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Yet, little is known on the relation of these layers with specific brain regions. Using voxel\u2010based analysis, we aimed to unravel specific brain regions associated with these retinal layers. We included 2,235 persons (mean age: 67.3\u2009years, 55% women) from the Rotterdam Study (2007\u20132012) who had gradable retinal OCT images and brain magnetic resonance imaging (MRI) scans, including diffusion tensor (DT) imaging. Thicknesses of peripapillary RNFL and perimacular GCL were measured using an automated segmentation algorithm. Voxel\u2010based morphometry protocols were applied to process DT\u2010MRI data. We investigated the association between retinal layer thickness with voxel\u2010wise gray matter density and white matter microstructure by performing linear regression models. We found that thinner RNFL and GCL were associated with lower gray matter density in the visual cortex, and with lower fractional anisotropy and higher mean diffusivity in white matter tracts that are part of the optic radiation. Furthermore, thinner GCL was associated with lower gray matter density of the thalamus. Thinner RNFL and GCL are associated with gray and white matter changes in the visual pathway suggesting that retinal thinning on OCT may be specifically associated with changes in the visual pathway rather than with changes in the global brain. These findings may serve as a basis for understanding visual symptoms in elderly patients, patients with Alzheimer's disease, or patients with posterior cortical atrophy.<\/jats:p>","DOI":"10.1002\/hbm.24246","type":"journal-article","created":{"date-parts":[[2018,6,23]],"date-time":"2018-06-23T10:25:35Z","timestamp":1529749535000},"page":"4290-4301","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Thinner retinal layers are associated with changes in the visual pathway: A population\u2010based study"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5497-0545","authenticated-orcid":false,"given":"Unal","family":"Mutlu","sequence":"first","affiliation":[{"name":"Department of Epidemiology Erasmus University Medical Center Rotterdam the Netherlands"},{"name":"Department of Ophthalmology Erasmus University Medical Center Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad K.","family":"Ikram","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Erasmus University Medical Center Rotterdam the Netherlands"},{"name":"Department of Neurology Erasmus University Medical Center Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gennady V.","family":"Roshchupkin","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine Erasmus University Medical Center Rotterdam the Netherlands"},{"name":"Department of Medical Informatics Erasmus University Medical Center Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter W. 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