The Correlation between Cognitive Function and Glaucoma

Hwang Sunjin; Un Shin Yong; Ho Kang Min; Yoon Cho Hee; Seong Mincheol

doi:10.3341/jkos.2017.58.8.968

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Sunjin, Yong, Min, Hee, and Mincheol: The Correlation between Cognitive Function and Glaucoma

Original Article

J Korean Ophthalmol Soc 2017;58(8):968-973.

Published online: 8 September 2017

DOI: https://doi.org/10.3341/jkos.2017.58.8.968

The Correlation between Cognitive Function and Glaucoma

Hwang Sunjin, M.D., Un Shin Yong, M.D., PhD, Ho Kang Min, M.D., PhD, Yoon Cho Hee, M.D., PhD, Seong Mincheol, M.D., PhD

Department of Ophthalmology, Guri Hospital, Hanyang University College of Medicine, Guri, Korea

Address reprint requests to Mincheol Seong, MD, PhD Department of Ophthalmology, Hanyang University Guri Hospital, #153 Gyeongchun-ro, Guri 11923, Korea Tel: 82-31-560-2354, Fax: 82-31-564-9479 E-mail: goddns76@hanmail.net

* Conflicts of Interest: The authors have no conflicts to disclose.

Received 18 May 201721 June 2017 Accepted 24 July 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare mini-mental state examination (MMSE) score between glaucoma group and normal control group and to evaluate the correlation between MMSE score and spectral domain-optical coherence tomography (SD-OCT) values in both groups.

Methods

This prospective study includes thirty glaucoma patients (eleven primary open angle glaucoma and nineteen normal tension glaucoma) and thirty normal controls. Retinal nerve fiber layer (RNFL) and Ganglion cell-inner plexiform layer (GC-IPL) thickness were measured with SD-OCT, and the average values of both eyes were used. The cognitive function was evaluated with MMSE by a single examiner.

Results

The mean MMSE scores of glaucoma group and normal group were 26.07 ± 2.95, and 27.00 ± 1.68 respectively (p = 0.137). MMSE score of less than 24 only showed in glaucoma group. MMSE score and RNFL thickness showed statistically no signifance in correlation (R² = 0.236; p = 0.070), however, MMSE score and GC-IPL showed statistically significant correlation (R² = 0.256; p = 0.048).

Conclusions

Glaucoma patients tend to show low cognitive function even though the correlation between glaucoma patient and low cognitive function was not statistically significant. Therefore, the aspect of cognitive depression should be concerned, when facing glaucoma patients.

Keywords: Cognitive function, Glaucoma, Mini-mental state examination (MMSE)

References

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Figure 1.

Box plot graph of mini-mental state examination (MMSE) scores in glaucoma and control groups. The mean score of MMSE was 26.07 ± 2.95 in glaucoma group, and 27.00 ± 1.68 in normal control group, respectively. Glaucoma group showed low MMSE score than normal con-trol group, but it was not statistically significant.

Figure 2.

Scatter plot of mini-mental state examination (MMSE) score and spectral domain– optical coherence tomography (SD-OCT) parameters. Scatter plot shows weak correlation be-tween MMSE score and SD-OCT parameters. RNFL = retinal nerve fiber layer; GC-IPL = ganglion cell-inner plexiform layer.

Table 1.

Demographic and clinical characteristics of glaucoma and control subjects

	POAG (n = 11)	NTG (n = 19)	Control (n = 30)	p-value	Glaucoma (n = 30)	Control (n = 30)	p-value
Age (years)	68.63 ± 10.45	67.58 ± 9.89	66.10 ± 9.78	0.739^*	67.97 ± 9.93	66.10 ± 9.78	0.466^*
Sex
Male	8 (72.7)	12 (63.2)	11 (36.7)	0.036^†	20 (66.7)	11 (36.7)	0.038^†
Female	3 (27.3)	7 (36.8)	19 (63.3)		10 (33.3)	19 (63.3)
Hypertension
Yes	6 (54.5)	11 (57.9)	18 (60.0)	0.115^†	17 (56.7)	18 (60.0)	1.000^†
No	5 (45.5)	8 (42.1)	12 (40.0)		13 (43.3)	12 (40.0)
Diabetic mellitus
Yes	4 (36.4)	5 (26.3)	5 (16.7)	0.091^†	9 (30.0)	5 (16.7)	0.360^†
No	7 (63.6)	14 (73.7)	25 (83.3)		21 (70.0)	25 (83.3)
BCVA	0.20 ± 0.23	0.10 ± 0.11	0.09 ± 0.13	0.080^*	0.15 ± 0.22	0.09 ± 0.13	0.189^*
Pseudophakia
Yes	9 (81.8)	6 (31.6)	12 (40.0)	0.110^†	15 (50.0)	12 (40.0)	0.604^†
No	2 (18.2)	13 (68.4)	18 (60.0)		15 (50.0)	18 (60.0)
MD (dB)	-19.17 ± 5.96	-10.65 ± 8.66			-13.78 ± 8.73

Values are presented as mean ± SD or n(%) unless otherwise indicated.

POAG = primary open angle glaucoma; NTG = normal tension glaucoma; BCVA = best corrected visual acuity; MD = mean deviation.

^* Analysis of variance (ANOVA).

^† Chi-square test.

Table 2.

Comparison of the mean RNFL, GC-IPL, and MMSE between glaucoma and control groups

	POAG (n = 11)	NTG (n = 19)	Controls (n = 30)	p-value	Glaucoma (n = 30)	Control (n = 30)	p-value
RNFL (μ m)	68.05 ± 29.81	79.79 ± 18.10	97.22 ± 11.73	<0.001^*	75.48 ± 23.30	97.22 ± 11.73	<0.001^*
GC-IPL (μ m)	55.27 ± 8.11	60.82 ± 9.70	68.48 ± 5.80	<0.001^*	58.78 ± 9.40	68.48 ± 5.80	<0.001^*
MMSE	25.82 ± 3.46	26.21 ± 2.70	27.00 ± 1.68	0.305^*	26.07 ± 2.95	27.00 ± 1.68	0.137^*

Values are presented as mean ± SD unless otherwise indicated.

RNFL = retinal nerve fiber layer; GC-IPL = ganglion cell-inner plexiform layer; MMSE = mini-mental state examination; POAG = primary open angle glaucoma; NTG = normal tension glaucoma.

^* Analysis of variance (ANOVA).

Table 3.

The percentage of glaucoma patients in lower MMSE group and high MMSE group

	Glaucoma (n = 30)		Controls (n = 30)	p-value
POAG (n = 11)	NTG (n = 19)		Controls (n = 30)	p-value
Low MMSE	3 (27.3)	4 (21.1)	0 (0)	0.016^*
High MMSE	8 (72.7)	15 (78.9)	30 (100)

Values are presented as n (%). ‘Low MMSE group’ means ‘MMSE score less than 24’, and ‘High MMSE group’ means ‘MMSE score more than 24, including 24’.

MMSE = mini-mental state examination; POAG = primary open angle glaucoma; NTG = normal tension glaucoma.

^* Chi-square test.

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