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An Association Between Large Optic Nerve Cupping and Cognitive Function.

Thasarat Sutabutr Vajaranant1, Joelle Hallak1, Mark A Espeland2

  • 1Illinois Eye and Ear Infirmary, Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA.

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Larger optic cup-to-disc ratio in postmenopausal women, even without glaucoma, is linked to poorer cognitive function. This finding suggests a potential association between optic nerve health and brain health.

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Area of Science:

  • Ophthalmology
  • Neurology
  • Gerontology

Background:

  • The relationship between optic nerve head morphology and cognitive function is not fully understood.
  • Large cup-to-disc ratio is a known risk factor for glaucoma, but its association with cognitive decline in the absence of ocular disease requires investigation.

Purpose of the Study:

  • To investigate the association between a large cup-to-disc ratio and cognitive function in postmenopausal women without glaucoma or ocular hypertension.
  • To determine if optic nerve head characteristics predict cognitive performance.

Main Methods:

  • Utilized data from the Women's Health Initiative (WHI) hormone trial, including stereoscopic optic nerve photographs and cognitive assessments (Modified Mini-Mental State Examination - 3MSE).
  • Defined large cup-to-disc ratio as >0.6. Excluded participants with ocular hypertension or glaucoma medication use.
  • Employed a generalized linear model to analyze the association between large cup-to-disc ratio and 3MSE scores, adjusting for multiple covariates.

Main Results:

  • The study included 1636 postmenopausal women (mean age 69.57 years).
  • 122 women (7.46%) had a large cup-to-disc ratio.
  • Women with a large cup-to-disc ratio showed statistically significantly lower 3MSE scores (mean difference -0.75, P = .04) compared to those without.

Conclusions:

  • A large cup-to-disc ratio is associated with lower global cognitive function in postmenopausal women, even in the absence of glaucoma or ocular hypertension.
  • These findings suggest a potential link between optic nerve structure and cognitive health.
  • Further research is warranted to explore this association and its underlying mechanisms.