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Multicenter Study
. 2010 May;5(5):867-73.
doi: 10.2215/CJN.08271109. Epub 2010 Mar 18.

Prevalence of ocular fundus pathology in patients with chronic kidney disease

Juan E Grunwald  1 , Judith Alexander, Maureen Maguire, Revell Whittock, Candace Parker, Kathleen McWilliams, Joan C Lo, Raymond Townsend, Crystal A Gadegbeku, James P Lash, Jeffrey C Fink, Mahaboob Rahman, Harold Feldman, John Kusek, Akinlolu Ojo; CRIC Study Group
Affiliations
Multicenter Study

Prevalence of ocular fundus pathology in patients with chronic kidney disease

Juan E Grunwald et al. Clin J Am Soc Nephrol. 2010 May.

Abstract

Background and objectives: The objective of this study was to describe the prevalence of ocular fundus pathology in the Chronic Renal Insufficiency Cohort (CRIC) study, a multicenter, longitudinal study of individuals with varying stages of chronic kidney disease (CKD).

Design, setting, participants, & measurements: In this cross-sectional study, 45 degree digital photos of the disc and macula in both eyes were obtained by nonophthalmologic personnel using a nonmydriatic Canon CR-DGI fundus camera in 1936 individuals who participated in the CRIC study. Photographs were assessed in a masked manner by graders and a retinal specialist at a central photograph reading center. The purpose of this review was to inform participants quickly of conditions that warranted a complete eye examination by an ophthalmologist.

Results: Among the 1936 participants who were photographed, 1904 (98%) had assessable photographs in at least one eye. Eye pathologies that required a follow-up examination by an ophthalmologist were identified in 864 (45%) of these 1904 participants. These eye pathologies included, among others, retinopathy (diabetic and/or hypertensive), a finding that was observed in 482 (25%) of these 1904 participants. Three percent (65 participants) of the 1904 participants had serious eye conditions that required urgent follow-up and treatment. Lower estimated GFR and cardiovascular disease were associated with greater eye pathology. Estimated GFR <30 ml/min per 1.73 m(2) was associated with a three times higher risk for retinopathy.

Conclusions: We found a high prevalence of fundus pathology in participants with CKD. This finding supports recommendations for regular complete eye examinations in the CKD population.

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Figures

Figure 1.
Figure 1.
Typical example of an eye with proliferative diabetic retinopathy and high-risk characteristics for visual loss that needed prompt ocular care. This gray-scale image was converted from a color photograph and was enhanced by increasing the contrast and brightness to highlight the pathologic features.
See this image and copyright information in PMC

References

    1. Klein R, Klein BE: Vision disorders in diabetes. In: Diabetes in America, Bethesda, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 1995, pp 293– 338 NIH publication 95-1468
    1. Kofoed-Enevoldsen A, Jensen T, Borch-Johnsen K, Deckert T: Incidence of retinopathy in type I (insulin dependent) diabetes: Association with clinical nephropathy. J Diabet Complications 1: 96– 99, 1987 - PubMed
    1. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 329: 977– 986, 1993 - PubMed
    1. Chavers BM, Mauer SM, Ramsay RC, Steffes MW: Relationship between retinal and glomerular lesions in IDDM patients. Diabetes 43: 441– 446, 1994 - PubMed
    1. Klein R, Klein BE, Cruishanks KJ, Brazy PC: The 10-year incidence of renal insufficiency in people with type I diabetes. Diabetes Care 22: 743– 751, 1999 - PubMed

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