Application of optical coherence tomography in the detection and classification of cognitive decline

Moon J. Lee, Alison G. Abraham, Bonnielin K. Swenor, A. Richey Sharrett, Pradeep Y. Ramulu

Research output: Contribution to journalReview articlepeer-review

8 Scopus citations


Aim: This review aims to critically analyze the current literature on the relationship of optical coherence tomography (OCT) measures to cognition and dementia. Background: Optical coherence tomography, a noninvasive method of imaging neuroretinal layers, and OCT angiography, a highly precise method of examining retinal vasculature, have widely been used to aid in the diagnosis and monitoring of a variety of ocular diseases. There is now an increasing body of evidence relating the structural and microvascular changes of the retina to cognitive impairment. Review results: In general, several studies have found decreased retinal nerve fiber layer (RNFL) thickness in Alzheimer’s disease (AD) and mild cognitive impairment (MCI) and an association between RNFL thickness and continuous measures of cognitive ability, though findings were inconsistent across studies. In many studies, associations were found for specific regions of the RNFL but not with overall thickness. Studies linking OCT measures to non-Alzheimer’s dementia were lacking, and limited work has been done on persons with past cognitive decline but who remain cognitively normal (the ideal stage at which to target treatment). Common limitations of prior studies include a failure to account for intraocular pressure (IOP) and axial length. Conclusion: Current research suggests a potential association between retinal findings observed on OCT and cognitive impairment. Methodologically robust research accounting for important covariates and looking at changes in OCT and/ or cognition is needed to better characterize the association between OCT and cognitive ability. Clinical significance: Further research is warranted to determine whether OCT findings can help identify the etiology of cognitive decline and/or serve as objective markers of AD. If this is the case, OCT may also help identify the presence of disease processes in cognitively normal individuals.

Original languageEnglish (US)
Pages (from-to)10-18
Number of pages9
JournalJournal of Current Glaucoma Practice
Issue number1
StatePublished - Apr 2018


  • Alzheimer’s disease
  • Cognitive impairment
  • Dementia
  • Literature review
  • Optical coherence tomography (OCT)
  • Retinal nerve fiber layer

ASJC Scopus subject areas

  • Ophthalmology


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