Author(s): Vajaranant TS, Hallak J, Espeland MA, Pasquale LR, Klein BE, Meuer SM, Rapp SR, Haan MN, Maki PM. An association between large optic nerve cupping and cognitive function. Am J Ophthalmol. 2019 Jun 1. pii: S0002-9394(19)30251-X. doi: 10.1016/j.ajo.2019.05.019. [Epub ahead of print]
Journal: American Journal Of Ophthalmology, Jun 2019
PURPOSE To determine if a larger cup-disc ratio is associated with poor cognitive function in postmenopausal women without glaucoma or ocular hypertension.
METHODS We used data from the Women’s Health Initiative (WHI), originally designed to test effects of hormone therapy (HT) on various health outcomes. Large cup-disc ratio was defined as greater than 0.6 in either eye based on stereoscopic optic nerve photographs. Global cognitive function was assessed annually by Modified Mini-Mental State Examination (3MSE) in the WHI Memory Study. Exclusions were no information on optic nerve grading; no 3MSE scores at the time of the eye examination, ocular hypertension (IOP >23 mm Hg, Goldmann applanation tonometry), or glaucoma medication use. A generalized linear model for log-transformed 3MSE scores was used for determining the association between large cup-disc ratio and 3MSE scores, adjusting for age, race, diabetes, body mass index, cardiovascular disease, smoking, HT randomization, education, and diabetic retinopathy.
RESULTS Analyses included 1636 women (mean age ± SD, 69.57±3.64 years; 90.39% white). Of those, 122 women had large cup-disc ratio. The mean 3MSE scores in women with versus without large cup-disc ratio were 95.4±6 vs 96.6±5. In the adjusted model, women with large cup-disc ratio had statistically significant lower 3MSE scores, compared with those without large cup-disc ratio, yielding the predicted mean difference in 3MSE scores of 0.75 with a standard error of 0.05 units (P = 0.04).
CONCLUSIONS Postmenopausal women who had large cup-to-disc ratio without glaucoma or ocular hypertension exhibited lower global cognitive function. Further investigation is warranted.