Accelerated Peripapillary Retinal Nerve Fiber Layer Degeneration in Patients With Chronic Kidney Disease: A 2-Year Longitudinal Study

Yeung, Ling; Wu, I‐Wen; Liu, Chunfu; Lin, Yu-Tze; Lee, Chin‐Chan; Sun, Chi‐Chin

doi:10.1167/tvst.11.12.10

Cited by 4 publications

(3 citation statements)

References 60 publications

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“…Furthermore, it should be kept in mind that in HD patients with CKD, episodes of intradialytic hypotension and hypertension may also cause endothelial dysfunction and an increase in arterial stiffness. Moreover, CKD often involves increased inflammation and oxidative stress, dysregulation of the renin-angiotensin system and the presence of uraemic toxins, which may exacerbate neuroinflammation, increase free radical formation, and cause vascular dysfunction [32]. HD itself also increases inflammation state [33].…”

Section: Discussionmentioning

confidence: 99%

The Impact of a Single Haemodialysis Session on the Retinal Thickness and Optic Nerve Morphology

Roskal-Wałek,

Gołębiewska,

Mackiewicz

et al. 2024

Diagnostics

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Background: The aim of the study was to assess the influence of a single haemodialysis (HD) session on the retinal and optic nerve morphology in end-stage kidney disease (ESKD) patients. Methods: It is a prospective study including only the right eye of 35 chronic kidney disease (CKD) patients subjected to HD. Each patient underwent a full eye examination 30 min before HD (8 a.m.) and 15 min after HD. Optical coherence tomography (OCT) was used to assess the peripapillary retinal nerve fibre layer (pRNFL) thickness, macular nerve fibre layer (mRNFL) thickness, ganglion cell layer with inner plexiform layer thickness (GCL+), GCL++ (mRNFL and GCL+) thickness, total retinal thickness (RT) and total macular volume (TMV). The correlation was tested between such systemic parameters changes as systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), body weight, plasma osmolarity and ocular perfusion pressure (OPP) and ultrafiltration volume with total RT and pRNFL thickness changes during HD. Results: In the results of a single HD session, we could observe a statistically significant increase in the total RT thickness (pre-HD 270.4 ± 19.94 μm, post-HD 272.14 ± 20.11 μm; p = 0.0014), TMV (pre-HD 7.48 ± 0.53 mm3, post-HD 7.52 ± 0.55 mm3; p = 0.0006), total pRNFL thickness (pre-HD 97.46 ± 15.71 μm, post-HD 100.23 ± 14.7 μm; p = 0.0039), total GCL+ thickness (pre-HD 70.11 ± 9.24 μm, post-HD 70.6 ± 9.7 μm; p = 0.0044), and GCL++ thickness (pre-HD 97.46 ± 12.56 μm, post-HD 97.9 ± 12.94 μm; p = 0.0081). We observed a significant correlation between the change in total RT and DBP change, as well as between body weight change and the change in total pRNFL thickness. There was also a correlation between total pRNFL thickness change and the presence of diabetes mellitus. Conclusion: Even a single HD session affects the retinal and pRNFL thickness, which should be taken into account when interpreting the OCT results in patients subjected to HD. The impact of changes after a single HD session on selected parameters requires further assessment in subsequent studies, including long-term observation.

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Section: Discussionmentioning

confidence: 99%

The Impact of a Single Haemodialysis Session on the Retinal Thickness and Optic Nerve Morphology

Roskal-Wałek,

Gołębiewska,

Mackiewicz

et al. 2024

Diagnostics

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“…Одним из наиболее известных офтальмологических проявлений уремии является альбуминурическая ретинопатия, описанная Гельмгольцем, которая характеризуется кровоизлияниями глазного дна, двусторонней отслойкой сетчатки, типичными ватообразными очагами и образованием «фигуры звезды» в области желтого пятна. Развитие технологий гемодиализа привело к тому, что при своевременном лечении указанные выше офтальмологические проявления в классической форме уже не наблюдаются, хотя эта тенденция не отражена в современной литературе [2,5].…”

Section:  введениеunclassified

Dynamic of pRNFL Thickness in Patients with End-Stage Chronic Kidney Disease

Юсупов,

Мавлянова,

Махкамова

2024

Офтальмология. Восточная Европа

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Цель. Определение степени нейродегенеративных процессов в сетчатке путем оценки динамики снижения толщины pRNFL у пациентов с терминальной стадией хронической почечной недостаточности (ХПН) недиабетического генеза, получающих гемодиализ. Материалы и методы. Исследование степени нейродегенерации в сетчатке проводилось на основании динамики снижения толщины pRNFL в течение 2-летнего периода наблюдения у пациентов с терминальной стадией ХПН, которые регулярно получали гемодиализ. На основании критериев отбора была сформирована выборка из 81 пациента (162 глаза). В качестве контрольной группы была также отобрана однородная по полу и возрасту выборка из 30 здоровых лиц (60 глаз). Исследование проводилось на устройстве DRI OCT Triton и включало расчет коэффициента регрессии (B), доверительного интервала (Cl), а также определение коэффициента линейной регрессии для выявления значимости факторов, влияющих на степень истончения pRNFL у пациентов. Результаты. В группе пациентов с терминальной стадией ХПН в течение 2-летнего периода наблюдения отмечалось статистически достоверное (p<0,05) снижение показателя толщины pRNFL, которое было подтверждено результатами расчета показателей коэффициента регрессии (B) и доверительного интервала (Cl). Наиболее выраженное истончение слоя pRNFL было выявлено в верхнем и нижнем назальных секторах, а также в нижне-темпоральном секторе у пациентов с терминальной стадией ХПН. Наиболее значимым фактором, влияющим на динамику снижения толщины pRNFL у пациентов основной группы, являлся показатель скорости клубочковой фильтрации (СКФ), главным образом характеризующий тяжесть ХПН. Заключение. У пациентов с терминальной стадией ХПН недиабетического генеза, получающих гемодиализ, имел место значительно ускоренный темп снижения толщины pRNFL по сравнению со здоровыми пациентами контрольной группы. Наличие у пациентов тяжелой формы ХПН, выражавшейся в сниженном показателе СКФ, обусловило более быстрое снижение толщины pRNFL. Purpose. Assessment of the degree of neurodegenerative processes in the retina by evaluating the dynamics of peripapillary retinal nerve fiber layer (pRNFL) thickness in patients with end-stage non-diabetic chronic kidney disease (CKD) undergoing hemodialysis. Materials and Methods. The study of neurodegeneration in the retina was based on the dynamics of peripapillary retinal nerve fiber layer (pRNFL) thickness over a 2-year observation period in patients with end-stage CKD regularly undergoing hemodialysis. A sample of 81 patients (162 eyes) was selected based on inclusion criteria, and a control group of 30 healthy individuals (60 eyes) matched for gender and age was also chosen. The study was conducted using the DRI OCT Triton device (Topcon). The investigation included the calculation of the regression coefficient (B), confidence interval (CI), and determination of the linear regression coefficient to assess the significance of factors influencing the degree of pRNFL thinning in patients. Results. In the group of patients with end-stage CKD, a statistically significant (p<0.05) decrease in pRNFL thickness was observed over the 2-year observation period, as confirmed by the results of the regression coefficient (B) and confidence interval (CI) calculations. The most pronounced thinning of the pRNFL layer was identified in the upper and lower nasal sectors, as well as the lower temporal sector in patients with end- stage CKD. The most significant factor influencing the pRNFL dynamics in the main group was the glomerular filtration rate (GFR), primarily indicative of the severity of CKD. Conclusion. Non-diabetic patients with end-stage CKD undergoing hemodialysis experienced a significantly faster rate of pRNFL loss compared to healthy individuals in the control group. The presence of more severe CKD, reflected in a lower GFR, was associated with a more rapid loss of pRNFL in CKD patients.

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“…In a study of patients with CKD but without DM, the pRNFL and macular thickness were found significantly lowered compared with the healthy population [23]. More recently, it was reported that patients with CKD experienced faster pRNFL loss compared with healthy controls, and the loss of the pRNFL was associated with the severity of CKD and HT [24]. Balmforth et al found that chorioretinal thinning in CKD is associated with lower eGFR and greater proteinuria [25].…”

Section: Introductionmentioning

confidence: 99%

Looking into the Eyes to See the Heart of Chronic Kidney Disease Patients

Kislikova,

Gaitán-Valdizán,

Parra Blanco

et al. 2024

Life

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In patients with chronic kidney disease (CKD), the main cause of morbidity and mortality is cardiovascular disease (CVD). Both coronary artery calcium scoring by computed tomography (CT) and optical coherence tomography (OCT) are used to identify patients at increased risk for ischemic heart disease, thereby indicating a higher cardiovascular risk profile. Our study aimed to investigate the utility of these techniques in the CKD population. In patients with CKD, OCT was used to measure the choroidal thickness (CHT) and the thickness of the peripapillary retinal nerve fiber layer (pRNFL). A total of 127 patients were included, including 70 men (55%) with an estimated glomerular filtration rate (eGFR) of 39 ± 30 mL/min/1.73 m2. Lower pRNFL thickness was found to be related to high-sensitivity troponin I (r = −0.362, p < 0.001) and total coronary calcification (r = −0.194, p = 0.032). In a multivariate analysis, pRNFL measurements remained associated with age (β = −0.189; −0.739–−0.027; p = 0.035) and high-sensitivity troponin I (β = −0.301; −0.259–−0.071; p < 0.001). Severe coronary calcification (Agatston score ≥ 400 HU) was related to a worse eGFR (p = 0.008), a higher grade of CKD (p = 0.036), and a thinner pRNFL (p = 0.011). The ROC curve confirmed that the pRNFL measurement could determine the patients with an Agatston score of ≥400 HU (AUC 0.638; 95% CI 0.525–0.750; p = 0.015). Our study concludes that measurement of pRNFL thickness using OCT is related to the markers associated with ischemic heart disease, such as coronary calcification and high-sensitivity troponin I, in the CKD population.

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Accelerated Peripapillary Retinal Nerve Fiber Layer Degeneration in Patients With Chronic Kidney Disease: A 2-Year Longitudinal Study

Cited by 4 publications

References 60 publications

The Impact of a Single Haemodialysis Session on the Retinal Thickness and Optic Nerve Morphology

The Impact of a Single Haemodialysis Session on the Retinal Thickness and Optic Nerve Morphology

Dynamic of pRNFL Thickness in Patients with End-Stage Chronic Kidney Disease

Looking into the Eyes to See the Heart of Chronic Kidney Disease Patients

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