Correlation between retinal thickness and cognitive impairment in cerebral small vessel disease

doi:10.3877/cma.j.issn.1673-9248.2025.02.005

Abstract

Abstract:

Objective

To investigate the correlation between retinal thickness and cognitive impairment in patients with cerebral small vessel disease (CSVD).

Methods

A total of 161 CSVD patients treated at the Department of Neurology, Huashan Hospital Affiliated to Fudan University from September 2022 to May 2024 were enrolled.Based on the Montreal cognitive assessment (MoCA) scores, patients were divided into a non-cognitive impairment group (29 cases) and a cognitive impairment group (132 cases).Optical coherence tomography (OCT) was used to measure retinal nerve fiber layer (RNFL) and ganglion cell complex (GCC) thickness in the optic disc and macular regions.Retinal parameters were compared between the two groups, followed by univariate and multivariate logistic regression analyses.Spearman correlation analysis was used to explore the associations between independent influencing factors and MoCA scores.

Results

The temporal RNFL thickness of the optic disc in the cognitive impairment group [75.0 (68.0,81.5) µm] was significantly thinner than that in the non-cognitive impairment group [86.0 (72.5, 92.0) µm],with a statistically significant difference (Z=2.602, P=0.009).Logistic regression analysis revealed that thicker temporal RNFL of the optic disc was an independent protective factor against cognitive impairment in CSVD patients (OR=0.96, 95% CI: 0.92-0.99, P=0.032).Temporal RNFL thickness was positively correlated with MoCA scores (r=0.235, P=0.006).

Conclusion

Thicker temporal RNFL of the optic disc is an independent protective factor against cognitive impairment in CSVD patients.

Key words: Cerebral small vessel disease, Cognitive impairment, Retina, Nerve fiber layer, Ganglion cell complex

Qi Han, Tiansiyu Wen, Yiqin Xiao, Mei Cui. Correlation between retinal thickness and cognitive impairment in cerebral small vessel disease[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2025, 19(02): 109-114.

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URL: https://zhnxgbzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1673-9248.2025.02.005

https://zhnxgbzz.cma-cmc.com.cn/EN/Y2025/V19/I02/109

Figures/Tables 3

项目	非认知障碍组（29 例）	认知障碍组（132 例）	统计值	P值
年龄[ 岁，M（Q_R）]	66.0（59.0，70.0）	69.0（63.5，73.0）	Z=1.973	0.049
女性[ 例（%）]	11（37.93）	52（39.39）	χ ²=0.021	0.884
受教育年限（年， $\overset{ˉ}{x}$ ± s ）	13.00±0.82	8.31±0.38	t=5.258	＜0.001
吸烟[ 例（%）]	4（13.79）	23（17.42）	χ ²=0.231	0.891
饮酒[ 例（%）]	4（13.79）	22（16.67）	χ ²=0.184	0.912
疾病史[ 例（%）]
卒中	10（34.48）	54（40.91）	χ ²=0.410	0.522
冠心病	1（3.45）	13（9.85）	χ ²=1.227	0.268
高血压	20（68.97）	91（68.94）	χ ²=0.000	0.998
糖尿病	8（27.59）	23（17.42）	χ ²=1.579	0.209
高血脂	8（27.59）	36（27.27）	χ ²=0.001	0.973
MoCA[ 分，M（Q_R）]	27.0（26.0，28.0）	19.0（11.5，22.5）	Z=8.431	＜0.001

项目	非认知障碍组（29 例）	认知障碍组（132 例）	统计值	P值
年龄[ 岁，M（Q_R）]	66.0（59.0，70.0）	69.0（63.5，73.0）	Z=1.973	0.049
女性[ 例（%）]	11（37.93）	52（39.39）	χ ²=0.021	0.884
受教育年限（年， $\overset{ˉ}{x}$ ± s ）	13.00±0.82	8.31±0.38	t=5.258	＜0.001
吸烟[ 例（%）]	4（13.79）	23（17.42）	χ ²=0.231	0.891
饮酒[ 例（%）]	4（13.79）	22（16.67）	χ ²=0.184	0.912
疾病史[ 例（%）]
卒中	10（34.48）	54（40.91）	χ ²=0.410	0.522
冠心病	1（3.45）	13（9.85）	χ ²=1.227	0.268
高血压	20（68.97）	91（68.94）	χ ²=0.000	0.998
糖尿病	8（27.59）	23（17.42）	χ ²=1.579	0.209
高血脂	8（27.59）	36（27.27）	χ ²=0.001	0.973
MoCA[ 分，M（Q_R）]	27.0（26.0，28.0）	19.0（11.5，22.5）	Z=8.431	＜0.001

项目	非认知障碍组（26 例）	认知障碍组（112 例）	Z值	P值
视盘RNFL 厚度
均值	106.0（95.5，116.5）	104.0（93.5，110.5）	1.263	0.206
上方	129.5（115，145.5）	125.8（100.3，139.0）	1.122	0.262
鼻侧	76.3（65.5，82.0）	80.5（68.5，87.0）	0.925	0.355
下方	136.0（115.5，150.0）	133.0（107.0，143.3）	0.888	0.375
颞侧	86.0（72.5，92.0）	75.0（68.0，81.5）	2.602	0.009
黄斑区RNFL 厚度
均值	41.0（36.5，42.5）	37.3（34.0，42.0）	1.415	0.157
上方	39.3（36.5，42.0）	37.0（33.5，40.0）	1.493	0.136
下方	41.5（36.0，44.0）	38.8（35.0，43.0）	1.307	0.191
黄斑区GCC 厚度
均值	64.0（59.5，68.5）	63.0（58.5，67.5）	0.725	0.468
上方	65.5（59.5，69.5）	63.5（59.0，68.0）	0.734	0.463
下方	64.5（58.0，68.0）	63.0（57.5，68.0）	0.526	0.599

项目	未调整混杂因素模型		调整混杂因素模型
项目	OR（95%CI）值	P值	OR（95%CI）值	P值
视盘RNFL 厚度
均值	0.99（0.96～1.02）	0.352	0.98（0.95～1.02）	0.301
上方	0.99（0.97～1.01）	0.266	0.99（0.97～1.01）	0.309
鼻侧	1.01（0.98～1.03）	0.515	1.01（0.98～1.04）	0.497
下方	1.00（0.98～1.01）	0.688	0.99（0.98～1.01）	0.526
颞侧	0.97（0.95～1.00）	0.055	0.96（0.92～0.99）	0.032
黄斑区RNFL 厚度
均值	0.99（0.93～1.06）	0.801	1.00（0.93～1.08）	0.923
上方	0.99（0.93～1.06）	0.828	1.01（0.93～1.10）	0.780
下方	0.99（0.94～1.05）	0.818	1.00（0.94～1.07）	0.962
黄斑区GCC 厚度
均值	1.01（0.95～1.07）	0.748	1.02（0.95～1.10）	0.633
上方	1.01（0.95～1.06）	0.855	1.02（0.95～1.09）	0.646
下方	1.01（0.95～1.07）	0.740	1.01（0.94～1.09）	0.747

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