March 18, 2012

Eye Disease May Give Clues of Brain Decline

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Joseph V. Madia, MD By:

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Retinopathy tied to cognitive decline and vascular changes in the brain

(dailyRx News) An eye exam can do far more than screen for potential vision problems. It also can give doctors a view into the body's vascular system, and it may even be able to pinpoint patients more likely to suffer cognitive decline.

University of California, San Francisco researchers have found that older women with even a mild form of retinopathy are more likely to to experience cognitive decline related to vascular changes.

Catching it early might enable doctors to stop its progression to dementia. Retinopathy is a progressive disease of blood vessels in the eye's retina, usually caused by type 2 diabetes or high blood pressure.

"Don't skip regular vision examinations."

Mary Haan, lead researcher and a University of California, San Francisco professor of epidemiology and biostatistics, found that while the women with retinopathy who participated in the study had more damage to blood vessels in their brains, brain atrophy, which is typically associated with Alzheimer's disease, was not present.

"The eye is truly a unique organ. It is the only place we can directly observe both neurologic and vascular tissue and many conditions can be detected even before other symptoms occur," said Dr. Christopher Quinn, an optometrist with Omni Eye Associates.

"These conditions, however, are not likely to be detected by a screening but by a comprehensive eye exam. In many cases, the visual acuity (clarity of vision) may be normal but manifestations of systemic disease will be revealed during the eye examination."

Researchers followed 511 women for ten years. The women were an average age of 69 at the beginning of the study, which was based on data from the Women’s Health Initiative Memory Study and the Site Examination study, two ancillary studies of the Women’s Health Initiative Clinical Trial of Hormone Therapy.

The women participated in a cognition test to check short-term memory and thinking each year. During the fourth year, they received an exam to assess eye health, and they underwent a brain scan during the study's eighth year.

Of the women, 7.6 percent were diagnosed with retinopathy. These women scored worse on average on the cognition and memory test as compared to women who did not have the eye disease.

In addition to the damage to blood vessels in the brain, those with retinopathy had 47 percent more ischemic lesions, or holes, in the vasculature overall and 68 percent more lesions in the parietal lobe. The lesions, believed to be caused by hypertension, are associated with vascular disease and sometimes stroke. Women with retinopathy also had more thickening of the white matter tracks that transmit signals in the brain.

The study was published in the March 14 issue of journal Neurology.

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Reviewed by: 
Joseph V. Madia, MD
Review Date: 
March 16, 2012

Last Updated:
March 18, 2012