Retinal neurodegeneration on optical coherence tomography and cerebral atrophy

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.