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Updated: Dec 17, 2025
Using Retinal Imaging to Study Dementia
Published on: November 6, 2017
Association of retinal layer measurements and adult cognitive function: A population-based study
David D Ward1, Matthias M Mauschitz1, Meta M Bönniger1
1From Population Health Sciences (D.D.W., M.M.M., M.M.B., N.M., M.M.B.B.), German Center for Neurodegenerative Diseases; Department of Ophthalmology (M.M.M., R.P.F.) and Institute for Medical Biometry, Informatics and Epidemiology (M.M.B.B.), Faculty of Medicine, University of Bonn, Germany; and Department of Population Health Sciences (N.M.), School of Medicine and Public Health, University of Wisconsin-Madison.
Objective:
To quantify the associations of peripapillary retinal nerve fiber layer (pRNFL) thickness and macular ganglion cell layer (mGCL) volume with cognitive functioning and to investigate how demographic and vascular health factors affect these associations in a population-based sample of adults.
Methods:
The sample included the first 3,000 participants (age range 30-95 years) of the Rhineland Study (recruited from March 2016 to December 2018) who underwent spectral-domain optical coherence tomography and cognitive assessment at 1 of 2 identical study centers in Bonn, Germany. We used multiple linear regression models to examine the relationships between retinal layer measurements and cognitive functioning after adjustment for confounders, and we examined the moderating effects of demographic and vascular health factors.
Results:
The analytical sample included 2,483 participants who were 54.3 years old (SD 13.8 years) on average. After full adjustment, each 1-SD decrease in mGCL volume was associated with a greater decrease in global function than that of pRNFL thickness (β = -0.048 [95% confidence interval (CI) -0.077 to -0.018] vs β = -0.021 [95% CI -0.049 to 0.007]). These relationships increased in strength with advancing age, were stronger in participants with hypertension, and were reversed in current smokers relative to nonsmokers.
Conclusions:
mGCL volume is more strongly related to adult cognitive functioning than pRNFL thickness, making it a better potential biomarker of neurodegeneration. Age and vascular health factors play important roles in determining the strength and direction of this association.
