PURPOSE To determine the association of retinal thickness with cognitive function in Japanese persons. DESIGN Cross-sectional, population-based survey. PARTICIPANTS A total of 1293 Japanese persons aged 65 to 86 years who resided in the Saku area in the Japan Public Health Center-Based Prospective Study participated in the eye and mental health screening. METHODS Participants underwent comprehensive ophthalmic assessment, including fundus photography, measurement of intraocular pressure, and determination of refraction status. We assessed the thickness of the macular retinal nerve fiber layer (mRNFL), ganglion cell-inner plexiform layer (GC-IPL), and ganglion cell complex (GCC, which includes the retinal nerve fiber layer and GC-IPL), and the full thickness in the macula and peripapillary retinal nerve fiber layer (ppRNFL) using spectral-domain (SD) OCT. Cognitive tests consisted of the Mini-Mental State Examination, Wechsler Memory Scale Revised logical memory I/II subtest, clock drawing test, and Clinical Dementia Rating Scale. These were used to designate the participants in the following 3 groups: Normal, those with mild cognitive impairment (MCI), and those with dementia. Multivariable logistic regression models were used to analyze associations between retinal thickness and cognitive function after adjusting potential confounding factors. MAIN OUTCOME MEASURES Association of retinal thickness with cognitive function. RESULTS Among the 1293 potential subjects, 114 were excluded for a diagnosis of depression, 64 were excluded for retinal disease, and 140 were excluded for scanning errors or suboptimal OCT images. The remaining 975 participants (mean age, 73.2 years) were included in this analysis. Significant differences were found in the 3 groups in all layers and GCC thickness, but not in ppRNFL thickness. After adjusting for age, sex, educational status, and refraction, full macular thickness and GCC thickness were inversely associated with the presence of dementia, but ppRNFL thickness was not. Furthermore, GC-IPL, GCC, and full macular thicknesses were all associated with the presence of dementia in the inferior sectors. CONCLUSIONS Macular thickness was associated with the presence of dementia, but ppRNFL was not. Our results suggest that OCT measurements of the macula could be superior to those of the ppRNFL in assessing neurodegenerative changes and a potentially useful diagnostic biomarker of cognitive function.

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使用OCT和与认知功能的关联对视网膜进行定量评估。

目的确定日本人视网膜厚度与认知功能的关系。设计基于人口的横断面调查。参加调查的日本公共卫生中心基于前瞻性研究的佐久地区共有1293名年龄在65至86岁之间的日本人参加了眼睛和精神健康检查。方法对参加者进行全面的眼科评估，包括眼底照相，眼压测量和屈光度测定。我们评估了黄斑部视网膜神经纤维层（mRNFL），神经节细胞内丛状层（GC-IPL）和神经节细胞复合物（GCC，包括视网膜神经纤维层和GC-IPL）的厚度，使用光谱域（SD）OCT评估黄斑和乳头周围神经纤维层（ppRNFL）的全层厚度。认知测试包括迷你精神状态检查，韦氏记忆量表修订的逻辑记忆I / II子测验，钟表绘画测验和临床痴呆评定量表。这些用于指定以下3组的参与者：正常，患有轻度认知障碍（MCI）的人群和患有痴呆症的人群。调整潜在的混杂因素后，使用多变量逻辑回归模型分析视网膜厚度与认知功能之间的关联。主要观察指标视网膜厚度与认知功能的关系。结果在1293名潜在受试者中，排除了114名诊断为抑郁症的人，排除了64名视网膜疾病的人，排除了140和140个扫描错误或次优的OCT图像。其余975名参与者（平均年龄73.2岁）被纳入了该分析。在所有层和GCC厚度的3组中发现了显着差异，但在ppRNFL厚度中没有发现显着差异。在调整了年龄，性别，受教育程度和屈光度后，全黄斑厚度和GCC厚度与痴呆症的存在呈负相关，而ppRNFL厚度则与痴呆症无相关性。此外，GC-IPL，GCC和全黄斑厚度均与下节段痴呆症的存在有关。结论黄斑厚度与痴呆有关，而ppRNFL与老年痴呆无关。