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Association between Retinal Vascular Geometric Changes and Cognitive Impairment: A Systematic Review and

Huiqun Wu¹, Chendong Wang¹, Cong Chen¹

¹Department of Medical Informatics, Medical School of Nantong University, Nantong, China.

Journal of Clinical Neurology (Seoul, Korea)

|January 17, 2020

Summary

A meta-analysis found that reduced retinal fractal dimension (FD) may be linked to cognitive impairment. Other retinal vascular measures like caliber and tortuosity showed no significant association with cognitive decline.

Keywords:

cognitive impairment meta-analysis retina retinal vessels

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Area of Science:

Ophthalmology
Neurology
Medical Imaging

Background:

Retinal vascular changes are increasingly studied for their association with cognitive impairment.
Shared characteristics between retinal and cerebral vasculature suggest potential links.
Quantitative retinal vascular metrics may serve as indicators of cognitive status.

Purpose of the Study:

To conduct a comprehensive meta-analysis clarifying the relationship between retinal vascular geometric changes and cognitive impairment.
To investigate associations between retinal vascular caliber, tortuosity, and fractal dimension (FD) with cognitive impairment.

Main Methods:

Systematic literature search for studies on retinal vascular geometric changes (caliber, tortuosity, FD) and cognitive impairment.
Meta-analysis performed using RevMan, with methodological quality assessed by the Newcastle-Ottawa Scale.
Sensitivity analyses and publication bias detection were conducted.

Main Results:

Analysis of 5 studies (2,343 subjects) found no significant association between central retinal artery/venular equivalents or tortuosity and cognitive impairment.
A significant association was observed between reduced retinal arteriolar fractal dimension (FD) and cognitive impairment (MD: -0.03, 95% CI: -0.05, -0.01).
Reduced retinal venular fractal dimension (FD) was also significantly associated with cognitive impairment (MD: -0.03, 95% CI: -0.05, -0.02).

Conclusions:

A smaller retinal microvascular fractal dimension (FD) may be associated with cognitive impairment.
Further large-scale, well-controlled studies are needed to validate these findings.
Retinal FD shows potential as a biomarker for cognitive decline.