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Todd Driver, Qi Cui, David Green, Mohit Jethi, Michael Ward, Yvonne Ou; Cognitive function in older adults with and without normal tension glaucoma. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2611.
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© ARVO (1962-2015); The Authors (2016-present)
Controversy exists as to whether there is increased prevalence of dementia in open angle glaucoma patients. We performed a prospective, cross-sectional clinical study to assess cognitive function using a battery of clinically validated neurocognitive tests in a cohort of patients with normal tension glaucoma (NTG) compared to control patients.
We recruited 50 NTG patients and 51 control patients. Patients were ages 65 or older with BCVA of at least 20/60. Exclusion criteria included secondary forms of open angle glaucoma or angle closure glaucoma, age-related macular degeneration, severe proliferative diabetic retinopathy, non-glaucomatous optic neuropathies, and history of retinal vascular occlusions. Patients were administered the EXAMINER battery (computer-based test of different components of executive function) and the California Verbal Leaning Test (CVLT II). The scores from the cognitive evaluation were analyzed with respect to the patient’s glaucoma status, as well as glaucoma severity. The Wilcoxon rank sum test with continuity correction was used for statistical analysis. We tested for a significance level of p < 0.05.
The average age (72.5 vs. 70.4 years) and years of education (15.7 vs. 16) in the control and NTG groups were similar, whereas there were more males (47% vs. 28%) and a greater proportion of white patients (63% vs. 54%) in the control vs. NTG group. There was no difference in CVLT-II scores between the NTG and control groups. An Executive Composite score based on the EXAMINER battery (including Flanker, N-back, dot counting, and animal fluency) was calculated for each patient. When controlling for age, sex, years of education, and the Charlson comorbidity index (a method of categorizing and weighting comorbidities), there was no difference in Executive Composite score in the NTG vs. control group (0.28 vs. -0.01; p = 0.26).
There is no evidence of reduced cognitive function in NTG vs. control patients in our study. Although open angle glaucoma and dementia are both age-related neurodegenerative diseases, our findings do not support an increased risk of cognitive dysfunction in open angle glaucoma patients.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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