PT - JOURNAL ARTICLE AU - Sean Mullany AU - Lewis Xiao AU - Ayub Qassim AU - Henry Marshall AU - Puya Gharahkhani AU - Stuart MacGregor AU - Mark M Hassall AU - Owen M Siggs AU - Emmanuelle Souzeau AU - Jamie E Craig TI - Normal-tension glaucoma is associated with cognitive impairment AID - 10.1136/bjophthalmol-2020-317461 DP - 2021 Feb 26 TA - British Journal of Ophthalmology PG - bjophthalmol-2020-317461 4099 - http://bjo.bmj.com/content/early/2021/02/25/bjophthalmol-2020-317461.short 4100 - http://bjo.bmj.com/content/early/2021/02/25/bjophthalmol-2020-317461.full AB - Background/aims Recent research suggests an association between normal-tension glaucoma (NTG) and dementia. This study investigated whether cognitive impairment is more strongly associated with NTG than high tension glaucoma (HTG) using cognitive screening within an Australiasian Glaucoma Disease Registry.Methods The authors completed a case–control cross-sectional cognitive screening involving 290 age-matched and sex-matched NTG participants and HTG controls aged ≥65 randomly sampled from the Australian and New Zealand Registry of Advanced Glaucoma. Cognitive screening was performed using the Telephone Version of the Montreal Cognitive Assessment (T-MoCA). The T-MoCA omits points requiring visual interpretation, accounting for confounding factors related to vision loss in visually impaired participants. Cognitive impairment was defined by a T-MoCA score of <11/22. Cognition was compared between NTG and HTG participants using predetermined thresholds and absolute screening scores.Results A total of 290 participants completed cognitive assessment. There were no differences in NTG (n=144) and HTG (n=146) cohort demographics or ocular parameters at baseline. Cognitive impairment was more prevalent in the NTG cohort than the HTG cohort (OR=2.2; 95% CI 1.1 to 6.7, p=0.030). Though a linear trend was also observed between lower absolute T-MoCA scores in the NTG cohort when compared with the HTG cohort, this association was not statistically significant (p=0.108).Conclusion This study demonstrated an association between NTG status and poor cognition, supporting the hypothesis that there exists a disease association and shared pathoaetiological features between NTG and dementia.