title: Retinal neurodegeneration on optical coherence tomography and cerebral atrophy.
abstract: Neurodegeneration in dementia is mainly evaluated by assessing cerebral atrophy, while retinal neurodegeneration can be quantified in vivo using optical coherence tomography (OCT). We examined the association of retinal nerve fibre layer (RNFL) and ganglion cell-inner plexiform layer (GC-IPL) thinning with global and regional cerebral atrophy on magnetic resonance imaging (MRI). Malay participants aged 60-80 years from the Epidemiology of Dementia in Singapore Study underwent comprehensive examinations, including 3-Tesla cranial MRI. RNFL and GC-IPL thicknesses were obtained from spectral domain-OCT; and cerebral grey and white matter volumes were obtained from MRI scans using a validated segmentation tool. Linear regression models were constructed with adjustment for age and sex; and additionally for vascular risk factors and MRI markers including intracranial volume. 164 participants without glaucoma with gradable quality MRI and OCT scans were included for analysis. GC-IPL thinning was associated with reduction in total brain volume in the occipital (mean change in GC-IPL per standard deviation (SD) decrease in occipital lobe volume: -1.77 μm, 95% confidence interval (CI) -6.55 to 0.01 μm) and temporal lobes (mean change in GC-IPL per SD decrease in temporal lobe volume: -3.45 μm, 95%CI -5.40 to -1.49 μm) in multivariate adjusted models. In particular, GC-IPL thinning was primarily associated with grey matter volume, whereas no association was found with white matter changes. Retinal neuronal damage, as reflected by GC-IPL thinning, was independently associated with grey matter loss in the occipital and temporal lobes, suggesting that retinal OCT may provide insights for assessing neurodegeneration in the brain.
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore; NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors.forename: Yi-Ting
authors.initials: YT
authors.lastname: Ong
authors.affiliation: Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore; Department of Pharmacology, National University of Singapore, Singapore, Singapore.
authors.forename: Saima
authors.initials: S
authors.lastname: Hilal
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore.
authors.forename: Carol Y
authors.initials: CY
authors.lastname: Cheung
authors.affiliation: Rafffles Neuroscience Centre, Raffles Hospital, Singapore, Singapore.
authors.forename: Narayanaswamy
authors.initials: N
authors.lastname: Venketasubramanian
authors.affiliation: Departments of Radiology & Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands; Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands.
authors.forename: Wiro J
authors.initials: WJ
authors.lastname: Niessen
authors.affiliation: Departments of Radiology & Medical Informatics, Erasmus Medical Center, Rotterdam, The Netherlands; Faculty of Applied Sciences, Delft University of Technology, Delft, The Netherlands.
authors.forename: Henri
authors.initials: H
authors.lastname: Vrooman
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore.
authors.forename: Ainur R
authors.initials: AR
authors.lastname: Anuar
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
authors.forename: Merwyn
authors.initials: M
authors.lastname: Chew
authors.affiliation: Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore; Department of Pharmacology, National University of Singapore, Singapore, Singapore.
authors.forename: Christopher
authors.initials: C
authors.lastname: Chen
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore.
authors.forename: Tien Yin
authors.initials: TY
authors.lastname: Wong
authors.affiliation: Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore; Memory, Aging and Cognition Center, National University Health System, Singapore, Singapore; Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore; Academic Medicine Research Institute, Duke-NUS Graduate Medical School, Singapore, Singapore. Electronic address: kamran_ikram@nuhs.edu.sg.
authors.forename: Mohammad Kamran
authors.initials: MK
authors.lastname: Ikram
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy; D001921:Brain / Q000473:pathology*; D005260:Female; D066128:Gray Matter / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009410:Nerve Degeneration / Q000473:pathology*; D009412:Nerve Fibers / Q000473:pathology; D012160:Retina / Q000473:pathology*; D012165:Retinal Ganglion Cells / Q000473:pathology; D041623:Tomography, Optical Coherence; D066127:White Matter / Q000473:pathology
keywords: Cerebral atrophy; Ganglion cell; Grey matter; Occipital lobe; Retina; Temporal lobe