Association of Retinal Nerve Fiber Layer Thickness With Brain Alterations in the Visual and Limbic Networks in Elderly Adults Without Dementia.

Juan Luis Méndez-Gómez, Amandine Pelletier, Marie-Bénédicte Rougier, Jean-François Korobelnik, Cédric Schweitzer, Marie-Noëlle Delyfer, Gwenaëlle Catheline, Solène Monfermé, Jean-François Dartigues, Cécile Delcourt, Catherine Helmer
JAMA Netw Open. 2018-11-09; 1(7): e184406
DOI: 10.1001/jamanetworkopen.2018.4406

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1. JAMA Netw Open. 2018 Nov 2;1(7):e184406. doi: 10.1001/jamanetworkopen.2018.4406.

Association of Retinal Nerve Fiber Layer Thickness With Brain Alterations in the
Visual and Limbic Networks in Elderly Adults Without Dementia.

Méndez-Gómez JL(1), Pelletier A(1)(2), Rougier MB(1)(3), Korobelnik JF(1)(3),
Schweitzer C(1)(3), Delyfer MN(1)(3), Catheline G(2)(4), Monfermé S(3), Dartigues
JF(1)(5), Delcourt C(1), Helmer C(1)(6).

Author information:
(1)University Bordeaux, Institut National de la Santé et de la Recherche Médicale
(INSERM), Bordeaux Population Health Research Center, Unité Mixte de Recherche
(UMR) 1219, Bordeaux, France.
(2)Centre National de la Recherche Scientifique (CNRS), Institut de Neurosciences
Cognitives et Intégratives d’Aquitaine (INCIA), UMR 5287, Bordeaux, France.
(3)Ophthalmology, University Hospital, Bordeaux, France.
(4)École Pratique des Hautes Études (EPHE), Paris Sciences et Lettres (PSL)
Research University, Bordeaux, France.
(5)Memory Consultation, Centre Mémoire de Ressource et de Recherche (CMRR),
University Hospital, Bordeaux, France.
(6)Clinical Epidemiology Unit, INSERM, Centre d’Investigation Clinique (CIC)
1401, Bordeaux, France.

Importance: The eye is a sensory organ that is easily accessible for imaging
techniques, allowing the measurement of the retinal nerve fiber layer (RNFL)
thickness. The eye is part of the central nervous system, and its neurons may be
susceptible to degeneration; therefore, changes in the RNFL thickness may reflect
microstructural and volume alterations in the brain.
Objective: To explore the association between the peripapillary RNFL thickness
and brain alterations in the visual and limbic networks in elderly people without
Design, Setting, and Participants: Cross-sectional analysis of the
Three-City/Antioxydants, Lipides Essentiels, Nutrition et Maladies Oculaires
(Alienor) Study cohort (April 2009 to December 2010). The dates of analysis were
July 2017 to August 2018. The setting was a population-based study in France. The
brain volume analysis included 104 participants, and the diffusion tensor imaging
analysis included 79 participants.
Main Outcomes and Measures: Global RNFL was assessed by spectral-domain optical
coherence tomography. Brain volumes were assessed via T1-weighted magnetic
resonance imaging by measurement of the global white and gray matter fractions
and the hippocampal fraction. Brain microstructural alterations were assessed
with diffusion tensor imaging at the level of the posterior thalamic radiations,
the limbic system tracts (the fornix and cingulum bundles), and the posterior
limb of the internal capsule (control region). Linear regression models adjusted
for several confounders were performed.
Results: Among a total of 104 participants, the mean (SD) age was 80.8 (3.9)
years, and the cohort was 56.7% women (n = 59). The mean (SD) global RNFL
thickness was 89.3 (12.9) µm. A thicker RNFL was associated with a greater
hippocampal fraction (quantity of increase β = 0.013; 95% CI, 0.001-0.025 per
10-μm increase in the RNFL thickness) and better diffusion tensor imaging
variables in the global cingulum (mean diffusivity β = -0.007; 95% CI, -0.015 to
-0.000) and the hippocampal part of the cingulum (mean diffusivity β = -0.009;
95% CI, -0.016 to -0.002 and radial diffusivity β = -0.010; 95% CI, -0.018 to
-0.002) and the posterior thalamic radiations (fractional anisotropy β = 0.008;
95% CI, 0.000-0.017). No significant associations were found with other magnetic
resonance imaging volumes or with other diffusion tensor imaging variables. In
particular, there was no significant association with the control region of
Conclusions and Relevance: Results of this study suggest that in elderly
individuals without dementia, a thicker RNFL was associated with better magnetic
resonance imaging variables both in a region that included the visual pathways
and in regions particularly involved in the neurodegenerative processes of
Alzheimer disease.

DOI: 10.1001/jamanetworkopen.2018.4406
PMCID: PMC6324371
PMID: 30646353 [Indexed for MEDLINE]

Auteurs Bordeaux Neurocampus