Lee Chan Ho, Kim Jae-Ik, Lee Kang Min, Park Joo Hyun, Bae Kunho
Department of Ophthalmology, Seoul National University Hospital, Seoul, South Korea.
Department of Ophthalmology, Dongguk University Ilsan Hospital, Goyang, Korea.
Neurol Sci. 2025 Jun 19. doi: 10.1007/s10072-025-08305-5.
Sensory impairments are significant contributors to cognitive dysfunction, but the relationship between cognitive decline and various forms of neurosensory degeneration remains poorly understood. This study aimed to evaluate retinal layer neurodegeneration and hearing impairment in the general Korean population using cognitive assessments.
This cross-sectional, retrospective study included participants who underwent Optical Coherence Tomography (OCT), Pure Tone Audiometry (PTA), and the Mini-Mental State Examination (MMSE). Participants were categorized into three groups based on MMSE scores: control group (MMSE > 27), mild cognitive impairment (MCI, MMSE 23-27), and dementia group (MMSE < 23). PTA thresholds were computed using the weighted four-frequency average formula (0.5 kHz, 1 kHz, 2 kHz, and 4 kHz). OCT images were analyzed to measure the Ganglion Cell Inner Plexiform Layer (GC-IPL), Peripapillary Retinal Nerve Fiber Layer (ppRNFL), and total macular thickness. These sensory parameters were compared across the three groups.
A total of 196 participants were included, with a mean age of 67.0 ± 10.4 years. MMSE scores showed an inverse correlation with both age and PTA thresholds, and a positive correlation with OCT parameters (all P <.05). After adjusting for age, significant differences in PTA thresholds were observed across all groups. However, significant reductions in OCT parameters and best-corrected visual acuity were only seen in the dementia group compared to the control and MCI groups (all P <.05).
Sensory assessments are reliable indicators of cognitive function, with hearing loss emerging as a more consistent and sensitive predictor of early functional decline than retinal thickness measurements. Advanced stages of cognitive impairment are closely linked to retinal neurodegeneration and visual impairment, underscoring the importance of careful monitoring and early intervention.
感觉障碍是认知功能障碍的重要促成因素，但认知衰退与各种形式的神经感觉退化之间的关系仍知之甚少。本研究旨在通过认知评估来评估韩国普通人群中的视网膜层神经变性和听力障碍。
这项横断面回顾性研究纳入了接受光学相干断层扫描（OCT）、纯音听力测定（PTA）和简易精神状态检查表（MMSE）的参与者。根据MMSE评分将参与者分为三组：对照组（MMSE＞27）、轻度认知障碍组（MCI，MMSE 23 - 27）和痴呆组（MMSE＜23）。使用加权四频率平均公式（0.5kHz、1kHz、2kHz和4kHz）计算PTA阈值。分析OCT图像以测量神经节细胞内丛状层（GC - IPL）、视乳头周围视网膜神经纤维层（ppRNFL）和黄斑总厚度。在三组之间比较这些感觉参数。
共纳入196名参与者，平均年龄为67.0±10.4岁。MMSE评分与年龄和PTA阈值均呈负相关，与OCT参数呈正相关（所有P＜0.05）。在调整年龄后，观察到所有组之间PTA阈值存在显著差异。然而，与对照组和MCI组相比，仅在痴呆组中观察到OCT参数和最佳矫正视力有显著降低（所有P＜0.05）。
感觉评估是认知功能的可靠指标，与视网膜厚度测量相比，听力损失是早期功能衰退更一致和敏感的预测指标。认知障碍的晚期阶段与视网膜神经变性和视力损害密切相关，强调了仔细监测和早期干预的重要性。
