A CLINICAL STUDY OF RETINAL GANGLION CELL LAYER AND RETINAL NERVE FIBER LAYER CHANGES IN COGNITIVE DYSFUNCTION IN ELDERLY PATIENTS ATTENDING PSYCHIATRY OPD IN A TERTIARY HOSPITAL IN NORTHEAST BIHAR

Abstract

Objective: The objective of this study was to study and compare retinal nerve fiber layer (RNFL) changes and retinal ganglion cell layer (GCL) changes in different quadrants of the eye in elderly patients (60 years or more) with cognitive impairment. Methods: Study conducted in the Department of Ophthalmology and Psychiatry in M.G.M. Medical College and L.S.K. Hospital Kishanganj, Bihar. It was a cross-sectional study. Random sampling among elderly patients with cognitive impairment attending Psychiatry OPD. A total 50 patients (32 cases+18 control). Thirty-two cases with mild cognitive impairment (MCI) having mini-mental state examination (MMSE) score <24 and 12 controls with normal cognition (NC) having MMSE score >30 were enrolled in this study. Mini-mental status examination and montreal cognitive assessment-for selection of cognitive impairment patients. Optical coherence tomography (OCT) to compare changes in the retinal GCL and RNFL in different eye quadrants. Results: The observation of the present study reveals mean thickness of the GCL and the inner plexiform layer (IPL) was significantly higher among healthy controls in both right and left eyes compared to the case group (p=0.05 and 0.008, respectively). The comparison of GCL and IPL thickness in the inferior temporal quadrant between case and control group. The observation of the present study reveals that the mean thickness of the GCL and IPL in the inferior temporal quadrant was comparable between healthy controls and the case group in the right eyes (p=0.606), and it was significantly higher among healthy controls compared to case group in the left eyes (p=0.05). Conclusion: As a result, it is recommended that all patients over the age of 60 have a routine retinal evaluation with OCT to detect early neurodegenerative alterations for the early diagnosis and management. According to our study, the sensitivity of GCL+IPL to distinguish MCI from controls was often higher than that of RNFL.