quadrants of pRNFL except the temporal quadrant were significantly thinner in NDCKD patients compared to controls. These changes were associated with the severity of CKD, but not its duration.

Dataset Information

Peripapillary Retinal Nerve Fiber Layer Thickness and the Evolution of Cognitive Performance in an Elderly Population.

Publications

Peripapillary Retinal Nerve Fiber Layer Thickness and the Evolution of Cognitive Performance in an Elderly Population.

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