Background and Objectives: Dementia is an essential neurodegenerative disease with
pathologic changes in the central nervous system, but also the retina. To evaluate
the diagnostic performance of Spectralis optical coherence tomography (OCT) parameters
for mild cognitive impairment (MCI) and mild dementia in an Asian population
from Taiwan. Methods: This retrospective cross-sectional study evaluated 43 patients
with MCI (mean deviation [MD]: −5.05 ± 4.25 dB), 13 patients with mild dementia
(MD: −9.03 ± 6.66 dB), and 32 healthy controls (MD: −2.50 ± 2.12 dB). OCT was performed
on both eyes of each subject. The diagnostic sensitivity in identifying individuals
with cognitive impairment of the Spectralis OCT parameters—such as those of the optic
nerve head and macula—was compared across these groups. The area under the receiver
operating characteristic curve (AUC) for each parameter was calculated to assess its sensitivity
in differentiating between healthy eyes and those of individuals with MCI or mild
dementia. Results: Among the parameters evaluated, the Bruch’s membrane opening
minimum rim width (BMO-MRW) nasal inferior region (ACU = 0.720) was the optimal
parameter for distinguishing individuals with MCI from healthy controls. However, the
highest AUC of 0.861 was achieved through a combination of five parameters. In distinguishing
individuals with mild dementia from healthy controls, the BMO-MRW temporal
superior region (ACU = 0.764) was the optimal parameter, with an AUC of 0.940 after
adjusting for age and MD. Moreover, the condition of the macular nerve fiber layer outer
inferior parameter moderately predicted disease progression (AUC = 0.713). Conclusions:
Our preliminary data demonstrate that Spectralis OCT shows potential in detecting MCI
and mild dementia as well as for assessing disease progression in a Taiwanese population.
Additional large-scale longitudinal and multiracial studies are essential to validate
these findings.
