[Comment on the article "Retinal ischemia as an early marker of renal failure in non-proliferative retinopathy"]

Regarding the article "Retinal ischemia as an early marker of renal failure in non-proliferative retinopathy" by Muñoz-Cornejo et al., retinal ischemia reflects microvascular damage, hyperglycemia causes endothelial damage, vascular occlusion, and the release of proangiogenic factors, which is linked with the presence of retinopathy and nephropathy. However, the study has limitations: it uses outdated terminology, it does not evaluate key renal markers, and it does not control for confounding factors. Although 25 (45%) of the patients with retinal ischemia had albuminuria, no correlation with renal deterioration was proven, and renal damage could precede ocular damage. More precise parameters are needed to establish this association.