What the Fundus

I very much enjoyed reading this paper. Lower Cognitive Function in Patients With Functionally and Structurally Severe Glaucoma: The LIGHT Study in the October 2021 edition of Journal of Glaucoma. This quote says it all right here.

“This cross-sectional study of 172 patients with glaucoma showed that functional and structural glaucoma damage was significantly associated with cognitive impairment independent of age and visual acuity.”

At first I was a little dubious about this because they linked the results to visual field loss. It’s a chicken or the egg type of question. Is the visual field loss an artifact because patients with cognitive impairments are less likely to take good visual fields. They supposedly solved for false positives by eliminating those bad fields from the data. I was still not fully convinced.

“However, our study demonstrated that a decrease in both visual field sensitivity and RNFL thickness was associated with cognitive impairment.” (emphasis added)

OCT was what convinced me here. Yes, you can get a bad OCT reading, but not with over 100 patients.

“Glaucoma may be involved in the pathogenesis of cognitive impairment by causing circadian disruption due to the loss of intrinsically photosensitive retinal ganglion cells. In patients with glaucoma, decreased transmission of light signals from the intrinsically photosensitive retinal ganglion cells to the suprachiasmatic nuclei leads to misalignment of circadian biological rhythms.”

I’ve been a nut about studying circadian rhythm and how it affects different aspects of our body and our health. I haven’t yet, but I’m going to read the paper Intrinsically photosensitive (melanopsin) retinal ganglion cell function in glaucoma next. Right up my alley. Look for that post in a few days.