ObjectiveTo evaluate early retinal microvascular abnormalities in patients with chronic kidney disease (CKD) via optical coherence tomography angiography.MethodsA cross‐sectional study. Two hundred patients with CKD stage ≧3 were enrolled in the CKD group, and 50 age‐matched healthy subjects were enrolled in the control group. Main outcome measures were the differences in parafoveal vessel densities in the superficial vascular plexus (SVP) and deep vascular plexus (DVP) between the CKD and control groups.ResultsThe mean ages were 62.7 ± 10.1 in the CKD group and 61.9 ± 9.7 (P = 0.622) in the control group. The CKD group had reduced parafoveal vessel densities in SVP (46.7 ± 4.3 vs 49.7 ± 2.9, P < 0.001) and DVP (50.1 ± 4.1 vs 52. 6 ± 2.9, P < 0.001) when compared to those of the control group. In multiple linear regression models, age, diabetes, estimated glomerular filtration rate, and use of anti‐hypertensive drugs were factors associated with vessel density in SVP, whereas age, diabetes, and smoking were factors associated with vessel density in DVP.ConclusionPatients with CKD had reduced vessel densities in parafoveal SVP and DVP, as compared to that of control subjects. Microvasculature in the different retinal layers may be affected by different systemic factors.
To examine retinal neurovascular changes in patients with chronic kidney disease (CKD). Methods: Case-control study. A total of 171 CKD cases and 40 controls were recruited (mean age 62.9 AE 10.3 versus 60.8 AE 9.2, p = 0.257). Retinal neural parameters, including parafoveal retinal thickness (PfRT), macular ganglion cell complex thickness (GCCt), global loss volume (GLV), focal loss volume (FLV) and peripapillary retinal nerve fibre layer thickness (RNFLt), were measured using optical coherence tomography (OCT). Microvascular parameters, including foveal avascular zone size, vessel density over the parafoveal superficial vascular plexus (SVP-VD), parafoveal deep vascular plexus (DVP-VD) and radial peripapillary capillary (RPC-VD), were measured using OCT angiography. Results: Chronic kidney disease (CKD) patients showed reduced PfRT, GCCt and RNFLt and increased GLV and FLV compared with the controls (all p < 0.005). Among patients with CKD, estimated glomerular filtration rate was an independent factor associated with PfRT (coefficient 0.19, p = 0.015), GCCt (coefficient 0.10, p = 0.006), GLV (coefficient À 0.08, p = 0.001), FLV (coefficient À 0.02, p = 0.006) and RNFLt (coefficient 0.15, p = 0.002). Parafoveal retinal thickness (PfRT), GCCt, GLV, FLV and RNFLt were correlated with SVP-VD (all p < 0.001) but not with DVP-VD (all p > 0.1). Conclusions: Chronic kidney disease (CKD) patients demonstrated a significant reduction in macular thickness and changes in retinal neural parameters. These changes were associated with the severity of CKD and correlated with the microvascular rarefaction in the parafoveal SVP.
Background: High-order aberration (HOA) may influence visual quality, therefore, we conduced a study to determine the correlation between best-corrected visual acuity (BCVA) recovery speed and high-order aberration (HOA) parameters measured using a new-generation aberrometer. Methods: This is a prospective case series. Children aged 3–7 years with refractive amblyopic eyes (Snellen equivalent < 0.8) were recruited. All participants were followed for at least 6 months after full correction of the refraction error. By using iDesign, the BCVA and the HOA were measured before cycloplegia and after cycloplegia (baseline) and at 3-month intervals. Next, the correlation between BCVA recovery speed after 6 months and mean HOA parameters was determined. The participants were divided into two groups according to BCVA recovery speed to compare the HOA parameters. Results: We analyzed 24 eyes of 12 children [mean age, 4.46 years (range, 3–6)]. Baseline mean BCVA was logarithm of minimal angle of resolution (logMAR) 0.335 (Snellen equivalent 0.46), which improved to logMAR 0.193 (Snellen equivalent 0.64) after treatment with full-correction spectacles for 6 months. The amblyopic eye recovery speed was significantly correlated with the tetrafoil value before cycloplegia (p = 0.045). The fast recovery group also showed significantly lower tetrafoil values before cycloplegia. Conclusion: Some HOA parameters measured using the new-generation high-order aberrometer could predict the recovery speed of refractive amblyopic eyes. The current study results may aid in designing customizable HOA-corrected contact lens for refractory refractive amblyopic eyes.
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