Exploring the Association Between Visual Field Testing and CERAD Neuropsychological Battery in Idiopathic Normal...

Area of Science:

• Ophthalmology
• Neurology
• Neuropsychology

Background:

• The relationship between visual field test results and cognitive function, as measured by the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Battery (CERAD-NB), is not well understood in patients with idiopathic normal pressure hydrocephalus (iNPH).
• Idiopathic normal pressure hydrocephalus (iNPH) presents a unique patient cohort for investigating visual field testing reliability and its association with cognitive performance.

Purpose of the Study:

• To evaluate the reliability of visual field testing in iNPH patients using the CERAD-NB.
• To determine the association between visual field test outcomes and cognitive function in this specific patient population.

Main Methods:

• Sixty-two probable iNPH patients underwent comprehensive ophthalmological examinations, optical coherence tomography (OCT) imaging, visual field testing, and the CERAD-NB.
• Patients were categorized into 'unreliable' (n=19) and 'reliable' (n=43) visual field test groups based on established indices.
• Independent t-tests and Pearson Chi-square tests were employed to analyze the relationship between visual field test results and cognitive function, as well as other clinical variables.

Main Results:

• Patients with unreliable visual field tests demonstrated significantly poorer performance across nine out of ten CERAD-NB subtests compared to those with reliable tests.
• No significant differences were found between the groups regarding amyloid-beta (Aβ) biopsy, hyperphosphorylated tau biopsy, apolipoprotein E allele, or general ophthalmological status.
• Statistically significant differences were observed in cerebrospinal fluid Aβ42 levels and patient age between the reliable and unreliable visual field testing groups.

Conclusions:

• Unreliable visual field test results in iNPH patients are associated with diminished performance on CERAD-NB cognitive assessments.
• The CERAD-NB does not currently offer specific cutoff values to exclude patients from visual field testing.
• Further research is warranted to determine if cognitive impairment screening is necessary for iNPH patients with unreliable visual field tests.