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In Vivo Visualization and Quantification of Optic Disc Microvasculature for Assessing Renal Dysfunction
Xiao Guo1, Zhuoting Zhu2, Weijing Cheng1
1State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
Microvasculature changes in the optic disc are linked to kidney function decline in diabetes patients without retinopathy. Lower vessel density in the optic nerve head indicates poorer kidney health, highlighting a potential early marker for diabetic kidney disease.
Area of Science:
- Ophthalmology
- Nephrology
- Diabetology
Background:
- Diabetic retinopathy (DR) is a common complication of diabetes mellitus.
- Renal dysfunction is another significant complication, often developing silently.
- The relationship between optic disc microvasculature and renal function in diabetes without DR is not well-established.
Purpose of the Study:
- To investigate the association between optic disc microvasculature and renal function.
- To explore potential early biomarkers for diabetic kidney disease (DKD) in the optic nerve head.
Main Methods:
- A prospective, cross-sectional study involving 1629 patients with type 2 diabetes mellitus without DR.
- Optical Coherence Tomography Angiography (OCTA) was used to assess microcirculation parameters: peripapillary vessel density (PVD) in radial peripapillary capillaries (RPC), superficial capillary plexus, deep capillary plexus (DCP), and choriocapillaris flow void density percentage (CC FVD%).
- Renal function was evaluated using microalbuminuria (MAU) and estimated glomerular filtration rate (eGFR).
Main Results:
- Subjects with chronic kidney disease (CKD) exhibited significantly lower PVD compared to non-CKD participants.
- Higher eGFR was significantly associated with increased PVD in RPC, superficial capillary plexus, and DCP, and decreased CC FVD%.
- Microvascular parameters in the RPC, DCP, and CC FVD% were significantly associated with MAU.
Conclusions:
- Reduced microcirculation in the optic nerve head is independently associated with renal dysfunction in diabetic patients without DR.
- Optic disc microvasculature may serve as a potential indicator of kidney health in diabetes.
- Further longitudinal studies are warranted to understand peripapillary vessel changes during CKD progression.
