Abstract：
BACKGROUND: Several studies report mixed associations between the retinal nerve fiber layer (RNFL) thickness with cognitive and physical disability in persons with multiple sclerosis (PwMS). Systematic synthesis of these findings is crucial in deriving credible conclusions.
METHODS: Five databases were searched from their inception to March 2022. The inclusion criteria for studies were MS-specific and required RNFL and cognitive performance data in order to be analyzed. The selection processes followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
RESULTS: The systematic review yielded 31 studies that investigated the association between RNFL thickness and cognitive performance. Twenty-two studies reported positive associations, and nine did not. The meta-analysis included 11 studies with a total of 782 PwMS with mean age of 40.5 years, mean Expanded Disability Status Scale (EDSS) of 2.7, and disease duration of 11.3 years. RNFL thickness was significantly associated Symbol Digit Modalities Test (pooled r = 0.306, p < 0.001), Paced Auditory Serial Addition Test (pooled r = 0.374, p < 0.001) and Word List Generation (WLG, pooled r = 0.177, p < 0.001). RNFL was also significantly correlated with visuospatial learning and memory tests (pooled r = 0.148, p = 0.042) and verbal learning and memory tests (pooled r = 0.245, p = 0.005). Within three eligible studies, no significant association between ganglion cell inner-plexiform layer and SDMT 0.083 (95% CI - 0.186, 0.352) was noted. The heterogeneity was high in all correlation studies (I2 > 63% and p < 0.008) except for the WLG and visuospatial memory findings.
CONCLUSIONS: RNFL thickness is associated with cognitive processing speed, verbal learning and memory, visual learning and memory, as well as verbal fluency in PwMS. The number of studies included in the meta-analyses were limited due to non-standardized reporting.
METHODS: Five databases were searched from their inception to March 2022. The inclusion criteria for studies were MS-specific and required RNFL and cognitive performance data in order to be analyzed. The selection processes followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
RESULTS: The systematic review yielded 31 studies that investigated the association between RNFL thickness and cognitive performance. Twenty-two studies reported positive associations, and nine did not. The meta-analysis included 11 studies with a total of 782 PwMS with mean age of 40.5 years, mean Expanded Disability Status Scale (EDSS) of 2.7, and disease duration of 11.3 years. RNFL thickness was significantly associated Symbol Digit Modalities Test (pooled r = 0.306, p < 0.001), Paced Auditory Serial Addition Test (pooled r = 0.374, p < 0.001) and Word List Generation (WLG, pooled r = 0.177, p < 0.001). RNFL was also significantly correlated with visuospatial learning and memory tests (pooled r = 0.148, p = 0.042) and verbal learning and memory tests (pooled r = 0.245, p = 0.005). Within three eligible studies, no significant association between ganglion cell inner-plexiform layer and SDMT 0.083 (95% CI - 0.186, 0.352) was noted. The heterogeneity was high in all correlation studies (I2 > 63% and p < 0.008) except for the WLG and visuospatial memory findings.
CONCLUSIONS: RNFL thickness is associated with cognitive processing speed, verbal learning and memory, visual learning and memory, as well as verbal fluency in PwMS. The number of studies included in the meta-analyses were limited due to non-standardized reporting.
摘要：
背景：一些研究报告了多发性硬化症（PwMS）患者视网膜神经纤维层（RNFL）厚度与认知和身体残疾之间的混合关联。这些发现的系统综合对于得出可靠的结论至关重要。
方法：从成立到2022年3月搜索了五个数据库。研究的纳入标准是MS特异性的，需要RNFL和认知表现数据才能进行分析。选择过程遵循系统审查和荟萃分析（PRISMA）指南的首选报告项目。
结果：系统评价产生了31项研究，调查了RNFL厚度与认知表现之间的关联。22项研究报告了积极的关联，九个没有。荟萃分析包括11项研究，共782个PwMS，平均年龄为40.5岁，平均扩展残疾状态量表（EDSS）为2.7，病程为11.3年。RNFL厚度与符号数字模式测试显著相关(合并r=0.306,p<0.001),起搏听觉序列添加测试（合并r=0.374，p<0.001）和单词列表生成（WLG，合并r=0.177，p<0.001)。RNFL也与视觉空间学习和记忆测试（合并r=0.148，p=0.042）和口语学习和记忆测试（合并r=0.245，p=0.005）显着相关。在三项符合条件的研究中，神经节细胞内丛状层与SDMT0.083(95%CI-0.186,0.352)之间无显著关联.除WLG和视觉空间记忆发现外，所有相关研究中的异质性都很高（I2>63％和p<0.008）。
结论：RNFL厚度与认知加工速度有关，口头学习和记忆，视觉学习和记忆，以及PwMS中的言语流畅性。由于非标准化报告，纳入荟萃分析的研究数量有限。
方法：从成立到2022年3月搜索了五个数据库。
结果：系统评价产生了31项研究，调查了RNFL厚度与认知表现之间的关联。
结论：RNFL厚度与认知加工速度有关，
