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

Abstract

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.

Retinal Neurodegeneration and Visual Acuity Decline in Patients with Chronic Kidney Disease

“…Reduction of RGCs has also been reported in systemic conditions, such as aging [11], neurodegenerative diseases [19], hypertension [20][21][22], and CKD [4,6,23]. Prior studies also found that the severity of RGC loss increased with more advanced stages of CKD [4][5][6]23].…”

“…RGC loss is a hallmark of glaucoma [7][8][9][10][11], but can also occur in other ocular diseases, such as DR [16,17] and pathologic myopia [18]. Reduction of RGCs has also been reported in systemic conditions, such as aging [11], neurodegenerative diseases [19], hypertension [20][21][22], and CKD [4,6,23]. Prior studies also found that the severity of RGC loss increased with more advanced stages of CKD [4][5][6]23].…”

Cross-sectional and Longitudinal Impacts of Chronic Kidney Disease on Retinal Ageing: An International Multi-Country Analysis

“…Assessing the factors that impact it and changes to the GCIPL over time is crucial for the clinical application of GCIPL, a biomarker for many NDDs. In a population-based study, Chow et al [19] identi ed signi cantly lower GCIPL thickness in CKD participants without diabetes than that in healthy controls. However, their data were not adjusted for confounding factors.…”

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

“…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].…”