# Thinner inner retinal layers are associated with lower cognitive performance, lower brain volume, and altered white matter network structure—The Maastricht Study

## TL;DR

Thinner retinal layers are linked to worse cognitive performance and brain structure changes, suggesting the retina could serve as a biomarker for dementia.

## Contribution

This study identifies retinal layer thickness as a potential non-invasive biomarker for cerebral neurodegeneration.

## Key findings

- Lower retinal layer thickness is associated with worse cognitive performance.
- Thinner retinal layers correlate with reduced brain volume and altered white matter network structure.
- These associations remain significant after adjusting for confounding factors.

## Abstract

The retina may provide non‐invasive, scalable biomarkers for monitoring cerebral neurodegeneration.

We used cross‐sectional data from The Maastricht study (n = 3436; mean age 59.3 years; 48% men; and 21% with type 2 diabetes [the latter oversampled by design]). We evaluated associations of retinal nerve fiber layer, ganglion cell layer, and inner plexiform layer thicknesses with cognitive performance and magnetic resonance imaging indices (global grey and white matter volume, hippocampal volume, whole brain node degree, global efficiency, clustering coefficient, and local efficiency).

After adjustment, lower thicknesses of most inner retinal layers were significantly associated with worse cognitive performance, lower grey and white matter volume, lower hippocampal volume, and worse brain white matter network structure assessed from lower whole brain node degree, lower global efficiency, higher clustering coefficient, and higher local efficiency.

The retina may provide biomarkers that are informative of cerebral neurodegenerative changes in the pathobiology of dementia.