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Retinal neurovascular changes in chronic kidney disease
I-Wen Wu1,2,3, Chi-Chin Sun1,4,5, Chin-Chan Lee1,2
1College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Acta Ophthalmologica
|March 20, 2020
Summary
Chronic kidney disease (CKD) is linked to significant retinal neural and neurovascular changes. These include reduced macular thickness and nerve fiber layer, associated with CKD severity and parafoveal microvascular rarefaction.
Area of Science:
- Ophthalmology
- Nephrology
- Medical Imaging
Background:
- Chronic kidney disease (CKD) affects systemic health, potentially impacting ocular structures.
- Retinal neurovascular integrity is crucial for vision and can reflect systemic vascular conditions.
Purpose of the Study:
- To investigate neurovascular alterations in the retina of patients with chronic kidney disease (CKD).
Main Methods:
- A case-control study involving 171 CKD patients and 40 controls.
- Optical coherence tomography (OCT) and OCT angiography were used to measure retinal neural parameters (e.g., PfRT, GCCt, RNFLt) and microvascular parameters (e.g., SVP-VD, DVP-VD).
Main Results:
- CKD patients exhibited reduced parafoveal retinal thickness (PfRT), macular ganglion cell complex thickness (GCCt), and peripapillary retinal nerve fiber layer thickness (RNFLt).
- CKD patients also showed increased global loss volume (GLV) and focal loss volume (FLV).
- Retinal parameters were significantly associated with estimated glomerular filtration rate and correlated with superficial vascular plexus vessel density (SVP-VD).
Conclusions:
- Patients with CKD demonstrate significant reductions in macular thickness and alterations in retinal neural parameters.
- These retinal changes are linked to CKD severity and microvascular rarefaction within the superficial parafoveal vascular plexus.
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