Affiliations: [a] Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UK
| [b] MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| [c] Cardiovascular Research Institute Maastricht School for Cardiovascular Diseases, Maastricht University, the Netherlands
| [d] Department of Internal Medicine, Maastricht University Medical Center, the Netherlands
| [e] Nuffield Department of Population Health, University of Oxford, Oxford, UK
| [f] Albertinen-Haus Centre for Geriatrics and Gerontology, University of Hamburg, Hamburg, Germany
| [g] Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, England, UK
| [h] Cambridge Public Health, University of Cambridge, Cambridge, UK
| [i] NIHR Biomedical Research Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK
Correspondence:
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Correspondence to: Grace S. Yin, Gonville and Caius College, University of Cambridge, Trinity Street, Cambridge, CB2 1TA, UK. E-mail: gyin@qmed.ca.
Abstract: Background:Retinal nerve fiber layer (RNFL) thickness may reflect cerebral status. Objective:This study assessed the relationship between RNFL thickness and incident all-cause dementia in the European Prospective Investigation into Cancer in Norfolk (EPIC-Norfolk) Eye Study. Methods:Glaucoma detection with variable corneal compensation (GDx-VCC) and Heidelberg Retinal Tomograph II (HRT II) derived global mean RNFL thickness from dementia-free participants at baseline within the EPIC-Norfolk Eye Study were analyzed. Incident dementia was identified through linkage to electronic medical records. Cox proportional hazard mixed-effects regression models adjusted for key confounders were used to examine the associations between RNFL thickness and incident dementia in four separate models. Results:6,239 participants were included with 322 cases of incident dementia and mean age of 67.5-years old, with 49.7% women (median follow-up 13.2-years, interquartile range (11.7 to 14.6 years). Greater RNFL thickness (GDx-VCC) was not significantly associated with a lower risk of incident dementia in the full adjusted model [HR per quartile increase 0.95; 95% CI 0.82–1.10]. Similarly, RNFL thickness assessed with HRT II was also not associated with incident dementia in any model (full adjusted model; HR per quartile increase: 1.06; [95% CI 0.93–1.19]. Gender did not modify any associations under study. Conclusion:GDx-VCC and HRT II derived RNFL thickness are unlikely to be useful predictors of incident dementia. Higher resolution optical imaging technologies may clarify whether there are useful relationships between neuro-retinal morphology and brain measures.
