Korean J Ophthalmol.  2017 Dec;31(6):548-556. 10.3341/kjo.2016.0118.

Analysis of the Retinal Nerve Fiber Layer Thickness in Alzheimer Disease and Mild Cognitive Impairment

• Kwon JY
• Yang JH
• Han JS
• Kim DG

• KMID: 2396706
• DOI: http://doi.org/10.3341/kjo.2016.0118

Abstract

PURPOSE
To compare the retinal nerve fiber layer (RNFL) as well as the macula volume and thickness in the eyes of age-matched healthy controls with no cognitive disabilities with those of elderly people with mild cognitive impairment (MCI) or Alzheimer disease (AD). We used optical coherence tomography (OCT) to determine the effectiveness of the above quantities for early diagnosis of MCI or AD.
METHODS
Ninety eyes were considered in this study, split between 30 normal eyes, 30 eyes from patients with MCI, and 30eyes from patients with AD. All subjects underwent ophthalmologic and cognitive examinations, and measurements of the RNFL thickness as well as macular volume and thickness were taken for all patients using OCT.
RESULTS
The mean RNFL thickness upon OCT was significantly thinner in the AD group than in the MCI group (p = 0.01). The RNFL was thinner in the superior quadrant in patients with AD when compared to the healthy controls (p = 0.03). The RNFL thicknesses in the inferior, nasal, and temporal quadrants did not differ significantly between the groups. Measurements in the 12 clock-hour zones revealed that zone 11 had a significantly thinner RNFL in the AD group as compared with the healthy control group (p = 0.02). In zone 2, the MCI group had a significantly thinner RNFL than the AD group (p = 0.03).
CONCLUSIONS
Our OCT findings revealed a neuroanatomic difference in the RNFL thickness among the three groups, i.e., the AD, MCI, and healthy control groups. This suggests that a change in average RNFL thickness could be a meaningful index for diagnosing early AD.

Keyword

Alzheimer disease; Mild cognitive impairment; Optical coherence tomography; Retinal nerve fiber layer

MeSH Terms

Aged
Alzheimer Disease*
Early Diagnosis
Humans
Mild Cognitive Impairment*
Nerve Fibers*
Retinaldehyde*
Tomography, Optical Coherence
Retinaldehyde

Figure

• 

  Fig. 1 An example retinal nerve fiber layer (RNFL) report obtained with Stratus optical coherence tomography in (A) the control group, (B) mild cognitive impairment group, and (C) Alzheimer disease group. The fundus image shows an optic disc of a right eye (OD). S, N, I, and T are the abbreviations for superior, nasal, inferior, and temporal, respectively. The numbers inside the circle are in a clockwise direction, and those outside the circle show the average RNFL thickness for each section.

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