Retinal Neurovascular Impairment in Non-diabetic and Non-dialytic Chronic Kidney Disease Patients

Zeng, Xiaomin; Hu, Yijun; Chen, Yuanhan; Lin, Zhanjie; Liang, Yingying; Zhong, Pingting; Xiao, Yu; Liu, Cong; Wu, Guanrong; Kong, Huiqian; Du, Zijing; Ren, Yun; Fang, Ying; Ye, Zhiming; Yang, Xiaohong; Yu, Honghua

doi:10.3389/fnins.2021.703898

Cited by 10 publications

(7 citation statements)

References 43 publications

(63 reference statements)

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“…Microvascular injury and choroidal thinning in CKD patients may compromise the blood supply to the retinal neural tissue resulting in retinal atrophy [ 39 , 41 , 42 ]. This is supported by observations of decreased retinal vessel density, parafoveal retinal thickness and macular ganglion cell-inner plexiform layer thickness among patients with CKD [ 43 – 45 ].…”

Section: Discussionsupporting

confidence: 60%

Comparison of peripapillary retinal nerve fiber layer and macular thickness in non-diabetic chronic kidney disease and controls

et al. 2022

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Objective This study aimed to compare the peripapillary retinal nerve fiber layer (pRNFL) thickness and macular thickness (MT) between patients with non-diabetic chronic kidney disease (NDCKD) and controls, as well as between different stages of NDCKD. We also evaluated the correlation between pRNFL thickness and MT with duration of NDCKD. Methods This was a comparative cross-sectional study. Subjects were divided into NDCKD and control groups. Both pRNFL thickness and MT, including center subfield thickness (CST), average MT as well as average ganglion cell-inner plexiform layer (GC-IPL) were measured using spectral-domain optical coherence tomography. One-way ANCOVA test was used to compare the differences in pRNFL and MT between NDCKD and controls, as well as between the different stages of NDCKD. Spearman rank-order correlation coefficients were employed to determine the effects of NDCKD duration on pRNFL thickness and MT. Results A total of 132 subjects were recruited, 66 with NDCKD and 66 controls. There was a statistically significant difference in superior (110.74 ± 23.35 vs 117.36 ± 16.17 μm, p = 0.022), nasal (65.97 ± 12.90 vs 69.35 ± 10.17 μm, p = 0.006), inferior quadrant (117.44 ± 23.98 vs 126.15 ± 14.75 μm, p = 0.006), average pRNFL (90.36 ± 14.93 vs 95.42 ± 9.87 μm, p = 0.005), CST (231.89 ± 26.72 vs 243.30 ± 21.05 μm, p = 0.006), average MT (268.88 ± 20.21 vs 274.92 ± 12.79 μm, p = 0.020) and average GC-IPL (75.48 ± 12.44 vs 81.56 ± 6.48, p = 0.001) values between the NDCKD group and controls. The superior quadrant (p = 0.007), nasal quadrant (p = 0.030), inferior quadrant (p = 0.047), average pRNFL (p = 0.006), average MT (p = 0.001) and average GC-IPL (p = 0.001) differed significantly between different stages of NDCKD. There was no correlation between pRNFL thickness and MT with duration of NDCKD. Conclusion CST, average MT, average GC-IPL thickness, average pRNFL and all quadrants of pRNFL except the temporal quadrant were significantly thinner in NDCKD patients compared to controls. These changes were associated with the severity of CKD, but not its duration.

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Section: Discussionsupporting

confidence: 60%

Comparison of peripapillary retinal nerve fiber layer and macular thickness in non-diabetic chronic kidney disease and controls

et al. 2022

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“…These OCT-A biomarkers confirmed progression in impaired macular perfusion in persistent DME eyes observed without treatment. It has been demonstrated that hypertension, blood pressure (BP) levels, and kidney function can affect OCTA metrics ( Peng et al, 2020 ; Zeng et al, 2021 ). In the future, it would be interesting to verify the impact of hypertension, BP levels, and kidney function on OCTA metrics after SMYL treatment.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of Subthreshold Micropulse Yellow Laser for Persistent Diabetic Macular Edema After Vitrectomy: A Pilot Study

et al. 2022

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Aim: To examine the effect of subthreshold micropulse yellow laser (SMYL) on best-corrected visual acuity (BCVA), central macular thickness (CMT), and optical coherence tomography angiography (OCT-A) changes in eyes with persistent diabetic macular edema (DME) after pars plana vitrectomy (PPV) for tractional DME (TDME).Patients and Methods: In a comparative study, 95 eyes of 95 consecutive patients with persistent DME were prospectively enrolled. The SMYL group (54 eyes) was treated with SMYL 6 months after PPV, while the control group (41 eyes) was followed up without treatment. BCVA and CMT by OCT were analyzed at baseline and 3 and 6 months. Additionally, parameters such as the vessel density (VD) in the superficial capillary plexus (SCP) and deep capillary plexus (DCP), respectively, and the area of the foveal avascular zone (FAZ) were also evaluated on OCT-A.Results: There were no significant differences between both groups in demographic data. In the SMYL group, mean BCVA was significantly increased [F(2,106) = 17.25; p < 0.001; ηp2 = 0.246] from 51.54 ± 13.81 ETDRS letters at baseline to 57.81 ± 12.82 ETDRS letters at 3 months (p < 0.001) and 57.83 ± 13.95 EDTRS letters at 6 months (p < 0.001), respectively. In comparison to the control group, BCVA values were statistically significantly higher in the SMYL group at 3 and 6 months, respectively. Mean CMT significantly decreased [F(2,106) = 30.98; p < 0.001; ηp2 = 0.368] from the baseline value 410.59 ± 129.91 μm to 323.50 ± 89.66 μm at 3 months (p < 0.001) and to 283.39 ± 73.45 μm at 6 months (p < 0.001). CMT values were significantly lower in the SMYL group (p < 0.001), especially at 6 months follow-up time (p < 0.001) compared with the control group. Parafoveal VD in the SCP and DCP was significantly higher in the SMYL group in comparison to the control group, respectively, at 3-month (SCP p < 0.001; DCP p < 0.001) and 6-month follow-up (SCP p < 0.001; DCP p < 0.001). FAZ area was also significantly smaller in the SMYL group at 6-month follow-up (p = 0.001). There were no adverse SMYL treatment effects.Conclusion: SMYL therapy may be a safe and effective treatment option in eyes with persistent macular edema following PPV for TDME.

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“…The utilization of OCT-angiography in assessing the retinal perfusion and retinal vascular density (VD) was widely described in systemic diseases. It is found that the retinal perfusion and retinal VD are decreased in patients with systemic hypertension, stroke, and chronic kidney [ 35 – 37 ]. Nonetheless, the assessment of retinal vasculature using OCT-angiography was previously described in one patient with lipemia retinalis, which demonstrated intact superficial and deep retinal capillary plexuses [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Alterations in ocular microcirculation and oxygen metabolism in patients with lipemia retinalis

Alsarhani

Adel²,

Alamri³

et al. 2022

BMC Ophthalmol

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Purpose The study aims to assess the alterations in retinal oxygen saturation and retinal and choroidal blood flow in lipemia retinalis. Methods This was a cross-sectional study on 10 eyes (5 patients) with history of lipemia retinalis. The study comprised 10 eyes with documented history of lipemia retinalis and 10 participants as healthy controls. Patients with a confirmed history of lipemia retinalis were grouped into two cohorts based on their most recent fundus examination: untreated lipemia retinalis (abnormal fundus) and resolved lipemia retinalis (normal fundus). Both retinal arteriolar and venular oxygen saturation were measured using the non-invasive spectrophotometric retinal oximeter (Oxymap T1). The mean blur rate (MBR) of the optic nerve and choroidal blood flow were analyzed using a laser speckle flowgraph (LSFG). Results Patients with untreated lipemia retinalis had a significantly higher retinal arteriolar and venular oxygen saturation than that of the other two groups (p < 0.001). Moreover, patients with untreated lipemia retinalis had significantly smaller retinal arteriolar and venular diameters (p < 0.001). On LSFG, there was a significant difference in the overall MBR (p = 0.007) and vessel MBR of the optic nerve between the groups (p = 0.011). The patients with history of lipemia retinalis (untreated and resolved) exhibited a high overall MBR and vessel MBR of the optic nerve than that of the control group. There was a significant elevation of the optic nerve (p = 0.002) and choroidal blowout score (p < 0.001), while the resistivity index of the optic nerve (p = 0.001) and choroids (p = 0.002) was significantly lower in patients with resolved and untreated lipemia retinalis. Conclusions There was a significant alteration in retinal oximetry, in untreated lipemia retinalis, and in retinal blood flow, in both the resolved and untreated groups. The increase in retinal blood flow and oxygen saturation may elucidate the preservation of visual acuity and function despite the fundus changes observed in lipemia retinalis.

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Retinal Neurovascular Impairment in Non-diabetic and Non-dialytic Chronic Kidney Disease Patients

Cited by 10 publications

References 43 publications

Comparison of peripapillary retinal nerve fiber layer and macular thickness in non-diabetic chronic kidney disease and controls

Comparison of peripapillary retinal nerve fiber layer and macular thickness in non-diabetic chronic kidney disease and controls

Efficacy and Safety of Subthreshold Micropulse Yellow Laser for Persistent Diabetic Macular Edema After Vitrectomy: A Pilot Study

Alterations in ocular microcirculation and oxygen metabolism in patients with lipemia retinalis

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