Individuals with and without normal tension glaucoma exhibit comparable performance on tests of cognitive function
Authors:   Department of Ophthalmology, University of California San Francisco, San Francisco, California 94143, USA; University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA, Cui Qi N. , Jethi Mohit ,   Department of Ophthalmology, University of California San Francisco, San Francisco, California 94143, USA, Driver Todd ,   Department of Ophthalmology, University of California San Francisco, San Francisco, California 94143, USA, Porco Travis C. ,   Department of Ophthalmology, University of California San Francisco, San Francisco, California 94143, USA; Francis I. Proctor Foundation, University of California San Francisco, San Francisco, California 94143, USA, Kuo Jane ,   Department of Ophthalmology, University of California San Francisco, San Francisco, California 94143, USA, Lin Shan C. ,   Department of Ophthalmology, University of California San Francisco, San Francisco, California 94143, USA; Glaucoma Center of San Francisco, San Francisco, California 94105, USA, Stamper Robert L. ,   Department of Ophthalmology, University of California San Francisco, San Francisco, California 94143, USA, Han Ying ,   Department of Ophthalmology, University of California San Francisco, San Francisco, California 94143, USA, Chiu Cynthia S. ,   Department of Ophthalmology, University of California San Francisco, San Francisco, California 94143, USA, Ramanathan Saras ,   Department of Ophthalmology, University of California San Francisco, San Francisco, California 94143, USA, Ward Michael E. ,   Department of Neurology, University of California San Francisco, San Francisco, California 94143, USA; Neurogenetics Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA, Possin Katherine ,   Department of Neurology, University of California San Francisco, San Francisco, California 94143, USA, Ou Yvonne ,   Department of Ophthalmology, University of California San Francisco, San Francisco, California 94143, USA
Published: October 2021

AIM: To evaluate aspects of cognition impacted by individuals with and without normal tension glaucoma.
METHODS: Fifty normal tension glaucoma (NTG) and 50 control patients ≥50y of age were recruited from the UCSF Department of Ophthalmology. Demographic data and glaucoma parameters were extracted from electronic medical records for both groups. Tests of executive function [Executive Abilities: Measures and Instruments for Neurobehavioral Evaluation and Research (EXAMINER)] and learning and memory [California Verbal Learning Test–Second Edition (CVLT-II)] were administered to both NTG and controls. Race, handedness, best-corrected visual acuity, maximum intraocular pressure, optic nerve cup-to-disc ratio, visual field and optic nerve optical coherence tomography parameters, and a measure of general health (Charlson Comorbidity Index) were compared between NTG and controls as well as within NTG subgroups. Multivariate linear regression was used to compare group performances on the EXAMINER battery and CVLT-II while controlling for age, sex, and years of education.
RESULTS: NTG and controls were comparable with respect to age, sex, race, education, handedness, and the Charlson Comorbidity Index (P>0.05 for all). Performance on the EXAMINER composite score and the CVLT-II did not differ between NTG and controls (P>0.05 for both).
CONCLUSION: This is the first prospective study in which the cognitive function of subject with NTG were evaluated using a comprehensive, computerized neurocognitive battery. Subjects with NTG do not perform worse than unaffected controls on tests of executive function, learning, and memory. Results do not support the hypothesis that individuals with NTG are at higher risk for cognitive dysfunction and/or dementia.