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. 2020 Jun;74(3):191-194.
doi: 10.5455/medarh.2020.74.191-194.

Assessment of Retinal Microangiopathy in Chronic Kidney Disease Patients

Aida Kasumovic  1 , Ines Matoc  1 , Damir Rebic  2 , Nesina Avdagic  3 , Tarik Halimic  1
Affiliations

Assessment of Retinal Microangiopathy in Chronic Kidney Disease Patients

Aida Kasumovic et al. Med Arch. 2020 Jun.

Abstract

Introduction: Optical coherence tomography angiography (OCT-A) is a useful diagnostic tool for assessing eyes' health in patients with chronic diseases, such as diabetes, hypertension, Parkinson's disease and chronic kidney disease (CKD).

Aim: To detect changes in macular structure and retinal vascular meshwork in the macular area and peripapillary in patients with chronic kidney disease (CKD).

Methods: This cross-sectional study included 80 eyes of patients with CKD in stages 2, 3 or 4, who were followed-up in the Nephrology Clinic of University Clinical Center Sarajevo. All patients were categorized according to the stage of CKD. All patients were scanned by a high-speed 840-nm-wavelength spectral-domain optical coherence tomography instrument (RTVue XR Avanti; Optovue, Inc, Fremont, California, USA). Blood flow was detected using a split-spectrum amplitude-decorrelation angiography algorithm. A fully automated microstructural analysis of the foveal avascular zone (FAZ), FAZ perimeter, foveal vessel density in a 300-μm area around the FAZ (FD), nonflow area, flow index in superficial and deep vascular plexus, choriocapillary flow, vascular density, radial peripapillary capillary density was performed.

Results: When comparing patients with CKD stage 2 and stage 3 there were no statistically significant changes in microvascular parameters on OCT angiography, as well as when comparing patients with CKD stage 3 and stage 4. But in the comparison between patients with less developed CKD (stage 2) and terminal CKD (stage 4) there was a significant difference between some microvascular parameters such as FAZ area, FAZ perimeter, choriocapillary flow.

Conclusion: Many studies demonstrated that evaluation of the microvascular changes in different retinal layers using SS-OCTA may be considered as a key to assessing the systemic perfusion status. Evaluation of retinal microvasculature may ease the management and approach of patients with CKD, having in mind that the retinal and the kidney vascular network are, concerning structure, development and the function, very similar.

Keywords: chronic kidney disease; microangiopathy; optical coherence tomography angiography; retinal angiopathy.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1.
Figure 1.. Foveal avascular zone area in chronic kidney disease patients
Figure 2.
Figure 2.
Figure 3.
Figure 3.. Choriocapillary flow area (3x3 mm) in chronic kidney disease patients
Figure 4.
Figure 4.. Retinal peripapillary capillary density – superior quadrant in chronic kidney disease patients
Figure 5.
Figure 5.. Retinal peripapillary capillary density – inferior quadrant in chronic kidney disease patients
See this image and copyright information in PMC

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