Introduction We compared peripapillary retinal nerve fiber layer and macular thickness measurements in patients with mild cognitive impairment (MCI) and control subjects using swept‐source optical coherence tomography (SS‐OCT). We also assessed the relationship between SS‐OCT measurements and the severity of cognitive impairment. Methods Peripapillary retinal nerve fiber layer and macular thickness were measured in 23 patients and 24 control subjects using SS‐OCT. Cognitive status was assessed using the Mini‐Mental State Examination, the Montreal Cognitive Assessment, and the Pfeffer Questionnaire. Results Most inner retinal layer thickness parameters were significantly smaller in patients with MCI, especially macular ganglion cell complex thickness measurements. Mini‐Mental State Examination and Montreal Cognitive Assessment findings were significantly correlated with most macular thickness parameters. Discussion The SS‐OCT–measured inner retinal layers of patients with MCI displayed thinning, especially in the central macular area. SS‐OCT technology can provide useful information on ocular involvement patterns and holds promise as an ocular biomarker in this patient population.

PurposeTo determine the level of agreement between trained family physicians (FPs), general ophthalmologists (GOs), and a retinal specialist (RS) in the assessment of non-mydriatic fundus retinography in screening for diabetic retinopathy (DR) in the primary health-care setting.Methods200 Diabetic patients were submitted to two-field non-mydriatic digital fundus camera. The images were examined by four trained FPs, two GOs, and one RS with regard to the diagnosis and severity of DR and the diagnosis of macular edema. The RS served as gold standard. Reliability and accuracy were determined with the kappa test and diagnostic measures.ResultsA total of 397 eyes of 200 patients were included. The mean age was 55.1 (±11.7) years, and 182 (91%) had type 2 diabetes. The mean levels of serum glucose and glycosylated hemoglobin A1c were 195.6 (±87.3) mg/dL and 8.9% (±2.1), respectively. DR was diagnosed in 166 eyes by the RS and in 114 and 182 eyes by GO1 and GO2, respectively. For severity, DR was graded as proliferative in 8 eyes by the RS vs. 15 and 9 eyes by GO1 and GO2, respectively. The agreement between the RS and the GOs was substantial for both DR diagnosis (GO1 k = 0.65; GO2 k = 0.74) and severity (GO1 k = 0.60; GO2 k = 0.71), and fair or moderate for macular edema (GO1 k = 0.27; GO2 k = 0.43). FP1, FP2, FP3, and FP4 diagnosed DR in 108, 119, 163, and 117 eyes, respectively. The agreement between the RS and the FPs with regard to DR diagnosis was substantial (FP2 k = 0.69; FP3 k = 0.73; FP4 k = 0.71) or moderate (FP1 k = 0.56). As for DR severity, the agreement between the FPs and the RS was substantial (FP2 k = 0.66; FP3 k = 069; FP4 k = 0.64) or moderate (FP1 k = 0.51). Agreement between the FPs and the RS with regard to macular edema was fair (FP1 k = 0.33; FP2 k = 0.39; FP3 k = 0.37) or moderate (FP4 k = 0.51).ConclusionNon-mydriatic fundus retinography was shown to be useful in DR screening in the primary health-care setting. FPs made assessments with good levels of agreement with an RS. Non-mydriatic fundus retinography associated with appropriate general physicians training is essential for the DR screening.