The relationship between the degree of cognitive impairment and retinal nerve fiber layer thickness
- 662 Downloads
The goal of the present study is to investigate the relationship between the degree of cognitive impairment and retinal nerve fiber layer (RNFL) thickness which is measured by the optical coherence tomography (OCT). Thirty-five patients with Alzheimer’s disease (AD), 35 patients with mild cognitive impairment (MCI), and 35 healthy volunteers, between the ages of 60–87, who were examined in the neurology outpatient clinic among 2012–2013 were prospectively involved in our study. Mini mental state examination (MMSE) test, montreal cognitive assessment (MOCA), and also neuropsychological test batteries were used for the neurocognitive evaluation. RNFL thickness was measured by the OCT technique and the differences among groups were studied. The relationship between RNFL thickness and MMSE scores with demographic characteristics was investigated. RNFL thickness was significantly lower in AD and MCI groups compared with the control group (p < 0.01). No significant differences of RNFL were found between the MCI and the AD groups (p > 0.05). Significant correlation was found between MMSE scores and the RNFL values (p < 0.05). Significant thinning in RNFL along with age was detected (p < 0.05). In our study, it is thought that retinal nerve fiber degeneration and central nervous system degeneration may be concurrent according to the thinning of RNFL measured by OCT in AD and MCI groups. RNFL measurement may also be useful for early diagnosis and evaluation of the disease progression. Further studies are needed to optimize the utility of this method as an ocular biomarker in AD.
KeywordsRetinal nerve fiber layer Optical coherence tomography Alzheimer’s disease Mild cognitive impairment
This study was funded by Baskent University Research Fund with a project code of KA11/115.
Conflict of interest
The authors declare that they have no conflicts of interest. The authors alone are responsible for the content and writing of the paper.
- 1.Walter G Bradley, R.B.D., Gerald M. Fenichel, Joseph Jankovic (2008) Neurology in Clinical Practice. In: R.B.D. Walter G. Bradley, Gerald M. Fenichel, Joseph Jankovic (Tr ed Tan E, Özdamar SE) (ed) Dementia, 5th edn. Istanbul, pp 1855–1909Google Scholar
- 4.Winblad B, Palmer K, Kivipelto M, Jelic V, Fratiglioni L, Wadlund LO, Nordberg A, Backman L, Albert M, Almkvist O, Arai H, Basun H, Blennow K, de Leon M, DeCarli C, Erkinjuntti T, Giacobini E, Graff C, Hardy J, Jack C, Jorm A, Ritchie K, van Duijn C, Visser P, Petersen RJ (2004) Mild cognitive impairment beyond controversies, towards a consensus: report of the International Working Group on mild cognitive impairment. J Intern Med 256:240–246PubMedCrossRefGoogle Scholar
- 5.Petersen RC (2004) Mild cognitive impairment. Continuum 10:9–28Google Scholar
- 11.Mudun A (2011) Nöro-Oftalmolojik Hastalıklarda Optik Koherens Tomografisi. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 2:5–9Google Scholar
- 12.Miller RN, Newman NJ, Biousse V, Kerrison BJ (2010) Walsh and Hoyt’s Clinical Neuro-Ophtalmology: the Essentials. In: Kansu T tr (ed), 2nd edn, pp 435–437Google Scholar
- 13.Gungen C, Ertan T, Eker E, Yasar R, Engin F (2002) Reliability and validity of the standardized Mini Mental State Examination in mild dementia in Turkish population. Turk J Psychiatry 13(4):273–282Google Scholar
- 14.Selekler K, Cangoz B, Uluc S (2010) Power of discrimination of montreal cognitive assesment (MOCA) scale in Turkish patients with mild cognitive impairement and Alzheimer’s disease [in Turkish]. Turk Geriatri Dergisi 13(3):166–171Google Scholar
- 15.Oktem O (1994) Nöropsikolojik testler ve Nöropsikolojik Değerlendirme. Türk Psikoloji Dergisi 9(33):33–34Google Scholar
- 16.Varan E, Tanör O, Gurvit H (2007) Rey complex figure test and recognition trial (RCFT): norm determination study on Turkish adult sample Bir Yetişkin Türk Örneklemi Üzerinde Norm Belirleme Çalışması. Türk Nörol Derg 13(6):387–394Google Scholar
- 17.Karakas S, Erdogan E, Sak L, Soysal AS, Ulusoy T, Ulusoy IY, Alkan S (1999) Stroop test TBAG form: standardization for Turkish culture, reliability and validity. Klinik Psikiyatri 2:75–88Google Scholar
- 18.Cangoz B, Karakoc E, Selekler K (2007) Standardization study of “trail making test” for Turkish adults and elderly people (ages 50 and over). Turk J Geriatr 10(2):73–82Google Scholar
- 19.Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR (2000) American Psychiatric Publishing, Inc.; 4 sub edition. JuneGoogle Scholar
- 20.Petersen RC, Stevens JC, Ganguli M, Tangalos EG, Cummings JL, DeKosky ST (2001) Practice parameter: early detection of dementia: mild cognitive impairment. (an evidence-based review). Report of the quality standards subcommittee of the American Academy of Neurology. Neurology 56:1133–1142PubMedCrossRefGoogle Scholar
- 30.Bowd C, Zangwill LM, Blumenthal EZ, Vasile C, Boehm AG, Gokhale PA, Mohammadi K, Amini P, Sankary TM, Weinreb RN (2002) Imaging of the optic disc and retinal nerve fiber layer: the effects of age, optic disc area, refractive error, and gender. J Opt Soc Am A Opt Image Sci Vis 19:197–207PubMedCrossRefGoogle Scholar
- 34.Kaya Y, Aki OE, Can UA, Derle E, Kibaroglu S, Barak A (2014) Validation of Montreal Cognitive Assesment and discriminant power of montreal cognitive assesment subtests in patients with mild cognitive impairment and Alzheimer dementia in Turkish population. J Geriatr Psychiatry Neurol 27(2):103–109PubMedCrossRefGoogle Scholar