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. 2023 Feb 9;23(1):55.
doi: 10.1186/s12886-023-02802-x.

Association of chorioretinal thickness with chronic kidney disease

Ahmed Ibrahim Basiony  1 , Sherry Nissem Atta  2 , Noha Mohamed Dewidar  3 , Adel Galal Zaky  4
Affiliations

Association of chorioretinal thickness with chronic kidney disease

Ahmed Ibrahim Basiony et al. BMC Ophthalmol. .

Abstract

Objective: To assess retinal and choroidal thickness changes in chronic kidney disease (CKD) patients using spectral domain optical coherence tomography (SD-OCT).

Background: CKD is a devastating health trouble. The eye and the kidney share similar structural and genetic pathways, so that kidney disease and ocular disease may be closely linked. OCT is a precise, fast method for high-definition scanning of the retina and choroid.

Patients and methods: A cross sectional study was conducted at Menoufia University Hospital ophthalmology department on 144 eyes of 72 CKD patients divided into 3 groups according to the stage of CKD as follows: group 1: CKD stage 1-2, with Glomerular Filtration Rate (GFR) > 60 ml/min/1.73m2 group 2: CKD stage 3, GFR 30-59 ml/min/1.73m2 and group 3: CKD stage 4-5, eGFR < 29 ml/min/1.73m2. All patients underwent full ophthalmologic examination followed by OCT assessment of retinal, retinal nerve fiber layer (RNFL) and choroidal thickness.

Results: Retinal and choroidal thickness were reduced in group 2 (CKD stage 3) and group 3 (CKD stage 4-5) compared with group 1 (CKD stage 1-2). The reduction was more severe in group 3 than group 2. RNFL thickness did not differ between groups. A thinner retina and choroid were associated with an elevated serum C-reactive protein (CRP) concentration, and greater degrees of proteinuria.

Conclusion: Chorioretinal thinning in CKD is associated with a lower eGFR, a higher CRP, and greater proteinuria. Further studies, in a large scale of patients, are needed to detect whether these eye changes reflect the natural history of CKD.

Keywords: Choroid; Chronic kidney disease; Optical coherence tomography; Retina; Retinal nerve fiber layer.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
This figure shows the chorioretinal structures En face (left images) and as a cross section (right images). The Early Treatment Diabetic Retinopathy Study map divides the macula into 9 subfields. A circular grid is centered over the fovea and consists of 3 concentric rings of diameters 1, 3, and 6 mm, respectively. A The inner and outer rings are further divided into quadrants: temporal, nasal, superior, and inferior (left). Retinal thickness was defined as the area between the internal limiting membrane (ILM) and the inner boundary of retinal pigment epithelium (RPE) (right). B Retinal nerve fiber layer thickness was defined as the area bordered in red. C Choroidal thickness was measured as the perpendicular distance between hyperreflective outer border of the retinal pigment epithelium bruch’s membrane layer and the sclera-choroidal interface
Fig. 2
Fig. 2
Relation between CRP and choroidal thickness and macular thickness (n = 144). CT = Choroidal thickness - MT = Macular thickness
Fig. 3
Fig. 3
Relation between albuminuria and choroidal thickness and macular thickness (n = 144)
See this image and copyright information in PMC

References

    1. Paterson EN, Meera ML, Griffiths K, Le Velly CA, Cardwell CC, Rachel V, et al. Association of reduced inner retinal thickness with chronic kidney disease. BMC Nephrol. 2020;21(1):37. doi: 10.1186/s12882-019-1679-1. - DOI - PMC - PubMed
    1. National kidney foundation K / DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am J Kidney Dis. 2002;39(Suppl 1):S1–266. - PubMed
    1. Kramann R, Humphreys BD. Kidney Pericytes: roles in regeneration and fibrosis. Semin Nephrol. 2014;34(4):374–383. doi: 10.1016/j.semnephrol.2014.06.004. - DOI - PMC - PubMed
    1. Balmforth C, van Bragt JJMH, Ruijs T, Cameron JR, Kimmitt R, Moorhouse R, et al. Chorioretinal thinning in chronic kidney disease links to inflammation and endothelial dysfunction. JCI Insight. 2016;1(20):e89173. doi: 10.1172/jci.insight.89173. - DOI - PMC - PubMed
    1. Leitgeb RA, Werkmeister RM, Blatter C, Schmetterer L. Doppler optical coherence tomography. Prog Retin Eye Res. 2014;41:26–43. doi: 10.1016/j.preteyeres.2014.03.004. - DOI - PMC - PubMed